Compliance With Recommendations for Universal Precautions Among Prehospital Providers

Byline: T.Chadwick Eustis, Seth W Wright, Keith D Wrenn, Elisabeth J Fowlie, Corey M Slovis Abstract: 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: IV 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. [Eustis TC, Wright SW, Wrenn KD, Fowlie EJ, Slovis CM: Compliance with recommendations for universal precautions among prehospital providers.Ann Emerg Med April 1995; 25:512-515.] Article History: Received 27 May 1994; Revised 10 October 1994; Accepted 17 October 1994 Article Note: (footnote) [star] From the Department of Emergency Medicine Vanderbilt University School of Medicine, Nashville, Tennessee., [star][star] Address for reprints: Seth W Wright, MD, FACEP, Department of Emergency Medicine, 703 Oxford House, Vanderbilt University Medical Center, Nashville, Tennessee 37212, 615-936-0087, Fax 615-936-0185., a Reprint no. 47/1/63329