M4S 098: 8 Tips for Wearing Disposable Nitrile Examination Gloves

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As a long-time paramedic, wearing disposable nitrile examination gloves is an essential part of my Personal Protective Equipment (PPE) and has been since 1987-1988. That is when, in my experience, EMS agencies in Southern California began “allowing” people to wear gloves in response to the HIV-AIDS epidemic. 

Before that, EMTs and Paramedics often got bloody and wore all kinds of other people's bodily fluids. Sometimes, our uniforms stayed dirty for hours, if not longer.

As the HIV epidemic worsened and became more well known, I recall running on my first patient, confirmed to have HIV. Yes, back in the pre-HIPAA (Health Insurance Portability and Accountability Act) days, medical diagnoses were routinely passed on.

Anyhow, I can recall how nervous I was to work on this patient. At that time, as with now, there was a lot of conflicting information, rumor, speculation, and uncertainty surrounding HIV and how it transferred between people. To say that people viewed HIV as a scary, long, miserable death sentence is an understatement.

The Early Days of Protective Gear

Now, when it comes to my first encounter with a person with HIV, as I said, I was nervous. Not only was I worried about myself, but I was also worried about treating the patient well. I was nervous about becoming infected with an unseeable, untreatable, microscopic death sentence. The idea of getting it and passing it on to my friends, family, and others was as equally nerve-racking. 

So, as my partner and I headed out, I recall calling my paramedic supervisor named Rick and asking something, for the time, that was crazy. And here's how that conversation went:

“Hey, Rick.” 

“Hey, Duff, (that's what most people called me back then) what's up?”

“Well, Rick, we're running on this person who has HIV, and since we know at least one route of infection is by bodily fluids, can we get some rubber gloves, just to be safe?”

(Remember, we didn't wear gloves back then. Not only did we NOT wear gloves, but we also didn't have any on any of our rigs. Yep, that's right, no gloves, period. When it came to equipment, it wasn't a big deal if it was bloody or covered with other bodily fluids. The accepted practice of the day: quickly wipe down and put the gear back in service as fast as possible, to be used on the next patient. That goes with all equipment, airways, cervical collars, etc.)

We Had to Get Special Permission to Wear Disposable Nitrile Examination Gloves

After voicing my concerns and request to my supervisor, Rick, I heard a sigh and a medium-length pause on the other end of the radio. 

(This is also pre-everyone had a cell phone days. It seems like the stone age now. No, ATMs, no texting, no nothing compared to now.)

Finally, Rick came back on the radio and agreed we could wear gloves with a couple of stipulations. Yes, requirements about protecting ourselves from a deadly virus. The stipulations were:

1. Our organization would not purchase gloves for us. 
2. We had to purchase our gloves.
3. If we didn't buy our gloves, we could take (steal) them from a hospital.
4. [Here's the cherry on top] While we were allowed to wear gloves, we weren't allowed to wear them on any known HIV patient because of the potential for perceived discrimination. Yes, discrimination, because we did not wear gloves on ANY patients then. So, wearing them only on HIV patients was viewed as potential discrimination.

Great! So, all of us got to suck an egg. 

Eventually, Changes Were Made

Fortunately, some years later, people realized the old way of “gloves are for the weak and scared,” was complete insanity. In turn, the thought of NOT wearing disposable nitrile examination gloves as protection against disease went the way of the dinosaur, and taking precautions against infectious diseases was encouraged. And, with that, the notion of PPE and Body Substance Isolation (BSI), which is fancy lingo for keeping other people's germisicles off us, became the standard.

As the notion of BSI became the standard that every course and training session beat into every healthcare worker's brain. PPE was so crucial that EMT and Paramedic students would automatically fail testing stations if they touched the training patient without first taking BSI safety precautions. 

Now the Rules Surrounding PPE Are Strict

For example, currently, the National Registry of Emergency Medical Technicians (NREMT), the primary certification body for EMTs and Paramedics in the United States, will FAIL anyone for “Failure to take or verbalize appropriate PPE precautions.” 

That's it; if a testing candidate fails to take action, they fail the test. Not only is BSI a critical testing failure, but it is also the first requirement on the student's grade sheet. 

So now, that's the history and current state of affairs for EMS and other healthcare workers regarding taking precautions against infectious diseases.

Finally, before I give you 8 tips when wearing disposable nitrile examination gloves, please remember that gloves and masks alone do NOT guarantee you won't get a virus. However, they help, and what also helps is by paying attention when going out and about. 

Eight Tips for Wearing Disposable Nitrile Examination Gloves

Now, for my eight tips on wearing disposable nitrile examination gloves to protect yourself and others from this virus or ANY disease:

Disclaimer: We are all our own best advocates for our safety and health. Therefore, take the information I and others provide, review it, research it further, and come up with the best course of action that helps protect you and your loved ones. 

1. Do NOT wear the same pair of gloves all day. Doing so is likely to transfer the virus just as if you did not wear gloves at all. 
2. Put your gloves ON anytime you are going into an area where you may encounter the virus.
3. After you touch something that may have the virus (door handles, shopping carts, groceries, etc.), do NOT touch your face. Also, don't touch your purse, wallet, glasses, or anything on your person again until you remove the gloves. 
4. When shopping, if possible, change your gloves before checking out so you don't spread any germs you may pick up while shopping. The checker and the next person in line don't need to get a virus because glove-wearing people are inconsiderate. 
5. After leaving the store, DO NOT touch your car, your keys, and so forth with your potentially nasty germisicle laden gloves on. Instead, take off your gloves.
6. Your job of remaining mindful and resilient does not end when you leave the store or other essential places. Remember, the groceries, the bags they're in, and anything you are taking with you can be a disease vector. Therefore, use your best judgment and your PPE to keep you and others safe.
7. Carry a small bowl, water, and some soap in your car. When you finsih up handling whatever you bought, remove your gloves and wash your hands! 
8. DO NOT be nasty and toss your disposable nitrile examination gloves on the ground for someone else to pick up. Throw them away!

Stay safe,