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BroMenn/St. Joseph EMS Systems

Policy and Procedure Manual

TITLE: AIDS PRECAUTIONS

POLICY STATEMENT:

The following is information concerning AIDS, how it is transmitted and precautions to be taken by pre-hospital care personnel.

GOAL/PURPOSE:

To protect health care workers and patients from Human Immunodeficiency Virus (HIV) exposure in the healthcare setting and to assure treatment is not withheld from HIV patients due to exposure concerns.

POLICY/PROCEDURE:

AIDS or Acquired Immunodeficiency Syndrome was first reported in the United States in 1981. AIDS is caused by the HIV, which infects various cells of one's immune system. However, infection by this virus does not always lead to AIDS. Many infected people remain in excellent health. Others may develop illnesses varying in severity.

The AIDS virus is transmitted by sexual contact or by introduction in to the bloodstream through actions such as needle sharing or blood transfusions.

Although the transmission risk of HIV or AIDS virus to health care workers is very low, there have been some documented cases when direct mucous membrane or broken skin contact to blood or body fluid has resulted in a positive HIV antibody test.

Pre-hospital care providers have an ethical and moral responsibility to provide care to all patients to the best of their abilities. In this role, they place themselves in certain circumstances, at a higher than normal risk of being exposed to blood and body fluids that might contain the AIDS virus. When administering care to patients on will not always be aware or informed that these patients are contagious. Therefore, we recommend the following precautions for pre-hospital care precautions taken to prevent HIV infection are the same as precautions for the person with Hepatitis B virus, infection, i.e. blood and body fluid precautions.)

A. Handwashing
All pre-hospital care personnel must wash their hands before and after contact with any patient. This should be done regardless of the use of gloves.

B. Needles and Syringes
Needles should be disposed of in a rigid, puncture-resistant container kept inside the back compartment of the ambulance. Needles should never be recapped or intentionally bent or broken. Also, a needle cutting device should not be used. There are new products on the market that employ a guard that automatically locks into place around the needle as you withdraw in from the patient. Your local ambulance distributor should be contacted for purchase of those devices.

C. Cleansing of Ambulance and Equipment
The ambulance and equipment used should be cleansed with a 1:10 bleach solution after each patient use. Gloves should be used when cleaning any contaminated surface.

D. Soiled Clothing
According to the Center for Disease Control, they recommend the following: Linen soiled with blood or body fluids should be placed and transported in bags that prevent leakage. If hot water is used, linen should be washed with detergent in water at least 71 C (160 F) for 25 minutes. If low-temperature water (70 C [158 F]) in the laundry cycle is used, chemicals suitable for low-temperature washing at properly used concentration should be used.

E. Masks
Although the AIDS virus cannot be transmitted by having a patient cough on you, masks should be worn whenever there is direct contact with a patient that has a transmissible respiratory disease, i.e., tuberculosis. Masks must also be worn when there is a risk of blood or body fluid splashing onto mucous membranes, such as when intubating or suctioning a patient, or when you are caring for a patient with major facial trauma.

F. Protective Eye Wear
Use of glasses or goggles is recommended when there may be splattering of blood or bloody secretions.

G. Gloves
Gloves should be utilized when there will be contact with blood or other body fluids from a patient. Any open cut or any skin dermatitis that leaves skin open (i.e., eczema, psoriasis) on pre-hospital care personnel should be covered with a sealed moisture proof covering. These precautions should be taken before the EMT leaves the ambulance to care for a patient.

H. Cardiopulmonary Resuscitation
Disposable resuscitating masks and one-way airways should be carried in all ambulances and easily retrievable when the need arises. No one should be administering unprotected mouth-to-mouth resuscitation.

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