Patients with reported home bed bug infestations were significantly more likely than those without bed bug infestations to arrive to the ED by ambulance (57% versus 14%; p < 0.05). If possible, the additional data obtained from the critically ill, intoxicated, and mentally ill ED patients would have provided a more accurate estimate of ED patients with bed bugs. National Library of Medicine [Nov;2019 ];University Hospitals, EMS Training & Disaster Preparedness Institute. Referral for appropriate assistance and follow-up are a part of our role as providers. If the exposure occurred at school empty out the backpack and/or duffel bag(s) outside or in a garage. A survey of patients with bed bugs in the emergency department. Do you think bed bugs live only in unsanitary conditions?

2022 Endeavor Business Media, LLC. Hearing that you have been exposed to bed bugs can be quite scary. Needless to say, this is the first time this has happened in our office and Im hoping weve done all the correct follow-up. hb```e``e`f`pb`g@ ~r =avI4zst0t@LKib^149N+vq3;dyFi/Hw(@ 8 endstream endobj 37 0 obj <> endobj 38 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/TrimBox[12 11 601 780]/Type/Page/u2pMat[1 0 0 -1 12 780]/xb1 12/xb2 601/xt1 12/xt2 601/yb1 11/yb2 780/yt1 11/yt2 780>> endobj 39 0 obj <>stream Bed bugs are excellent hitchhikers. Most of our respondents have provided EMS services for more than 15 years. We found that 25% of patients with bed bugs worried about receiving worse healthcare because of their infestation. 0W?q{ivV`gU?bqenA:A"7/L>q*K]Ql2 They feed on them mainly at night.

2 0 obj Dropped off by someone you live with: 21%, Dropped off by someone you live with: 26%, Dropped off by someone you dont live with: 0%, Dropped off by someone you dont live with: 12%. It is important that you dismiss without abandonment, giving reasonable notice to allow a patient to secure care, and providing care for the allotted amount of time your state requires.

C. lectulariususually seeks refuge near their human host when not seeking a blood meal [1]. Goddard J, deShazo R. Estimating the feeding rate of the bedbug Cimex lectularius in an infested room: an inexpensive method and a case study. The CDC has a great resource page for bed bugs at

But boy, can they bug you!

We surveyed 706 active emergency department (ED) patients about their experiences with bed bugs. 36 0 obj <> endobj 49 0 obj <>/Filter/FlateDecode/ID[<38968A5B4EEC3A9B79BC92F46AE5D2BC><5F7306A1B485467F8D8E94CCE05136A7>]/Index[36 25]/Info 35 0 R/Length 77/Prev 125402/Root 37 0 R/Size 61/Type/XRef/W[1 2 1]>>stream One of my favorite things right now: VoiceWorks from Florida Probe, <>>>

You might be the person who makes a difference to them.

UHCMC ED patients with bed bugs are more likely to be older, male,brought to the ED by EMS providers, andadmitted to the hospital [3-5]. Immediately wash all of the clothing worn that day and dry them on the hottest setting of the dryer. Institutional review board approval was obtained from University Hospitals (UH) inOhio to administer an anonymous survey to approximately 180 EMS agencies under UH medical command in northeast Ohio between September 1, 2018, and March 31, 2019. Cowleys Pest Services1145 NJ-33Farmingdale, NJ 07727Cowleys Pest Services21 E High StSomerville, NJ 08876. The C. lectularius life cycle begins with an egg and proceeds through five nymphal stages before becoming an adult [1].

This approximates to ~3-4 bed bug infested patients being seen in our ED daily. and transmitted securely. Other popular TroubleshootersIs it legal to make hygienists clock out for no-shows?Hygienist working in 'hygiene hell'. EMT-paramedics were significantly more likely than non-EMT-paramedics to report seeing bed bugs weekly [83% (20/24) vs. 17% (4/24); p: .002]. 3.

exterminator pet safe Among the respondents, 80% (86/108) of predominantly urban EMS providers, 66% (152/231) of suburban providers, and 48% (32/67) of rural providers reported previously seeing a bed bug (p: <.001). Orkin, Orkin releases top 50 bed bug cities list, 2018, Y. Wu, D. M. Tracy, A. M. Barbarin, C. M. Barbu, and M. Z. What's buggin' EMS. endobj Monday, November 11th, 2013 by Bill Cowley.

