EMS Infection Precautions for TB/HIV/Hepatitis Patients

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Discussion Overview

The discussion revolves around infection precautions for EMS personnel dealing with patients who have tuberculosis (TB), HIV, and hepatitis. Participants explore the effectiveness of various protective equipment, particularly masks, and the transmission methods of these viruses.

Discussion Character

  • Exploratory
  • Technical explanation
  • Debate/contested

Main Points Raised

  • One participant questions the effectiveness of N95 masks against small viruses like HIV and hepatitis, suggesting that full face masks and additional protective gear may be necessary.
  • Another participant expresses a belief that most TB patients are also HIV positive, linking the two diseases in terms of risk.
  • Concerns are raised about the effectiveness of Zidovudine (AZT) in preventing AIDS after potential exposure, with suggestions for alternative treatments like interferon and protease inhibitors.
  • A participant questions whether viruses are expelled as single particles or within larger droplets, which may affect the transmission risk and the effectiveness of masks.
  • Discussion includes the notion that while TB is spread through airborne transmission, many of the listed viruses are not, emphasizing the importance of protecting against bodily fluid splatter.

Areas of Agreement / Disagreement

Participants express differing views on the effectiveness of various masks and treatments, and there is no consensus on the best protective measures or the nature of virus transmission.

Contextual Notes

Participants mention various assumptions about virus sizes and transmission methods, but these are not universally agreed upon. The discussion highlights the complexity of infection control in EMS settings without resolving the uncertainties involved.

cronxeh
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I'm currently undergoing training to become an EMT-B and as we were going over basic equipment it occurred to me that EMS uses an N95 mask for TB patients. Well I will assume bluntly that most TB's are also HIV patients.

Those N95 masks are for non-oily particles of at least 300 nm in size, and here is where my question is. I dug up some info on some deadlier viruses from the net and their sizes:

Bacteriophage MS-2 20nm
Hepatitis 24nm - 30nm
Adenovirus 70nm
HIV (AIDS) 80nm
Cytomegalovirus 100nm
Orthomyxovirus 120nm
Coronavirus (SARS) 80nm - 160nm

It appears to me that the N95 or N99 or N100 or P99 - P100 masks won't protect anybody from any aforementioned viruses for respiratory contraptions. Furthermore, wearing a full face mask would probably be a wise choice over just goggles that have 2-5 mm gaps in between your eyes and nosal areas. And finally a medical set of hard gloves on top latex or nonlatex non sterile gloves, and perhaps some kind of an apron and a hair net.

The information I've stumbled upon also suggests that the surgical masks arent quiet as effective as N95, meaning that most surgeons are not very safe from any aforementioned viruses. So my question is - what kind of a respirator should I use for TB/HIV/Hepatitis patients? Or what kind do they use at BSL-4?
 
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cronxeh said:
Well I will assume bluntly that most TB's are also HIV patients.
hiv realates to tb too, mostly the same dagerous level, and being beaten by hiv's is mot painful becos it bit in a dogg way.
Bacteriophage MS-2 20nm
Hepatitis 24nm - 30nm
Adenovirus 70nm
HIV (AIDS) 80nm
Cytomegalovirus 100nm
Orthomyxovirus 120nm
Coronavirus (SARS) 80nm - 160nm
all can be cured or prevented exept hiv's. iam tryin to dig deeper in hiv for more inforemation and bring them all to light. i swear!
 
Also, how effective is Zidovudine in prevention of AIDS in a puncture kind of contraptions? I'd like to be certain that there are solutions to all problems I might encounter before I dive into the field, so any suggestions or info is welcome
 
zidovudine (azt) will most likely kill you if you take it. therefore, if you merely suspect an infection, this would not be a good choice.

you would probably be better off with interferon and protease inhibitors. note that these are also very nasty, and will make you sick.

there is obviously no easy answer to getting rid of a virus, especially something like hiv. no single antiviral can be guaranteed to work, and in reality very few work at all.

your best bet is to continue looking for ways to prevent the particle from entering your body, and keep your immune system healthy (good rest, food, etc.)

keep in mind that doctors are exposed to these things all the time, yet most don't get sick.
 
Granted the virus particles themselves may be very small, however, are they shed from infected patients as single virus particles or do they come along with bodily fluids? In other words, if an infected patient sneezes and expells numerous droplets of saliva, mucus, etc, those droplets may indeed contain active virus but are they also so large as to not pass through the 300 nm cutoff for the mask? It's kind of like stopping malaria by keeping the mosquito from biting you.
 
Most of those viruses you listed are not spread by airborne transmission, while TB is. As DocToxyn mentioned, the bigger risk would be splatters of bodily fluids coming into contact with your own body, so the mask puts a layer of material between you and that splatter. A full face shield would be a good idea for preventing HIV if you're dealing with a patient with a high viral load, because while there's a low chance of contracting the disease from just skin contact (assuming you quickly wash any exposed skin and use a topical disinfectant), you don't want any splatters hitting any broken skin or getting into mucous membranes.