I have been asked to discuss turnout gear use on medical emergencies. Does your department prohibit or allow turnout gear to be used on medical emergencies? What other considerations exist including appearance, cross contamination, body substance isolation, OHSA etc? Our department does not specifically allow the gear on medical emergencies but if they are on their way back from a fire or motor vehicle collision and catch a medical they wear their turnout gear.
Your thoughts, policies, procedures, guidelines etc?
Normally no, we do not wear turnouts on medical calls. However, we do wear them on traffic accidents where the potential for body fluids is similar. How we would treat this would be the same. If they are exposed to fluids they would be taken out of service until cleaned. In doing this they would be contained in a Bio-hazard bag and taken to our cleaner provider.
Chief Newberry, Keep in mind that worst case exposure is bloodborne pathogens which often times requires the use of bleach to kill things, right? That's the good news. Bleach works really well when it comes to sanitization. The bad news is that bleach literally dissolves nomex thread fibers. Take a look at the manufacturers label on the inside of your turnouts... It's there under the don't use bleach section. Using nomex PPE is not one of the better things to wear on EMS incidents. Full PPE on any incident that could involve physical hazards such as a MVA or structure fire. On a side note, the easiest way to detect the presence of bloodborne pathogens is by using a handheld black light. Any bodily fluids easily show up. If you have any doubts, go to someone's house that has indoor pets and check for where the animals pee'd at night when it is dark. Don't take your wife. It really works...
Dupont Statement: Chlorine bleach should not be used on Nomex® protective garments. Chlorine bleach or other additives will not remove the flame protection as they can with flame-retardant treated fabrics; however, to preserve garment strength and prolong garment life, chlorine bleach should not be used.
We only allow use of it on a as needed or as required basis. Since turnout gear has to be compliant with blood borns protection, if the crew is out on training or another call and needs to take a medical, its allowed, but not encouraged. We have a clothing allowence for EMS gear and jump suits if someone is taking a off duty call. Gear should always be worn for the purpose it was designed.
The argument about shorts not providing protection for EMS incidents makes no sense to me.
I had worked as medic for a local Beach Patrol and we wore swim trunks and tank tops only, occasionally maybe some type of footwear, but very rarely. The arms are exposed more than anything during warmer weather. Yet I have so far only seen Metro Dade wear arm protection.
We are provided with face, eye, hand, and mouth protection, but raraely used when it should be. Ever see how they conduct the BPE testing for turnout gear? You would have to be in the cross-fire of several heart transplants-gone-bad to soaked with that much juice.
Really though, for those of us who deliver EMS transport and fire suppression/rescue, etc. the whole issue of chosing, affording, and using the right type PPE at the right time is a challenge. We would need curtains on the engine to change from run to run.
I require bunker pants to be worn on all MVC's, and the rest of the ensamble is on the rig, whatever rig your assigned to. If it's extrication, then you are in PPE. If your coming off a fire call and in your bunker pants...oh well. If you have your shoes with you, and have the time enroute, change...BUT, now what happens to being seated and belted?