Remember, you'll be helping others who share the same issue. Some of the data in this manuscript was presented as an oral abstract at the Annual Society of Academic Emergency Medicine Conference in Indianapolis, IN, in May 2018 and appeared in a poster at the Ohio American College of Emergency Physicians Meeting in Columbus, OH, in August 2018. The mean level of concern about getting bed bugs was 3.8 (SD: 1.2) for providers working predominantly in an urban environment, 3.4 (SD: 1.2) for those working predominantly in a suburban environment, and 3.6 (SD: 1.1) for those predominantly working in a rural environment (p: .02). A survey of UHCMC ED patients found that about one in 50 reported an active home bed bug infestation; 37% (253/680) reported a past history of being fed on by a bed bug, and 59% (415/702) reported knowing someone other than persons living in their home having a bed bug infestation in the past five years [4,5]. The good news is ff you find that you have been exposed to bed bugs, there are simple measures you can take to help stop them from spreading. Only 2% (n = 2) of EMS providers reported taking no action when seeing bed bugs. C. lectularius is not known to be an important vector of human infectious disease, although no major metagenomic investigation has examined its microbiome [1,12-16]. The site is secure.

Our study has several limitations. Most bed bug infested patients are older, arrive to the ED by ambulance, do not report their infestation to healthcare providers, and are not adequately placed into isolation precautions, potentially putting other patients and providers at risk for acquiring the infestation.

Leulmi H, Bitam I, Berenger JM, et al. The First 5 Steps to Take if You've Been Exposed to Bed Bugs, The Benefits of Crawl Space Encapsulation, 9 Questions to Ask Before Inviting Technicians Into Your Home, local New Jersey university alerted parents, tips to prevent bringing home bed bugs from a trip, contact us today for a free inspection and estimate. In a 2018 survey, 59% and 39% of pest management professionals reported that they had decontaminated nursing homes and hospitals for bed bugs, respectively [7].

HWi+pU"D]GR!0$0]1>gpq*].EiF$J.%18{zusRAO/!Q7x|}/.dID}MY@?}Xw[z'EF FtRT#K# }zS$/u8\_u%sZeS>U%[;qY:'lzR{zV: 6OKqV[At $ct|/M4O?M#;|2:q3fqIu!O;Q M}tu_U6^ho` We eventually surveyed 407 EMS providers who were all 18 years of age. The .gov means its official. Sheele JM, Barrett E, Dash D, Ridge GE. Bed bugs: clinical relevance and control options. EDs trying not to let the bed bugs bite.

Zygowicz WM. If the treatment was urgent then there are appropriate steps that can be taken to minimize contamination. I told the office manager when we were done, and then I found a live bed bug on the floor!

The feasibility of putting everyone with a reported home bed bug infestations on bug isolation precautions remains unknown, but having an infested patient bringing bed bugs into the ED puts other patients and ED staff at risk for acquiring an infestation. We anonymously surveyed 407 EMS providers from 180 EMS agencies in northeast Ohio between September 1, 2018, through March 31, 2019. This person could be dealing with everything from fever to anemia. It freaked us out! Exposure to bed bugs can happen anywhere from your local movie theater to a stay at a hotel or an outbreak at your childrens dormitory at college. EMS providers, especially those working in an urban environment, encounter bed bugs frequently during patient care. The direct annual costs for the ED to decontaminate a patient room due to a bed bug were approximately $50,000 per year [5]. 7vbI@Xn9lSYTgz*cPcDywL^s/&5Xop`Lnim~t)^f=I=K*9B>J8nQ+|"fn=sCT|IU2]';*IYTrTJQos*ihQ`Jk]% bSc(nNf/;l2hjaF]/~. Langley R, Mack K, Haileyesus T, Proescholdbell S, Annest JL. The National Pest Management Association: PPMA survey highlights bed bug prevalence nationwide. Do bed bugs lay eggs under a persons skin?

A failure to isolate bed bug-infested patients in the ED puts other healthcare providers and patients at risk for infestation. The hospital in which the survey was performed previously reported finding a bed bug in the institution approximately every 2 days, with most insects found in the ED at a frequency of every 3-5 days [2, 5]. If you didn't alert ED staff that you had bed bugs are you concerned that by doing so you might receive worse care in the hospital, If you didn't alert ED staff that you had bed bugs are you concerned that others might get bed bugs from you, How much distress do bed bugs cause you at home.

Johnathan M. Sheele, Cameron J. Crandall, Brandon F. Chang, Brianna L. Arko, Colin T. Dunn, Alejandro Negrete, "Characteristics of Bed Bug Infested Patients in the Emergency Department", Emergency Medicine International, vol. Responses will come from various dental consultants, as well as other experts in the areas of human resources, coding, front office management, and more.

