|Articles|June 12, 2019

Infection Control in Pre-Hospital Settings Falls on EMS Personnel

EMS practiced hand hygiene before patient contact in just 7% of assessments but wore gloves in 100% of observed interactions

The task of infection prevention and control can begin even before a hospital admission, in the case of emergency transport. During that time, it is the responsibility of emergency medical services (EMS) personnel to ensure hygienic and safe patient care.

Investigators with the Los Angeles Department of Public Health sought to assess EMS infection control policies and practices between 2016 and 2017. The team presented their results in an oral abstract session at the Association for Professionals in Infection Control and Epidemiology (APIC 2019) annual meeting.

To assess practices and policies, Department of Public Health and Emergency Medical Services Agency nurses performed ride-alongs in Los Angeles in >2 ambulances per 14 providers included in the study.

Of the 14 providers included, 11 had a designated infection control officer, 13 had written infection control policies, 12 reviewed and updated the policies annually, 12 had written policies for cleaning/disinfection, and all 14 required infection control training for new staff. However, only 59% assessed skills after the training, and only 31% audited across 4 infection control topics.

Twelve of the 14 providers required staff to receive an influenza vaccination, but the median vaccination rate was only 55% (range 1-99%).

The study found that EMS practiced hand hygiene before patient contact in just 7% of assessments but wore gloves in 100% of observed interactions. Personnel practiced hand hygiene after glove use in 79% of cases assessed. High-touch surfaces in ambulances were cleaned after each patient encounter 79% of the time and replaced disinfectants and cleaners 89% of the time.

“EMS providers are an important part of the health care system as they transport patients in and out of hospitals and other health care facilities,” investigators concluded. “Overall, findings were encouraging, but ensuring up-to-date policies for all areas of infection control, monitoring competencies, and observing practices to assess adherence may improve infection control.”

The study, “The State of Infection Control Among Los Angeles County (LAC) Emergency Medical Services (EMS) Providers,” was presented on Wednesday, June 12, 2019 at APIC 2019 in Philadelphia, Pennsylvania.


Related to this article

How The Food Safety Surveillance Infrastructure Works in the US
In the first episode of our news series looking at the food safety network, Lynette Johnston, PhD, offers insights into how the federal government surveillance infrastructure operates, and how epidemiologists serve as food detectives in determining bacterial pathogens and potential foodborne outbreaks.
Ebola and the Ongoing Tale of US Failures
In mid-May, as the world was still grappling with an unexpected hantavirus outbreak aboard a tourism vessel, news broke of an Ebola outbreak in the Ituri Province of the Democratic Republic of the Congo spanning at least 3 health zones, including Bunia, Rwampara, and Mongbwalu.
This Week's Top 5 Infectious Disease News Stories: September 12-September 18, 2026
In this week's top infectious disease stories, a Pennsylvania teen became the state's fourth measles death in weeks, the CDC reported a 17% summer surge in rabies exposure calls, new research revisited whether cefepime raises mortality risk, a multihospital review examined ceftriaxone's safety after state alerts, and examining Legionella pneumonia diagnostics.
Measles Update: September 18, 2026
The latest CDC numbers show a 5.37% increase of measles cases from week-to-week. In Pennsylvania, the fourth measles-related death was reported in 2026. Additionally, the CDC has made a change in the way it will report deaths.
CDC Responds to Surge in Rabies Exposures
A "Clinician Outreach" from the Centers for Disease Control and Prevention (CDC) in April anticipated an increase in rabies exposures, and the striking surge in case reports this summer prompted a recent health advisory alert from the federal agency.
New Diagnositics for Legionella Pneumonia May Streamline Care Continuum
Reported cases of Legionnaires’ disease have been on the rise for the past decade, and identifying Legionella bacteria requires specialized testing in the microbiology lab. Here is a clinical overview of Legionella bacteria, including required testing, treatment, and reporting to public health officials.
Ceftriaxone Safety: Separating Signal From Risk
A retrospective multihospital study found that severe adverse events occurred at similarly low rates with ceftriaxone and other IV cephalosporins suggesting there is no evidence to support avoiding ceftriaxone despite recent health department safety alerts.