Safety update

Safety update

THE LATEST NEWS

 

The CDC has issued Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for 2019-nCoV in the United States.

 

Based on the CDC’s guidance…

 

·         If the dispatcher advises that the Wuhan coronavirus may be a concern, a crew should put on appropriate Personal Protective Equipment (PPE) before entering the scene.

·         When assessing any respiratory infection patient, a crew should be cautious, begin their assessment from at least 6 feet away, and minimize patient contact until the patient is wearing a surgical mask.  If a coronavirus is a concern, use PPE.

·         If applying both a nasal cannula and a surgical mask, put the mask over the nasal cannula.  If the patient needs oxygen by nonrebreather, the nonrebreather can take the place of a surgical mask.

·         When transporting a possible coronavirus patient, limit the number of providers in the patient compartment.

·         Appropriate PPE includes gloves, a disposable isolation gown, respiratory protection (ideally an N95 or higher mask), and front and side eye protection.

·         Rig the unit for an infectious transport before loading the patient.  Close the pass-through door and window (between the cab and the patient compartment) if possible.  Turn on the rear exhaust fan.  Allow outside air into the driver’s area.

·         Before entering the cab, drivers transporting a possible coronavirus patient should dispose of PPE (except for respiratory protection) and perform hand hygiene.  If the cab is completely isolated from the patient, the driver should also dispose of the respiratory protection while driving.

·         Avoid touching your face while working.

·         After patient turnover, dispose of PPE and wash your hands.

·         If performing aerosol-generating procedures, such as BVM ventilation, suctioning, intubation, nebulization, CPAP, or CPR, take all the above precautions; also, when possible, open the rear doors of the ambulance, activate the HVAC system, and do these things away from pedestrian traffic.

·         Keep uninfected people away.  Discourage family and friends from riding in the ambulance; if they insist, they should wear a facemask.

·         An ambulance should be thoroughly cleaned after transporting a suspected coronavirus patient.  Contact an EMS field supervisor for help.

 

For more information, please follow the link above and read the guidance.

 

WHAT WE’RE DOING

 

·         The EMS Department, the 911 center, and Dr Martin (our Operational Medical Director) have collaborated to ask additional questions when a 911 caller is describing fever, cough, and/or shortness of breath.  The additional questions are designed to determine if the caller is describing signs, symptoms, and/or risk factors for the Wuhan coronavirus.  If a 911 call is concerning for the Wuhan coronavirus, comments will be added to the case on the MDT, and the dispatcher will notify responding units about the concern by voice.

·         The EMS Department has placed orders for additional PPE.  (HOWEVER, see the CHALLENGES section below.)

·         The EMS Department has surveyed the volunteer rescue squad supply officers and issued guidance to them about how they order and stock PPE.  (HOWEVER, see the CHALLENGES section below.)

 

·         The EMS Department and the Virginia Beach Public Health Department are reviewing each other’s guidance and plans.

CHALLENGES WE ARE FACING

 

·         Surgical masks and respirators are difficult to buy right now.  Many vendors have stopped selling them on the open market, to prevent opportunistic stockpiling and price gouging.  They are taking extra steps to make sure they’re only shipping these items to bona fide healthcare organizations.  These extra steps are slowing down the procurement process.

·         Respirator fit testing is complicated in a volunteer-based system even in normal circumstances.  We are assessing ways to address this challenge.  Our first priority is to make adequate PPE available to our personnel.

 

— Division Chief Kevin Lipscomb, NRP

— Regulation & Support Services

— Va Beach EMS Department