Paramedics to Get AIDS Guards : Orange County Fire Officials Also Consider Vaccinations

Concerned with the threat of AIDS and other communicable diseases, the Orange County Fire Department plans to purchase equipment that will help paramedics avoid direct mouth-to-mouth contact with emergency victims.

Officials in Anaheim are also planning to purchase equipment similar if not identical to manual mask resuscitators that the Los Angeles County Fire Department has been distributing this week. Los Angeles fire officials decided to buy 1,500 of the $10 masks after a county firefighter gave mouth-to-mouth resuscitation May 19 to a suspected victim of AIDS, acquired immune deficiency syndrome.

Orange County fire officials also are considering administering costly hepatitis B vaccinations. Westminster paramedics have been undergoing the hepatitis vaccinations for a month and Newport Beach began an inoculation program two weeks ago, officials from those cities said this week.

“Almost every fire department in Orange County is doing something about it (the threat of AIDS and other diseases). If nothing more than education, they’re doing something about it,” said county Fire Battalion Chief Charles Prather.

Across the nation, people who are the first to reach the scene of an emergency are becoming increasingly concerned about potential exposure to AIDS and hepatitis B, said Kim Mueller, health and safety director of the Sacramento-based Federated Firefighters of California, a lobbying group for 17,000 firefighters in the state.

“Half of the firefighters’ calls are medical calls,” Mueller said. “It’s right at the top of firefighters’ concerns right now, along with hazardous materials exposure.”

Mueller cautioned, however, against “a tendency to overreact,” which she said “has a lot to do with homophobia,” or a fear of homosexuals, a group identified as being at high risk to contract the usually fatal disease that destroys the body’s immune system.

Agreeing with Mueller is Randy Pesqueira, AIDS response program director at the Gay and Lesbian Community Center in Garden Grove.

“My concern is what does it mean when they say the person is suspected of having AIDS? . . . If that person appears gay or if the call comes from Laguna Beach, are they going to assume he’s gay?” Pesqueira said. “Is the attention of the paramedic going to be diverted because this person is suspected of having AIDS or of being gay?”

While neither condemning nor condoning use of mask resuscitators or other devices, Pesqueira questioned their use. “It’s a little homophobia. It’s a little lack of education. And it’s fear.”

Jeff Irwin, a paramedic firefighter in Anaheim who has researched the subject, said the prospect of contracting AIDS “scares me, but we cannot drop the level of our service because of the threat. We do the best we can . . . we will do mouth-to-mouth on anyone if all else fails. I would do mouth-to-mouth on an AIDS victim.”

In Los Angeles County, paramedics now use a resuscitator to blow air through a tube that leads to a mask covering the victim’s face. The masks are as medically effective as direct artificial respiration, officials said. Los Angeles officials purchased the resuscitators after a firefighter attempted to revive a man whose car had plunged over a Topanga Canyon Boulevard cliff May 19. Officials later learned that the man, who died, was suspected of having AIDS, Capt. Al Bennett said. Last week, the Los Angeles County Firefighters Union called for a state law requiring that municipalities make mechanical and manual resuscitators available to protect the paramedics during rescues.

AIDS is transmitted primarily through sexual contact or through intermingling of blood. Although the AIDS virus has been found in saliva and tears, the U.S. Centers for Disease Control in Atlanta reports that there are no known cases of the virus being transmitted through either fluid.

Paramedics run the risk of contagion through nicks and cuts, blood spurting into their eyes or accidentally jabbing themselves with needles used on patients, they said. While no officials contacted knew of a firefighter contracting AIDS while working, many said it was not uncommon for the rescuers to be infected with hepatitis B, a liver disease transmitted by blood and often found among intravenous drug users who handle contaminated needles, a group also identified as being at high risk of contracting AIDS.

Newport Beach Paramedic Coordinator Nick Waite, one of about 75 of the city’s paramedics to volunteer for the new hepatitis vaccines, just learned that he has hepatitis B, although he is not an active carrier. “I don’t know where I got it,” Waite said. “I wasn’t very happy about it.”

At the Metro-Dade Fire Rescue Department in Florida, the first one in the country to offer the hepatitis B vaccinations about five months ago, Capt. David James said Wednesday that more firefighters are requesting the inoculations after two paramedics, who were not vaccinated, contracted the disease.

At $100 for a series of three shots per person, the tab could run high for the Orange County Fire Department and its 1,200 employees if the county decides to begin a vaccination program, Deputy Fire Chief Robert O. Schmahl said.

Westminster Paramedic Coordinator Bill Lawler agreed that the price had been a concern for his city also, but he continued, “When you figure out the length of time a person could be off work (with hepatitis B), the price of the shots could be made up in one day’s overtime.”

As for mechanical and manual masks, James said that his department, which handles the unincorporated areas of Dade County, uses the adjunct devices, such as Ambu bags, which push air from a bag to a mask placed over the patient’s face.

“I’m surprised that any professional health organization doesn’t have adjuncts. There is almost no reason why any professional health organization has to do mouth-to-mouth,” James said.

All fire departments carry some type of equipment used to resuscitate accident victims. In cities such as Westminster and Costa Mesa, fire officials said Wednesday they are awaiting word from the county Fire Department before purchasing aids such as the $10 hand masks.

Meanwhile, several departments are conducting communicable disease training programs and suggesting plans that include use of rubber gloves and other prevention measures.