When we think of bioterrorism, we tend to think of agents such as anthrax or smallpox. Actually, says Mike McEvoy, EMS coordinator for Saratoga County, New York, responders face greater risks from germs they encounter daily on their jobs. "I'm here to tell you that our efforts to prepare for bioterrorism are failing to protect ourselves and our families from the most dangerous bioterrorist out there - Mother Nature," McEvoy said at Thursday's General Session. Just eating at the fire station, he noted, poses a risk far greater than that of a deliberate bioterrorist attack with anthrax or smallpox.

McEvoy offered "three simple steps" responders can take to protect themselves and their families from diseases such as chicken pox, measles, colds, and the flu," plus the unfamiliar bioterrorist agents and bugs we haven't seen or heard of yet!"

  1. Look Out. Germs are transmitted, typically from nose to hand to object and then to the responder. Skin is our normal defense against germs, McEvoy explained. Germs can enter our bodies through open wounds or other breaks in our skin. Sewage found in floodwaters or pump-outs and on contact lenses, turnout gear, helmets, hats, or uniforms can infect if they enter through the skin.

    He cited the example of fire boots as a vehicle for serious infection. "The dark, moist environment inside a fire boot or a sneaker is the perfect breeding ground for a deadly infection called pseudomonas," McEvoy explained. "What seems like an innocent nail through the boot into a foot can inject pseudomonas directly into the bloodstream or a bone. Don't ignore puncture wounds through boots or sneakers. They need medical care and probably antibiotics."

    In addition, to prevent inhalation of such germs, responders should observe a "hot zone" of five feet around an infectious person. Signs of an infectious person include a high fever, looking sick, and a rash. They will identify virtually any seriously infected patient. If a person has these symptoms, restrict the number of responders who have contact with the patient.

  2. Gear Up. The most important piece of gear is an isolation mask for the patient. Responders should use gloves, gowns, masks, eye protection, and face shields. Gloves should be worn only while touching patients. Do not leave them on when you leave, and do not touch objects such as the clipboard, the monitor, the radio, the steering wheel, or the phone, otherwise the germs will be transferred onto every item you touch.
  3. Take Aim. "The first rule of infection is to wash your hands," McEvoy stresses. (The Centers for Disease Control and Prevention recently revealed that alcohol wipes are even more effective than hand washing for killing germs.) Stay away from people and patients you recognize to be infectious. Implement an alerting system for infectious outbreaks. Get vaccinated. "Twenty diseases in the United States are entirely preventable through vaccination," noted McEvoy, "yet 60,000 Americans die from them every year." He added that vaccinating health care workers in hospital nurseries or homes for the aged cuts the death rate for their patients in half. "If you want to protect your patients - better yet, protect your families - keep your vaccines current," McEvoy advised.

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