Mercy! MRSA!

The media has reported a fair bit about MRSA in ambulances of late, one of my commenters has asked how the London Ambulance Service deals with patients who are MRSA positive.

(Note: I'm also writing this to avoid losing my job by posting about a family who have called an ambulance more than seven times in the past week for the same illness).

Primarily the problem is that we just don't know who are MRSA positive, MRSA is prevalent in the community, and I would suggest that most nursing homes have plenty of colonised residents. I remember working in hospital, having to swab everyone coming in from a 'high risk' environment, which basically meant anyone from a nursing home, or another hospital.

It takes time to swab and grow a culture (three days if I remember correctly), and each test costs a not inconsiderable amount of money.

If a patient is MRSA positive, then our infection control booklet tells us that we should use our 'personal protective equipment' (our uniforms) plus what are known as 'universal precautions' – essentially latex gloves.

To clean an ambulance after transporting an MRSA positive patient we use 'System 1' and 'System 2 or 3'.

System 1 – Detergent. System

2 – Chlorine spray System

3 – Alcohol.

So anything the patient has come in contact with is wiped with detergent, and then we either spray it with chlorine solution, or wipe down with alcohol wipes.

The other problem that we have is that we are so chronically overworked, that we often only have a little time to clean the ambulances. If you are having a heart attack, then you won't be impressed if all the ambulances on duty are off the road waiting to dry.

When the LAS do something, we often do it right. Our boss realised that the ambulances aren't as clean as they should be, and that road staff didn't have time to 'deep clean' ambulances every shift. The solution was to contract an outside firm who now cleans and stocks our ambulances for us and from what I have seen, they do a pretty good job.

So every night a gang of underpaid workers clean as many ambulances as possible. This 'make-ready' crew are paid a frankly pitiful £6 an hour, working from 1am to 6am they can clean around 16 ambulances a night using industrial cleaning materials. Every month they are quality controlled by random swabbing. So far they have only had good results.

So I personally think that the LAS is doing something positive and effective against the spread of MRSA

MRSA will never be eradicated, unless we force everyone at gunpoint to use alcohol gel after every physical contact (and this includes 'civilians') and enforce daily antibacterial showers for the entire population of, well, the entire world. But we can do our best to prevent the spread of MRSA (and other, nastier diseases).

11 thoughts on “Mercy! MRSA!”

  1. blimey, the ambulance service that I followed had to clean their own ambulances, and even then I couldn't comment on how frequently that occurred.When I was working in the hospital this summer, I was told how clean our hospital was, with rregards to MRSA, yet whenever they did have a positive patient, they had been transferred from a larger hospital, which has a greater problem with virus.

  2. You don't need to elaborate on the comment on the family who call you so often the emergency services show up on the cheap rates for friends and family bit on their phonebill – all of us here in the health service know exactly what you would have written given the chance.Keep your job safe, and recognise us for the mind readers that we are 🙂

  3. Thanks Reynolds for the explanation. An outside cleaning firm is a cracking idea, although it won't happen here any time soon. Re: the family that called 7 times, get your own back and call them 7 times next time you're on nights!!Carl.

  4. so now all we need are clean hospitals!Interestingly on this subject I have been doing some light reading:-

    with the old metal hospital beds there was a 'car wash' system that pulled the bed along through a machine to deep clean it all over using very hot steam to deep penetrate all the little fiddely bits.

    Now we have lovely electric beds which might get a little wipe with a alcohol wipe if there is time.

    They call this Progress!

  5. replying to my own post…me again… followed some thinks through the BBC story:MRSA stands for methicillin-resistant Staphylococcus aureus

    I'll just go away and read something now…

  6. Hi, have been reading your blog for a while and finally thought i'd comment on something that i actually know something about!! i'm a researcher and i work on MRSA. MRSA is methicillin resistant S. aureus (but thats a colloquial name and MRSA actually refers to ALL antibiotic-resistant bacteria) and despite what the govt. are trying to tell you, cleaning left right and center isn't going to get rid of the problem but control it! Thanks for making that point Tom! Answering questions such as 'how can we get rid of it' with 'erm..you cant , you can control it' was getting a bit tiresome.Take care

    nesha

  7. My wife and I spent a good part of last year visiting at the North Staffs hospital in Stoke-on-Trent and I noticed that we were the only people who ever used the alcahol gel before going into a surgical ward.

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