COMPLIANCE WITH RECOMMENDATIONS FOR UNIVERSAL PRECAUTIONS AMONG PREHOSPITAL PROVIDERS

Study objective: To evaluate the compliance of emergency medical respo nders with local employer and Centers for Disease Control and Preventi on recommendations for disposal of sharps and use of personal protecti ve equipment in the prehospital environment. Design: Prospective, sing le-blinded observational study of 297 ambulance runs conducted for 3 m onths. Setting: A metropolitan emergency medical service system. Parti cipants: Sixty-nine emergency medical technicians and paramedics. Inte rventions: None. Results: Observers recorded the handling of sharps an d 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 dur ing 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 th e use of gloves but often underused goggles, masks, and gowns. Althoug h education and restructuring of the environment and equipment may imp rove compliance, strong consideration should be given to developing st andardized and more practical recommendations for the prehospital envi ronment.