This is a quick hit on topics related to transporting patients who are concerning for Communicable Respiratory Illness (CRI).
(Keep in mind, stable CRI patients with no serious underlying conditions may be better served staying home and keeping in touch with their primary care providers and public health officials. Contact medical control for specific guidance.)
WHEN TRANSPORTING A CRI PATIENT…
- MINIMIZE EXPOSURES
Taking advantage of a teachable moment is not the priority when transporting these patients. “Thirds” (students and interns) should be detached from the ambulance and driven to the hospital in a different vehicle to re-connect with their crewmates. The reunion should take place after the patient has been turned over, and after the ambulance has been cleaned.
- RIG THE AMBULANCE FOR TRANSPORT
You can reduce the odds of person-to-person transmission by doing some things to the patient (putting a surgical mask or sealed non-rebreather on them), doing some things to yourself (using PPE), and doing some things to the ambulance per CDC guidance:
This graphic is attached to this email as a PNG file in case anyone wants to make a job aid out of it.
- AVOID CONTAMINATING THE EMERGENCY DEPARTMENT AND ITS OCCUPANTS
When bringing in a patient with coronavirus-like illness, medical control will advise when, where, and how to enter the emergency department.
A FINAL NOTE APPLICABLE TO ALL TRANSPORTS:
You may see emergency department personnel using “clean-in/clean-out” procedures to prevent cross-contamination and unnecessary exposure. These procedures involve applying fresh PPE just before entering a patient’s room, and disposing of that PPE and washing up just before leaving the patient’s room. This doesn’t exactly work for EMS since we perform our “clean-in” steps when we arrive on scene, and our “clean-out” steps after we clean up our stretcher, monitor, etc.
But we do need to respect the hospital staff’s goal of minimizing contamination and exposure. I didn’t communicate this very well yesterday. I probably should’ve phrased the advice this way:
Upon entering the emergency department with any patient:
— Division Chief Kevin Lipscomb, NRP
— Regulation & Support Services
— Va Beach EMS Department
— “EMS Chief 7” (ECH07)
Older posts: https://www.vbems.com/author/klipscomb/