Questioning for infectious diseases as part of medical history.

[Ging599 13]

I have been out of the EMS business for a little bit now and I apologize if this has been addressed elsewhere but....

Is questioning if a patient has an infectious disease being done as part of gathering a patient's medical history?

Very often we learn of a patient's infectious history after transport is complete and everyone is perturbed that they didn't know on scene but, is anyone asking if the patient is infectious during assessment?

I understand that we are all supposed to use PPE and treat everyone as if they are infectious, but having the knowledge on scene would probably cause us to work with a little more diligence.

Thanks

[sueg 77]

If we have a high degree of suspicion (certain medications, overall appearance and presentation, past history with patient, Police giving us a heads-up on the side, evidence of possibility on scene) we may ask, but if a regular Joe falls down and is bleeding and we walk over and ask for a medical history from him, we are not going to ask "By the way, do you have AIDS, ebola, HIV, Hep-anything, TB or anything we would almost want to call a Haz Mat team for?" We hope they will be honest and tell us if we ask the general questions, but we have enough problem getting patients tell us the normal stuff ( "I have no medical problems. " "Why are you taking this med. (from the 2-page list)? "For my BP" "And this one...?") Some patients may even get very offended if we ask them the contagious list. So we usually do not, and hope for the best. Remember BSI always, keep an eye on the patient as much as possible and watch for sharps, and sanitize what you can if it gets in contact with everyone but you, and even then......

[antiquefirelt 994]

Would you change how you do things if they denied any infectious diseases even though you suspected one? Chances are someone with a disease that has a stigma attached to it, will not give you an honest answer if they don't think it's pertinent, best to try and treat everyone the same and protect yourself all the time, many people may have infectious diseases but not know it.

[ny10570 745]

Why does it matter aside from maybe helping figure out what is wrong with the patient? Forget about how its just wrong to treat someone differently based upon a medical condition, what if they don't know they're carrying some disease. Everyone gets treated the same unless I suspect an infection requiring droplet precautions.

Moderator note: This was the very last post made by Lenny, before he left us for keeps. RIP.

Edited July 25, 2012 by jack10562

[Ging599 13]

The scenario I had in my mind when I posted this was a cardiac arrest call with family present. Members performing CPR would benefit from having respiratory protection due to the increased likelihood of aspiration. A simple, does he/she have any infectious diseases question during initial interview with the family. Of course first responders should have respiratory protection on but you honestly don't see that being worn so much.