Updated: Jun 11, 2020
How do EMS agencies protect their personnel from contracting or spreading the COVID-19 virus?
1. Assess the patient for fever, difficulty breathing, dry cough, GI problems, and respiratory symptoms.
2. Ask the patient if they have had contact with someone diagnosed with or being checked for COVID-19. Updated PPE recommendations for the care of patients with known or suspected COVID-19:
Surgical masks are an acceptable alternative to N95 respirators until the supply chain is restored. Respirators should be prioritized for procedures that are likely to generate respiratory aerosols (bag valve mask, non-rebreather mask, CPAP, intubation, etc.) which would pose the highest exposure risk to health care providers.
Cover any respiratory device that is being used for treatment of the patient i.e. nebulizer, or any administration of oxygen devise i.e. nasal cannula with a simple face-mask. If patient condition allows, discontinue use of the respiratory treatment device before entering the hospital.
Eye protection, gown, and gloves continue to be recommended. If there are shortages of gowns, they should be prioritized for aerosol-generating procedures, care activities where splashes and sprays are anticipated, and high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of health care professionals.
When the supply chain is restored, fit-tested EMS clinicians should return to using respirators when treating and transporting patients with known or suspected COVID-19.
3. Place surgical face-mask on any patient that is contacted/transported.
4. Wear recommended PPE when transporting patients with possible COVID-19.
5. Family members and other contacts of patients with possible COVID-19 should not ride in the transport vehicle. Consideration may be given for a family member or guardian to go with the patient if the patient is a minor or there is a specific reason the family member or guardian needs to be with the patient in the transport vehicle. Individuals accompanying the patient should wear a face-mask.
6. On arrival to the facility/home, EMS/transport personnel should remove and discard PPE and perform hand hygiene. Used PPE should be discarded in accordance with established procedures.
7. All persons in the transport vehicle should avoid touching their face, mouth, nose and eyes.
8. Perform hand hygiene often, as well as before and after each patient contact.
9. When transporting a patient to an appointment (e.g., to dialysis or medical office), ensure patients have contact information for their primary care provider/specialist, and that they have called ahead of their appointment to report fever or respiratory symptoms so the facility can be prepared for their arrival or triage them to an appropriate setting.
10. Inform staff of any patient fever or respiratory symptoms immediately prior to arrival to the facility.
11. Use cleaning procedures appropriate for SARS-CoV-2 (the virus that causes COVID-19), along with all routine cleaning and disinfection procedures. Refer to List N on the EPA website for EPA-registered disinfectants that have qualified under EPA’s emerging viral pathogens program for use against SARS-CoV-2.
12. After transporting the patient and decontaminating the unit, leave the rear doors of the transport vehicle open to allow for enough air exchange to remove potentially infectious particles.
13. The time it takes to complete transfer of the patient to the receiving facility and completion of all documentation should provide air changes for sufficient decontamination.
14. When possible, use vehicles that have isolated driver and patient compartments that can provide separate ventilation to each area.
Close the door/window between these compartments before bringing the patient on board.
During transport, vehicle ventilation in both compartments should be on non-recirculated mode to maximize air exchanges that reduce potentially infectious particles in the vehicle.
If the vehicle has a rear exhaust fan, use it to draw air away from the cab, toward the patient-care area, and out the back end of the vehicle.
Some vehicles are equipped with a supplemental recirculating ventilation unit that passes air through HEPA filters before returning it to the vehicle. Such a unit can be used to increase the number of air exchanges per hour (ACH). See the NIOSH study.
15. If a vehicle does not have an isolated driver compartment, then ventilation should be used, open the outside air vents in the driver area and turn on the rear exhaust ventilation fans to the highest setting. This may create a negative pressure gradient in the patient area.
For more information, please view main article on the FEMA website here.