Lesson Eleven: The Most Important Thing In Your Kit
Whatever you've
packed in it, something in your kit has to be the most important thing. Think
about it a minute, and come up with what you think it should be.
Bandages? Scissors?
CPR mask? Aspirin? Your EpiPen?
All good choices. But
if you picked these, I'd suggest you rethink the question; and I'd offer that
the most important thing in your kit is your barrier gloves. (You knew that, and you already have them in your
kit, right? RIGHT??
I'd say latex gloves, but some of you may be
sensitive or allergic to latex. Or you may have been concerned that a patient
might be, so you opted for non-latex gloves. Score yourself extra points if
you've already considered that and/or prepared for it.
A set (or hopefully
several sets) of barrier gloves should be the first thing you think about
having for first aid emergencies. Gloves do two things:
They keep your
cooties on your side.
They keep the patient's
cooties on their side.
This is exactly what
we want. While HIV and AIDS are a concern, the virus is incredibly fragile
outside the host, and you need blood to blood contact, like through open sores
or cuts. Barrier gloves stop this better than intact skin.
But there are other
far worse things than HIV. Hepatitis A, B, or Q, X, and Z are much tougher to kill. Hep B or Hep C can
live for hours to days in a single drop
of dried blood. Like the one you didn't see on the steering wheel when you
leaned in to check on that guy after his car crash.
The first thing
you're liable to need to do or want to do when you help someone is touch them.
That's why the first thing every medical professional is liable to be doing in
the hospital or out on the field is slipping into a sturdy set of yuck-proof
gloves, in latex, heavy vinyl, or other materials. Because I don't know about
or want your Hepatitis, influenza, plague, Ebola, or even whatever's on your
hands because you don't wash after you poop, that I might inadvertently touch
if I touch you barehanded. And you want to avoid the same crud from me, and
more. Maybe I pick my nose or scratch my other end.
With the simple
expedient of barrier gloves, we no longer need concern ourselves with each other's
regrettable lapses in sanitation and personal hygiene, and can get down to
helping or being helped and concentrating on the important stuff.
They need to be tough
enough to withstand average usage (some are highly puncture resistant), but
still thin enough to allow you to be able to feel a pulse beat or find a vein
through them. And if you're really sensible, you'd be well-advised to wash your hands before and after using your
gloves. If there's no sink where you are, or you're just smart enough to prepare
for that, a small bottle of stuff like Purell hand sanitizer is basically
jellied alcohol with a bit of skin moisturizing stuff in it. You pour it on,
and rub until it evaporates. It's great stuff.
And when you're done,
put your weak hand into your strong one, and peel the weak-side glove off,
holding it and rolling it into a ball. Take your now uncovered weak hand, and
pull up the glove cuff on your dominant hand, keeping that hand in a loose
ball, and strip the second glove inside out over
the first glove, and thus sealing all the yuck inside a ball of latex, with the
clean inner side now facing out. And
throw it in an appropriate receptacle (usually an ordinary trash can is just
fine).
Gloving up is
important because it protects your patient from the normal bacteria and viruses
on your hands. And protects you from
all the nasty crud out in the World, especially on your patient, which means
you stay healthy, in order to help someone else another day.
So
pack gloves, and glove up!
I don't even pull a pt up in bed without wearing gloves. I glove and wash like a madman. I was around in the early 80's when HIV first came out and we didn't know what it was, didn't even have a name for it. We didn't know how it was spread, how to protect ourselves from it. If our PPD would protect us or not. And flesh eating bacteria came out at the same time and the treatment of choice was amputation. I thought to myself, "Boy did I pick a great time to go in to healthcare."
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