REMS bed bugs training

1. “What’s bugging you?”
Bed Bugs
Rotterdam Emergency Medical Services
Douglas Hexel, AEMT-P, NYS CLI

2. Bed Bugs
• As contact with infested homes and patients
increase, it’s important to know the basics.
• Many of you may have seen some recent news
articles detailing reactions of local fire and
EMS agencies to bed bug contact.
• This is intended to guide you through your
rather unpleasant experience.

3. Agenda
• What are bed bugs?
• What can I catch from bed bugs?
• How do bed bugs infest?
• Will bed bugs infest me?
• Will bed bugs infest our gear?
• Will bed bugs infest the station?
• What to do with bed bugs?
• Should we decon?

4. What are bed bugs?

5. What are bed bugs?
• Bed bugs are small, parasitic insects of the
cimicid family.
• Bed bugs feed exclusively on blood, usually
human but sometimes from other mammals.
• Bed bugs are mainly active at night but are
NOT exclusively nocturnal.
• Fully-grown adult bed bugs can reach 5mm in
length

6. What are bed bugs?
• Bed bugs are found mostly in warm, dark
areas like mattresses and furniture.
• Bed bugs can live up to a year without
feeding.
• Prolonged contact is required to allow bed
bugs to infest in clothing or equipment.
• Bed bugs do NOT live on the skin of hosts but
can be found on their clothing.

7. What can I catch from bed bugs?
• Bed bug bites result mainly in skin rashes that
can be worse when accompanied with a
localized allergic reaction to the bites.

8. What can I catch from bed bugs?
• Bed bug do NOT transmit any communicable
diseases to humans.
• Unlike other mites such as scabies and head
lice, person-to-person transmission is very
unlikely.

9. How do bed bugs infest?
• Bed bugs generally nest in furniture but can
nest in clothing and bags.
• Bed bugs are slow and do not jump or fly so
prolonged contact is needed for bed bugs to
nest into EMS bags or equipment.

10. Will bed bugs infest me?
• If bed bugs get onto a responder, there are
usually too few to cause any further
infestation.
• They may be able to bite you and be on your
clothing, but they are HIGHLY unlikely to be
spread further.
• Remember, bed bugs cannot live on skin but
can only live on a person on their clothing.

11. Will bed bugs infest our gear?
• While bed bugs may be able to climb into or
onto EMS bags, they will not prefer to nest in
these.
• There will not be enough bed bugs to nest and
reproduce, infesting the bag.
• The most likely place for a bed bug to nest
would be on the cot, but that’s one of the
reasons we use linens.

12. Will bed bugs infest the station?
• It is more likely for an employee to
unknowingly bring bed bugs from home and
infest the station than it is to bring bed bugs
back from a call and infest the station.
• As mentioned previously, prolonged contact
with clothing or personal items is required for
enough bed bugs to nest and be transmitted
to other articles to infest.

13. What to do with bed bugs?
• We have a distinct advantage against bed
bugs: we can see them.
– Unlike other mites, bed bugs are big enough to see!
– If you don’t see them, you’re probably not infested!

14. What to do with bed bugs?
• If you come in contact with someone infested
with bed bugs, the most important thing is to
wrap the patient in a sheet or blanket. This
should contain the bugs on the patient.
• Continue to try to set gear and bags down on
hard floors or surfaces, not clothes, beds, or
carpets.
• Be certain to leave ALL linen from the cot at the
hospital (this is done with every call anyway)

15. What to do with bed bugs?
• If you believe you may have bed bugs on you,
return to the station and change into your
spare uniform (everyone should keep a spare
uniform with them)
• Wash your clothing at the station. Heat from
residential clothes driers are sufficient to kill
ALL bed bugs if they aren’t killed in the
washer.

16. What to do with bed bugs?
• If you feel the need, quickly shower at the
station. Remember, bed bugs do not live on
skin so IF you did have any on you, they likely
came off with your clothes.

17. What to do with bed bugs?
• Bed bugs will not infest the back of the
ambulance.
• Prolonged decontamination of the back of the
ambulance is NOT necessary.
• Bed bugs do not prefer hard surfaces so if you
regularly wipe your cot mattress after every
call, you’ll be good.

18. What to do with bed bugs?
• The only place bed bugs may prefer in an
ambulance are the front CLOTH seats.
• If you think you may have bed bugs on you,
throw a sheet on the front seat before riding
back to the station. Wash that sheet along
with your clothing.
• Bed bugs are HIGHLY unlikely to infest in the
ambulance.

19. Should we decon?
• Remember, bed bugs are highly unlikely to be
transmitted in the short amount of time we
have contact with patients.
• Bed bug transmission will be prevented by our
normal, everyday clean up and disposal of
used linen.
• You may shower and wash your uniform, but
prolong decon of ambulances and gear is
unnecessary.

20. Conclusion
Bed bugs are becoming more prevalent and we’re
sure to see more people infested than we’ve ever
seen before.
Bed bugs are highly unlikely to infest us, our gear, or
our ambulance.
Full, systematic decontamination of gear and
ambulances after bed bug calls is not necessary.

21. Questions/Comments
Questions? Comments? Concerns?
Please direct them to me at dhexel@gmail.com