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Compliance with recommendations for universal precautions among prehospital providers
T C Eustis1, S W Wright, K D Wrenn
1Department of Emergency Medicine, Vanderbilt University School of Medicine, Nashville, TN.
Study Objective:
To evaluate the compliance of emergency medical responders with local employer and Centers for Disease Control and Prevention recommendations for disposal of sharps and use of personal protective equipment in the prehospital environment.
Design:
Prospective, single-blinded observational study of 297 ambulance runs conducted for 3 months.
Setting:
A metropolitan emergency medical service system.
Participants:
Sixty-nine emergency medical technicians and paramedics.
Interventions:
None.
Results:
Observers recorded the handling of sharps and the use of personal protective equipment in four situations: i.v. line placement, endotracheal intubation, large-wound management, and body fluid hazard. Emergency medical workers properly handled sharps in 24 of 65 situations (37%). They were usually compliant with glove use during the observed procedures. However, compliance with the use of other personal protective equipment was poor.
Conclusion:
Sharps were often improperly handled. Most workers complied with recommendations for the use of gloves but often underused goggles, masks, and gowns. Although education and restructuring of the environment and equipment may improve compliance, strong consideration should be given to developing standardized and more practical recommendations for the prehospital environment.