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I think that it is important to communicate the two main objectives of EMS and first responders during this pandemic. |
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The first priority is for providers to protect themselves by following their protocols and using their PPE correctly. The second and equally important priority is to decrease the rate of transmission so that our communities can care for the large number of patients over time instead of all at once. I feel confident that EMS and first responders are in a strong position to help our communities weather this pandemic, save lives and do it safely.
Protect Yourself
Use your PPE as instructed in your protocols. If providers follow recommended screening of patients and use PPE as instructed, they will be safe. Everyone should be trained on correct donning and doffing. We know that people who work in public safety want to help people and do their jobs. It is still important for them to remember that if a provider feels sick, they should not go to work. They should inform their supervisor and take care of themselves. If we don’t take care of ourselves, we cannot take care of others. Perhaps even more importantly we do not want to spread disease.
Also, be sure everyone in your agency understands the North Carolina SC2 High Consequences Pathogens Protocol.
Providers are also encouraged to refer to the CDC website which addresses EMS workers and first responders.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-for-ems.html
Decrease the Rate of Transmission
Our second objective is to slow the rate of transmission as much as possible. Most patients do not get very sick with COVID-19. If we can slow the rate of transmission over a prolonged period, then the healthcare system can care for that number of patients. If we cannot slow the rate of transmission then our healthcare system will be confronted with a huge bolus of patients over a short period of time. Our job is to help slow the rate of transmission and avoid the huge surge of patients.
Summary of Key Changes for the EMS Guidance
Updated PPE recommendations for the care of patients with known or suspected COVID-19:
— Facemasks are an acceptable alternative until the supply chain is restored. Respirators should be prioritized for procedures that are likely to generate respiratory aerosols, which would pose the highest exposure risk to HCP.
— 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 HCP.
— When the supply chain is restored, fit-tested EMS clinicians should return to use of respirators for patients with known or suspected COVID-19. Updated guidance about recommended EPA-registered disinfectants to include reference to a list now posted on the EPA website.
Information from the CDC pertaining to Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States.
We can help accomplish this by appropriately screening patients, using PPE correctly, and assisting public health with slowing community transmission of disease. Our role is critically important. Each agency should work with their local health department to determine if there are ways that they can assist with screening, contact tracing, and other infection control measures. EMS and other first responders serve a critical role in protecting our communities so that they can better weather this pandemic.
James Winslow
04/14/2020 – 