UH has an existing prehospital bed-bug policy of medical control procedures [19]. To view more Troubleshooters, visit and search "Troubleshooter.". Additionally, 25% (2/8) reported a concern that notifying ED staff that they had bed bugs would result in them receiving inferior care in the hospital (1 unsure, 5 no answers). The respondent demographic characteristics and rawresponses are summarized in Table Table11.

C. lectularius feeds every few days but can go months without a blood meal [1,10]. Binomial logistic regression identified non-white race [OR: 11.93 (95% CI: 1.97 to 72.33), p: .007] and a previous history of being fed upon by a bed bug [OR: 39.85 (95% CI: 7.58 to 209.41), p: <.001] as risk factors for a home bed bug infestation. We found that 2% of ED patients reported having a current bed bug infestation, significantly more than the historical number of ED patients upon which we find bed bug; 37% of ED patients report previously having been fed on by a bed bug; 15% currently know someone with an active infestation; and 59% know someone that has had an infestation within 5 years. This research received internal support from the Department of Emergency Medicine at the University Hospitals Cleveland Medical Center. -IC+aiIe(P8$ARS"V(lc8YZ I5/GsB^M"J7\[f6Msy_7g*Yb]V",]D!|!"%B>c [Sep;2019 ]; National estimates of noncanine bite and sting injuries treated in US hospital emergency departments, 2001-2010. Only 18% (2/11) of persons with bed bugs notified EMS providers or ED staff about their home infestation. If someone is walking around with bed bugs on their body, they have a need that goes well beyond the dental chair. Data was collected seven days a week and predominantly during the day and evening hours.

J. M. Sheele, E. Barrett, D. Dash, and G. E. Ridge, Analysis of the life stages of Cimex lectularius captured within a medical centre suggests that the true numbers of bed bug introductions are under-reported,, J. M. Sheele, E. Barrett, O. Farhan, and N. Morris, Analysis of bed bug (cimex lectularius) introductions into an academic medical center,, J. M. Sheele, S. Gaines, N. Maurer et al., A survey of patients with bed bugs in the emergency department,, R. Langley, K. Mack, T. Haileyesus, S. Proescholdbell, and J. L. Annest, National estimates of noncanine bite and sting injuries treated in US hospital emergency departments, 2001-2010,, V. Totten, H. Charbonneau, W. Hoch, S. Shah, and J. M. Sheele, The cost of decontaminating an ED after finding a bed bug: Results from a single academic medical center,, J. Goddard and R. DeShazo, Bed bugs (cimex lectularius) and clinical consequences of their bites,, S. L. Doggett, D. E. Dwyer, P. F. Peas, and R. C. Russell, Bed bugs: Clinical relevance and control options,, S. R. Susser, S. Perron, M. Fournier et al., Mental health effects from urban bed bug infestation (Cimex lectularius L.): A cross-sectional study,, R. Minocha, C. Wang, K. Dang, C. E. Webb, P. Fernndez-Peas, and S. L. Doggett, Systemic and erythrodermic reactions following repeated exposure to bites from the Common bed bug Cimex lectularius (Hemiptera: Cimicidae),. There is little chance that anyone would spread bed bugs to other patients. After near extirpation, in the past two decades the number of bed bug infestations has risen dramatically in many parts of the world including the United States [6, 7]. Copyright 2019 Johnathan M. Sheele et al. Emergency medicine policies and procedures should be developed to appropriately identify and intervene with patients with bed bugs to help prevent the spread of the infestation. The authors have declared that no competing interests exist. The cost of decontaminating an ED after finding a bed bug: results from a single academic medical center. In outpatient settings, such as emergency rooms and dental offices, the Centers for Disease Control states that the key is prevention and patients need to be seen immediately. stream The EMS providers who reported seeing bed bugs at least weekly primarily worked in urban areas [50% (n = 12)]; while 46% (n = 11) lived in the suburbs, and4% (n = 1) lived in ruralcommunities. Accessibility EMS provider actions when encountering bed bugs. The majority of EMS providers gave correct responses to questions except that 69% (279/406) incorrectly thought bed bugs could jump. will also be available for a limited time. Bed bugs are commonly encountered by emergency medical service (EMS) providers. 2019, Article ID 8721829, 5 pages, 2019., 1Department of Emergency Medicine, University Hospitals Cleveland Medical Center, 11100 Euclid Ave., B-517, Cleveland, OH 44139, USA, 2Case Western Reserve University School of Medicine, Cleveland, OH 44139, USA. This study was approved by the Institutional Review Board of University Hospitals Cleveland Medical Center with the approval number STUDY20180361. A survey of patients that had a bed bug on or near them in the ED found that these patients were more likely to be male, older in age, have higher emergency severity index (ESI) scores, be admitted to the hospital, and arrive to the ED by ambulance [2, 3]. Risk factors for bed bugs among urban emergency department patients.

