Bed bugs used to make headlines all the time. After the craze slowed down, many people assumed the problem vanished.

But these pesky insects made a comeback. Don’t ignore seeing these creepy crawlies around a patient’s home, on their clothing or on the cot inside the ambulance. Especially when it comes to cleaning an ambulance after bed bugs.

Signs bed bugs are nearby

Researchers believe it correlates to more global travel, insecticide resistance and moving infested items from one place to another, according to University of California Agriculture and Natural Resources department. Look for bed bugs in hard-to-reach crevices, mattresses and tight seams of furniture.

Dini M. Miller, PhD, urban pest management specialist with Virginia Tech’s Department of Entomology, said bed bugs commonly dwell in urban areas with high housing density, such as apartments and assisted living facilities.

“Elderly disabled are the biggest population prone to bed bugs, and they are also the biggest group who is transported in an ambulance,” Moore said.

Rooting out the bed bug problem starts with prevention, said Dan Jarrett, EMS Deputy Chief with Daisy Mountain Fire District in Phoenix.

“If we are aware of bed bugs, the crews would send one or two members to the apparatus, we have disposable gowns, a full-body apron and a mask, which adds another barrier of protection, so bugs can’t attach onto the apron,” he said.

But unless the crew sees an infestation, the EMS team likely will be unaware a bed bug problem exists. These pests leave little evidence at the scene.

“A lot of times we won’t know that we’ve brought patients to the hospital until they call to tell us the patient had bed bugs on them,” he said.

Moore said bed bugs tend to be more active at night, which is one reason why they are easy to miss.

Jarrett’s crew also uses a “hard Pelican box” for equipment and supplies. But if your bag is made from soft material, such as nylon, he suggests placing it inside a trash bag. But, you should never place it directly on the floor while at the patient’s home.

The typical lifespan of a bed bug ranges from 4 to 6 months. They can,  however, survive up to a year without food, which makes them difficult to eradicate. Some live up to 400 days without food, according to the University of California.

Cleaning an ambulance after bed bugs

After a bed bug alert, it’s time to decontaminate the ambulance and inside the fire house. Jarrett said his team removes clothing from the firehouse, such as uniforms worn during the incident. Additionally, they change all the bed sheets inside the firehouse.

Active firefighter, EMT and Attorney Scott Moore of the American Ambulance Association offered a few suggestions.

  • First, remove equipment and medications from the ambulance, Moore said. You can place equipment in a deep freezer for four days to kill bugs. With medications, he said to read the FDA labels, since freezing temps can destroy medications and solutions.
  • Another option is to heat up any exposed equipment for an hour at 122 degrees Fahrenheit, Moore said. Always check if sensitive equipment can handle the heat, though.
  • After wiping down gurneys and removing cots’ linens, heating up the ambulance is the best way to kill the bugs. Thermal heaters can be purchased for ambulances but they can be expensive, he said.
  • Finally, contact local health departments or aging councils. “Ask them if there are any emerging trends they are seeing, or what you should keep an eye out for,” Moore said. The information can help you stay on top of any potential health concerns and be incorporated into your training programs. Sometimes local agencies provide free training.

Quick steps to take if you notice bed bugs

Use this checklist provided by Miller to ensure you fully eradicate all bed bugs.

  1. Do not take your field jacket, boots, equipment or other clothing into the station living space until they have been inspected by you or one of your teammates.

  2. Use an extra sticky lint roller (for removing cat hair, etc.) to roll over your clothing and shoes during inspection. You will see any hitching bugs stuck on the roller.

  3. If a team member finds bed bugs in their clothing, bag and seal everyone’s clothing before entering the station house.

  4. Bagged clothing, including shoes, should be placed in a clothes dryer set on high heat for 30 minutes.

  5. If a patient had bed bugs, remove the patient transport cot from the ambulance. Then make sure to wipe it down using disinfecting wipes.

  6. While wiping down the cot, inspect the mattress, straps, wheels and other components for bed bugs.

  7. Did you find one or two bed bugs on the cot? Smash them. If you find several, bag the cot in plastic sheeting and call a pest control company with bed bug expertise to treat the cot (heat chamber or chemical).

  8. If you suspect that bed bugs dropped off the patient inside the ambulance, inspect all cracks, crevices and surfaces for bed bugs. You can use any labeled insecticidal cleaning product such as Steri-Fab (isopropyl and sumithrin) on upholstered and other surfaces as a contact bug killer.

  9. A vacuum also can be used to remove bed bugs from cracks and crevices in the ambulance, but ensure the vacuum bag is sealed and taken outside to the garbage immediately after use.

  10. Sequester any items you may have taken from the patient’s home (medications, oxygen, etc.) and inspect them for bed bugs. If you find bugs, smash them.

Learn more about cleaning an ambulance after bed bugs in our Live Individual BLS L-1 course that includes at-risk populations, culture of safety, EMS hygiene and ambulance safety.