WHEN IT REALLY MATTERS              

As individuals we have different needs and in our own ways we deal with most challenges that life throws at us, in our own ways. We have guidelines and protocols, policies and procedures to refer to when we are working, but an over-riding consideration is how we manage our own comfort. We are provided with a uniform so that we are easily recognisable as being members of the ambulance service and the Trust does its best to ensure that the items of clothing are robust, easy to wash and comfortable to wear. 

We are (according to our parents) “unique in our own little ways” which is why some of us are able to work in most weathers in the uniform, but others may feel the need to wear additional clothing to add the extra level of warmth and for some this often involves a long sleeved tee shirt. Others can manage to keep warm just by wearing the outer jacket. But that is not what this article is about, although it does have considerable bearing.

When not actively involved in providing patient care, we are able to wear our jackets which have got long sleeves and these effectively cover any long sleeved tee shirts which we might be wearing under the uniform shirt, but the IPC requirement is that “at the point of providing the care to the patient, we should be bare from the elbows down”. So how can we best view and interpret this? Let’s take Mike and Bernie, a Paramedic / EMT crew working together on a DSA. Mike has a short sleeved tee shirt on under his uniform shirt and Bernie is wearing a long sleeved tee shirt.

During the VDI they are both wearing their jackets and keep them on as they travel to their first job of the shift. On arrival, they enter the property and locate the patient sat on the settee. Mike takes off his jacket and commences his patient care; Bernie meanwhile is making notes on the PRF. They soon reach the conclusion that the patient needs to go to hospital so Bernie goes back to the ambulance to retrieve the carry chair. When he returns, Mike has completed his initial assessment and they assist the patient onto the carry chair. Mike then dons his jacket and they move the patient to the ambulance. Once inside, and with the patient on the stretcher, Mike once again removes his jacket and commences to reassess the patient while Bernie goes back to the property to retrieve the bags and to secure the front door.

When Bernie re-enters the ambulance Mike asks him to assist in setting up a fluid line, so Bernie removes his jacket, pushes up the long sleeves of his tee shirt, and following the correct procedure sets up the fluids. Before very long Mike indicates that he is ready to start the journey to hospital, so Bernie cleans his hands, pushes histee shirt sleeves down and puts his jacket back on.

When they arrive at hospital Bernie opens the ambulance rear doors, Mike has already tidied up the kit, the fluids have been switched off, detached from the vehicle and Mike is putting his jacket back on. They had observed the IPC requirement at the point of providing….. However, there are instances where due to the weather or hazardous conditions that jackets , hi-viz jackets and helmets should be worn and the health, safety and welfare of our crews is paramount if we are to be able to provide that care.

Jeff Pittman

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