By Marjory Inglis, health reporter

TAYSIDE AND Fife ambulance crews will remove vehicles from service if they are concerned about contamination and the risk of infection to patients and staff.

Crews’ absolute authority to take their vehicles off the road emerged in the wake of claims south of the border that ambulances could spread superbugs, such as the antibiotic resistant MRSA.

Health union Unison claimed that the Government’s failure to tackle ambulance cleanliness was a major flaw in its infection control policy. Ambulances were “potentially the weakest link,” with crews not always having time between emergency calls to keep their vehicles clean and infection free.

But a top Scottish Ambulance Service manager serving Tayside and Fife gave a very different picture of what was happening locally from the position in England and Wales described by Unison.

Grant Gordon, general manager for the east central division, said all ambulance staff go through formal training on control of infection. There were strict procedures for cleaning each vehicle every day and further deep cleaning carried out weekly.

He acknowledged the greatest potential risk was when blood and body fluids spilled on to the vehicle and equipment in an emergency situation and, if not appropriately dealt with, posed a risk to following patients and staff.

He stressed that in that situation crews had the power, and responsibility, to immediately remove the vehicle from service until it had been appropriately cleaned.

“It is our ambulance staff themselves who have the authority to be booked off to clean the vehicle,” said Mr Gordon.

“We have recognised that with regard to control of infection the ambulance service have a huge part to play in that.”

He explained as part of their formal training ambulance staff studied how to clean vehicles and equipment and the risks of failing to do so, in particular the risk of cross contamination and infection.

Additionally, when crews were informed a patient was known to have MRSA or any of the infectious diseases, they were trained to minimise the risks with appropriate care and handling.

Mr Gordon said crews followed guidance on the appropriate level of protective equipment to use in such situations.

“That can range from wearing latex gloves to full infectious disease suits,” he said. “That’s white paper overalls and masks but that is extreme. It is very rare that a patient has to be transferred with that high level of disease. I think the point that is important to grasp is we do have different levels of response dependent on the type of information we get.”

Crews would “always, always err on the side of caution” to try to ensure there was no risk of contamination and infection. “If we get a patient who has infectious disease, that vehicle is then removed from service until it has been completely cleaned.

“There are always going to be occasions when we are transporting a patient and don’t know (they have an infectious disease), particularly with the blue light service (999 calls) when we pitch up and don’t have a lot of history. It might become apparent during questioning of a patient they have got a history (of infection) but if we don’t find that out, that is one of the risks.”

Unison called on ambulance organisations to employ in-house cleaners to free crews to care for patients and help ensure cleanliness of vehicles.

Mr Gordon said that in Dundee there was a cleaner at work in the busy depot. In the smaller, rural depots there was time for crews to undertake regular cleaning of the vehicles. “In most ambulance stations part of their shift roster includes cleaning.”