The risk to EMS providers for acquiring a home bed bug from work-related dutiesis difficult to quantify from a survey and remains unknown.

Risk factors associated with EMS providers reporting a past home bed bug infestation. It remains unclear if persons with bed bugs are at baseline more likely to be chronically ill, whether they have fewer resources (e.g., needed transportation to the ED), or whether the bed bugs are indirectly or directly contributing to human disease. The mean level of concern for encountering bed bugs among EMS providers was 3.54 (SD: 1.15; scale: 1 = no concern, 5 = very concerned). government site.

They spread so rapidly because of their innate ability to hide in your belongings.

Interestingly, 64% (7/11) patients that reported home bed bugs stated they felt no chance (on a scale of 1-5 with 1 being no chance and 5 being very likely) that they could have brought bed bugs with them to the ED. Characteristics of Bed Bug Infested Patients in the Emergency Department, Department of Emergency Medicine, University Hospitals Cleveland Medical Center, 11100 Euclid Ave., B-517, Cleveland, OH 44139, USA, Case Western Reserve University School of Medicine, Cleveland, OH 44139, USA,, + current home bed bug infestation (n = 14), - current home bed bug infestation (n = 684), Placed in bed bug isolation precautions at the time of data collection in the ED. Do not disregard or avoid professional medical advice due to content published within Cureus. Emergency Medicine, Case Western Reserve University School of Medicine, Cleveland, USA. Don't be shy! They get their name because they are often found in the bed and will feed on their host at night. Bed bugs (Cimex lectularius) and clinical consequences of their bites. We received Institutional Review Board (IRB) approval to survey 706 ED patients in a single center, academic, tertiary care, level 1 trauma center in Cleveland, OH, between June and October 2017. bedbug revolting bettwanze cimice wanze cimex lectularius percevejo punaise heteroptera combatting topical steroids manifestations antihistamines detection lesions addressed

Received 2020 Apr 6; Accepted 2020 Apr 17. These flat, small reddish brown bugs range in size from 1 mm to 7 mm. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. The objective of our study was to estimate the prevalence of bed bug infested patients in an ED and determine how infested patients were presenting to the ED and how often infested patients were being placed in isolation. Most of our study participants were white, male EMT-paramedics, who worked in a suburban community that has a high number of community bed bug infestations.

2019 Top 50 Bed Bug Cities in U.S. [Sep;2019 ]; Analysis of bed bug (Cimex lectularius) introductions into an academic medical center. Delaunay P, Blanc V, Del Giudice P, Levy-Bencheton A, Chosidow O, Marty P, Brouqui P. Artificial infection of the bed bug with Rickettsia parkeri. C. lectulariusis a hematophagous insectthat preferentially feeds on humans [1,9]. Emergency Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA, 3 Its important to have a professional address them, possibly more than once. QUESTION: We had a patient recently who was infested with bed bugs. endobj @!L+TlNVfk1N!,"z- G( E'5"RI4%buC,-$Gd# EL]A_JEk;ZFv6cJ=*a=P# YN-P)E"Wp N@K=9y||_PuQ6]/]\Bj.htV5SnI}~*+VP}UNuQ,?j"PdTQyz1M-iUE15ygH&QiKAfu{L\RM39-Jj_]' E/xV,brt&rJp#cp|({'.

They will first identify if the bug is a bed bug and apply the necessary steps to rid the office of them. They are not a sign of being dirty and can occur in even the poshest hotels. We can take care of most pest problems in just 48 hours! Sheele JM, Crandall CJ, Chang BF, Arko BL, Dunn CT, Negrete A. Bed bug infested patients can be common in the ED. Be aware that bed bugs can easily hide in books so thoroughly inspect books that come home. The most common actions taken by21% (n = 84) of EMS providers who reported seeing on average 1 bed bug per monthwas: using extra blankets (58%); inspecting their own clothes for bed bugs (82%); cleaning the EMS stretcher with disinfectant (83%); notifying the ED about the patient having bed bugs (88%) (Table (Table44). Bed bugs are very resistant to pesticides. 4 0 obj % P!,`=5A Gp ' LS#r`=J(e)8ZzMich&S;tXya -/ N5bRuKpJ"VY((k"AAJXD90NC+DpU4*%r{-@UVS! However, bed bugs can infest any area of a home and can be found in soft furnishings including couches, draperies, bedding, clothes, luggage, etc. They are parasitic and feed off people and animals as they sleep.

