HomeMy WebLinkAboutcovid-ems-memo-3-13-20
ALAMEDA COUNTY HEALTH CARE SERVICES
AGENCY Colleen Chawla, HCSA Director
Emergency Medical Services District
1000 San Leandro Blvd, Suite 200
San Leandro, CA 94577
Lauri McFadden, EMS Director
Karl Sporer, MD, Medical Director
Main: (510) 618-2050
Fax: (510) 618-2099
MEMORANDUM
Date: March 13, 2020
To: Alameda County Fire Departments
Falck Alameda County
Alameda County Permitted Ambulance Transport Providers
Re: Update on management of possible COVID-19 patients
From: Dr. Karl Sporer, Alameda County EMS Medical Director
This memo is to provide an update for the current guidance on managing exposure risk
from COVID-19. This memo does not replace the guidance on recommended actions to
minimize exposure, including recommended PPE.
EMS personnel should exercise appropriate precautions when responding to any
patient with signs or symptoms of respiratory infection.
o If possible, initial assessment should occur from a distance of at least six
(6) feet from the patient
o Place a surgical mask on the patient to contain droplets
o Involve the fewest EMS personnel required to minimize possible exposures
o EMS personnel who will directly care for a patient, or who will be in the
compartment with the patient, should follow standard, contact and airborne
precautions. Recommended PPE includes:
A single pair of disposable patient examination gloves
Disposable isolation gown.
Respiratory protection (surgical facemasks are an acceptable
alternative when N-95 or higher-level respirators are unavailable)
Eye protection (i.e., goggles or disposable face shield that fully
covers the front and sides of the face)
Respiratory aerosol-generating procedures should be minimized as
much as clinically possible. This includes nebulized medication,
CPAP, Bag Valve Mask, and advanced airways. If an advanced
airway is required, it is suggested that the IGel be used preferentially
over an endotracheal tube.
If a respiratory aerosol-generating procedure cannot be avoided,
EMS personnel treating the patient must use P-100 preferably or an
N95 filtering face piece respirators (FFRs) (commonly known as N95
respirators). The available supply of N95 FFRs and P-100s, if
limited, should be prioritized for these procedures.
During transport, restrict the number of providers in the patient
compartment to only essential personnel to minimize possible
exposures.
Family members and other contacts of patients with possible COVID-
19 should NOT ride in the transport vehicle, if possible. If riding in
the transport vehicle, they should wear a facemask.
Notify the receiving hospital of the situation and provide an
appropriate patient care report as soon as possible.