Chetty Melvin, Govender Kevin P, Sobuwa Simpiwe
Department of Emergency Medical Care and Rescue, Durban University of Technology, South Africa.
School of Clinical Sciences, Aukland University of Technology, New Zealand.
Afr J Emerg Med. 2022 Jun;12(2):97-101. doi: 10.1016/j.afjem.2022.01.001. Epub 2022 Feb 12.
Emergency Medical Service (EMS) providers in South Africa are among health care workers (HCW) most at risk of contracting infectious diseases due to occupational exposure to blood and body fluids (BBF). While the austere, dynamic, and challenging nature of the prehospital environment appears to be one of the primary drivers to this risk, the growing prevalence of bloodborne infections within the country; particularly Hepatitis B, C and Human Immunodeficiency Virus (HIV), has inevitably compounded the problem. The aim of this study was to investigate the knowledge, practices, and prevalence of BBF exposure among EMS providers in the eThekwini metropole of KwaZulu-Natal, South Africa.
This cross-sectional questionnaire-based study was completed by 96 randomly selected EMS providers who worked for the state-run ambulance service and were stationed within the eThekwini metropole.
A total of 41 (42.7%) of the 96 respondents indicated memorable exposure to BBF at some point in their operational career. Exposure appeared to be mostly as a result of needlestick injuries (NSI) (63.4%), followed by BBF exposure into the eyes (19.5%). At the time of exposure, a total of 40 participants (97.6%) were wearing gloves, 22% (n = 9) were wearing facemasks, and 9.8% (n = 4) were wearing eye protection. Less than half of the respondents (46, 47.9%) were aware of existing EMS espoused BBF exposure policies, and 55 (57.3%) knew about post-exposure prophylaxis for HIV. Majority of the respondents (n = 74; 77.1%) indicated that they always recapped needles, and 46.9% (n = 45) dispose of sharps containers when completely full.
The findings suggest that BBF related knowledge and practices among EMS providers working in the eThekwini metropole may be inadequate, and may increase the risk of blood exposure. In order to improve knowledge, immediate provision of EMS-specific BBF exposure training is required.
在南非，紧急医疗服务（EMS）提供者是医护人员中因职业接触血液和体液（BBF）而感染传染病风险最高的群体之一。虽然院前环境的严峻、动态和具有挑战性的性质似乎是导致这种风险的主要驱动因素之一，但该国血源感染的患病率不断上升；特别是乙型肝炎、丙型肝炎和人类免疫缺陷病毒（HIV），不可避免地使问题更加复杂。本研究的目的是调查南非夸祖鲁-纳塔尔省伊泰夸尼市大都会地区EMS提供者中BBF暴露的知识、做法和患病率。
这项基于问卷的横断面研究由96名随机选择的EMS提供者完成，他们就职于国营救护车服务机构，驻扎在伊泰夸尼市大都会地区。
96名受访者中共有41人（42.7%）表示在其职业生涯的某个阶段有过难忘的BBF暴露经历。暴露似乎主要是由于针刺伤（NSI）（63.4%），其次是BBF溅入眼睛（19.5%）。暴露时，共有40名参与者（97.6%）戴着手套，22%（n = 9）戴着口罩，9.8%（n = 4）戴着眼部防护装备。不到一半的受访者（46人，47.9%）了解EMS支持的现有BBF暴露政策，55人（57.3%）知道HIV暴露后预防措施。大多数受访者（n = 74；77.1%）表示他们总是重新盖帽针头，46.9%（n = 45）在锐器容器完全装满时处理。
研究结果表明，在伊泰夸尼市大都会地区工作的EMS提供者中，与BBF相关的知识和做法可能不足，可能会增加血液暴露的风险。为了提高知识水平，需要立即提供针对EMS的BBF暴露培训。