Continuous variables were analyzed using the t-test and analysis of variance (ANOVA). Survey results comparing those with and without an active home bed bug infestation. sharing sensitive information, make sure youre on a federal Study concept and design was done by Johnathan M. Sheele; acquisition of data was carried out by Cameron J. Crandall, Brandon F. Chang, Brianna L. Arko, Colin T. Dunn, and Alejandro Negrete; analysis and interpretation of data was done by Johnathan M. Sheele; drafting of the manuscript is carried out by Johnathan M. Sheele; critical review of the manuscript for intellectual content is done by Johnathan M. Sheele, Cameron J. Crandall, Brandon F. Chang, Brianna L. Arko, Colin T. Dunn, and Alejandro Negrete; statistical expertise is provided by Johnathan M. Sheele. Keep in mind that if the clothing has been put into a hamper then it is best to wash any other clothing that it has come into contact with. What are the patients real needs? Persons reporting home bed bug infestations are more likely to be older and arrive to the ED by ambulance; unlikely be put into bed bug isolation precautions in the ED; report that bed bugs cause them significant distress; not disclose to EMS providers or ED staff that they have bed bugs at home; feel embarrassed about having bed bugs; and feel it is unlike that they brought the insects with them to the ED. about navigating our updated article layout.

Can we legally ask this woman not to return to our office unless shes treated for bed bugs?

Article of the Year Award: Outstanding research contributions of 2021, as selected by our Chief Editors. Each life stage requires a blood meal and a molt, and the insect can go from instar to adult in several weeks to months. All rights reserved. Read the winning articles. You can get secondary infections from the excessive itching and scratching. The reasons for people not reporting their home bed bug infestations to EMS or ED staff were that they either did not think about it, did not think it was necessary, were not asked, did not feel like it was a problem, felt like they were in "too much distress", and felt like it was "too embarrassing".

EMS providers scored poorly (mean: 69% correct responses) in a seven-question assessment of basic bed bug biology and public health.

<> For instance, the number of bed bug introductions in the ED is unknown and likely underreported partly because healthcare workers predominantly only find the larger insects, and no International Statistical Classification of Diseases and Related Health Problems (ICD-10) code exists for bed bug infested patients to study the problem [1, 2]. Being younger, male, and working in an urban environment (vs. rural) were associated with EMS providers reporting more frequent bed bug encounters (p: .05).

Previous research has suggested that ED patients with bed bugs are more likely to be older, sicker, and associated with several psychiatric conditions common in ED patients such as anxiety and depression which could result in an underreporting of bed bug infestations in our ED [3, 68]. Cimex lectularius L., known as the common bed bug, is one of the most frequent parasites encountered by emergency medicine physicians in industrialized nations [15]. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Your compassion and humane attitude may change someones life. Among the respondents, 4% (n = 16) of EMS providers reported that they had a previous home bed bug infestation. Bed bugs feed on the blood of mammals. The data is summarized in Table 1. Categorical variables were evaluated with chi-square analysis. Even though EMS providers are concerned about getting bed bugs, they have inadequate knowledge about bed bugs and their effects on human health. 9BF|me[@Jm Ozj'5E97\S;2#Sd;&KU^F| ?pU%XvpYU!j^8:3 The variables associated with increased EMS provider concern about getting bed bugs on linear regression were: working 20 hours per week in patient care [beta: -0.50 (95% CI: -0.26 to 0.74), p: <.001]; working in a suburban vs. rural environment [beta: -0.34 (95% CI: -0.66 to -0.02), p: 0.04], and asking patients more frequently about possible home bed bug infestations [beta: 0.16 (95% CI: 0.03 to 0.29), p: .02]. Bed bugs in healthcare settings.

The data used to support the findings of this study are included within the article. Statistical significance was set at a p-value of .05. I LT"pvwyf|Fdgs_vN 6iJ_;w"\|ik KRwS(pD!r Beds bug isolation precautions at our institution involve putting a patient in a single occupancy room with the door closed, the patients clothing and belongings closed inside two plastic bags, a bed sheet placed across the bottom doorway to hopefully prevent bed bugs from leaving the room, and the patient being placed on contact precautions. Most people develop an itchy rash after being fed upon by a bed bug, and bed bugs can be associated with human anxiety [1,9,11]. Persons with bed bugs were more likely compared to those without bed bugs to be older (52 vs. 41 years) and arrive by ambulance (57% vs. 14%) (p < 0.05), but not reporting insomnia (50% vs. 49%) (p = 1.0).