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When decon is not enough to assure patient comfort and safety, consider replacing your stretcher mattress with an affordable, durable substitute

By Tim Nowak for EMS1 BrandFocus                                                                                                    

Have you ever taken damp sheets out of your drier, snugly placed them on your bed, and then bundled-up for a good night’s sleep in them?

Accidentally, probably. Intentionally, likely not.

Your ambulance cot (stretcher) linens – and mattress – are no different.

Considering all the gross decontamination, regular disinfecting, spot-cleaning and wet-wiping that we do in EMS, it’s only a matter of time that this will end up happening to you (and your patient).

Whether it’s a full-disinfecting regimen after a suspected COVID-positive patient transport or the gross decontamination (which involves more than just wiping off the fluids) after transporting a major trauma patient, there are simply times where your cot mattress just needs to take a break – if not for the purpose of completing a proper disinfecting cycle, then simply for the comfort of being fully dry when the next patient gets placed on it.

Our colleagues in the fire service are placing greater emphasis on supplying two sets of turnout gear for each firefighter so there’s always access to a clean set after one gets wet, soiled (by blood or other fluids) or contaminated by smoke and other combustion byproducts. But what about our own cots? We often rely on just the mattress that comes with it as a part of its initial purchase.

We try to tape, reseal or simply ignore the wear and tear or even obvious rips and holes compromising its integrity. Lack of budget for spare or replacement mattresses have led some agencies to ignore some of these signs of degradation, of a decrease in infection control and even a decrease in patient comfort.

One thing that COVID brought to light is that EMS providers can no longer ignore the problem and hope it goes away. It’s especially important that a ripped, torn, stained or otherwise damaged mattress be replaced right away, and not just for patient comfort and safety. The agency also risks costly fines for deficiencies in infection control – making “lack of budget” a short-sighted excuse, especially when an affordable alternative exists.

Yes, our cot mattresses are pretty durable. They’re made to accommodate varying body weights, maintain a protective layer away from its internal foam structure, and be flexible enough to bend along the creases of the back and legs (for Fowler’s and Trendelenburg positioning).

A little bit of this and that leaked onto an intact exterior doesn’t necessarily require a full decon and swap-out, but it certainly requires some due attention toward properly disinfecting your mattress’s surface.

Cleaning jobs that require, let’s say (anecdotally), more than three wipes in order to get a clean surface really should warrant a full mattress decon – which includes the following:

Think of it like a hazmat decon line: gross decon, technical decon and then wash, followed by a drying timeline. Additional ultraviolet light options may also find their place in this stage of the game, as you’re now trying to kill any remaining bacteria or viruses that made it past your scrub and wash phases.

Keeping to the “three wipes rule,” your first wipe should remove any gross contents, like blood or emesis pools. The second should clear away the remainder, and the third should produce a clean wipe – assuring that all of the bad stuff has been removed. If your third wipe still has contents on it, then it’s time to progress toward a mattress swap and a full mattress decon.

Just as it’s important to follow the same cleaning process and guidelines for your cot’s seat belts (no one likes wet seat belts, either), it’s equally important to make sure that you’re using the right equipment whenever you make any form of an equipment swap.

But the cost of an original manufacturer’s replacement mattress can be a barrier. That’s why Medline has created a more affordable option that is compatible with many Stryker model cot mattresses. Medline’s XPS Expandable Stretcher Replacement Mattress is made of a durable yet comfortable vinyl cover, designed to protect the inner mattress from natural wear and tear and extend its useful life.

Yes, duct tape will fix just about anything, but that doesn’t mean it’s truly the right thing to use – especially in EMS, where infection control is a must. A good rule of thumb is that if you’re using tape of any kind to keep any EMS item secured, enclosed or combined (excluding bandaging), then you’re likely doing something wrong. There’s probably a better way of doing things, or at the very least, a cleaner way.

If this applies to your cot mattress, then the most correct answer is to simply replace the mattress altogether. Get rid of it and replace it with a new one – if not for the sake of maintaining a cleaner environment, then simply for the peace of mind in knowing that you’re providing a higher level of comfort for the patient.

Now that there is a more affordable option available, what’s your agency’s excuse for not having a replacement mattress in its cache of equipment?

Learn more about Medline’s replacement stretcher mattresses.

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Tim is the founder and CEO of Emergency Medical Solutions, LLC, an EMS training and consulting company that he developed in 2010. He has nearly two decades of experience in the emergency services industry, having worked as a career firefighter, paramedic and critical care paramedic in a variety of urban, suburban, rural and in-hospital environments. His background includes nearly a decade of company officer and chief officer level experience, in addition to training content delivery and program development spanning his entire career. He is experienced in EMS operations, community paramedicine, quality assurance, data management, training, special operations and administration disciplines, and holds credentials as both a supervising and managing paramedic officer.

Tim also has active experience as a columnist and content developer with over 200 published works and over 100 hours of education content available online, and is a social media influencer on LinkedIn within the EMS industry. Connect with him on LinkedIn or at tnowak@emergencymedicalsolutionsllc.com.

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