Team:Lethbridge/HP/Silver
Human Practices (Silver)
Introduction, Interviews, Literature Review
Introduction
Our human practices story began when our local Fire and EMS Department contacted us about wanting to about the efficacy of their cleaning standards for their ambulances. In addition, they also wanted to find out about what microorganisms are found in the EMS vehicles and a way that they can detect any pathogens in a real time detection system.
Interviews
To have more of an understanding of the issues the Fire and EMS Department were facing, we interviewed Ward Eggli, the Fire and EMS Resource Officer who initially contacted us, and four first responders.
In order to get opinions from a variety paramedics about their feelings on current cleaning standards, an unregulated survey was sent out to them. 32 first responders answered. Most responded with wanting to see a more standardized method of cleaning implemented. There was almost a 50/50 split in responses on whether or not the risk of infection would impact how the paramedic handled the call. The majority of respondents feel like risk of infection affects their family or social life because they are uncertain as to what exactly they are coming into contact with.
Literature Reviews
After being contacted by EMS, we conducted a literature search on previous practices in detecting pathogens in EMS vehicles. We discovered that no study has been conducted in Canada and sparsely in the United States and Europe. Below are tables summarizing what we found in the 8 papers we found.
Table 1. Overview of the sample sizes (where n= the number of ambulances), number of samples taken, and the sampling techniques used in each paper.
| First author, reference | Sample size (n=ambulances) | Number of samples taken | Sampling techniques |
|---|---|---|---|
| Alrazeeni, D. (2014) | 10 | 60 | Swabs |
| Alves, D.W. (2008) | 4 | 20 | cotton swabs with saline solution, agar plates |
| Luksamijarulkul, P. (2015) | 30 | 544 | Air samples, surface swabs |
| Makiela, S. (2016) | 2 helicopters | 360 | Swabs |
| Nigam, Y. (2003) | 6 | 164 | Swabs with saline solution, blood agar plate |
| Roline, C.E. (2007) | 21 | 105 | Swabs with saline solution, agar plates |
| Vikke, H.S. (2016) | 60 | 50 | Agar plates |
| Wepler, M. (2015) | 150 | 2136 | Agar plates |
The number of ambulances and amount of samples taken varied greatly between the papers examined. The sampling techniques used were all based on cell culturing methods.
Table 2. Overview of sampling locations, study lengths, methods of disinfection, and pathogens found in the ambulances sampled in each paper.
Most of the studies sampled the oxygen flowmeter knob, a handle located in the ambulance, and a part of the stretcher. While the length of each study was not reported in each paper, most were two months. The most common methods of disinfection involved using alcohol-based wipes. The types of pathogens found varied between each study as some were looking at detecting specific pathogens while others were looking at the general microflora. Variations of Staphylococcus spp. were the most common microorganisms found.
