Update

COVID EMS Response Guidehttps://qrs.ly/tdbetzc

5/18

Protocol Supplement

• Got fluids on you?• Got coughed on?• You didn’t wear a mask?• No mask on patient? ! Report to supervisor pg4

Exposure Risks

• Wear Gloves and Gown 9

• Wipe surfaces & gear 10

• Allow vehicle to air out 11

• Truck is back in service

Gear & Truck Decon• Remove PPE 8 (consider reuse)

• WASH YOUR HANDS• Scrub hard for 20 sec.• You are back in service

When to Suspect COVID 1

• Symptoms: Fever, Cough or Dyspnea 2 or (prior 24h) • Travel: any high risk area pg2 or (prior 14d) • Close Contact: w/ diagnosed COVID 3 or (prior 14d) • Dispatch: possible COVID or quarantined patient 4

COVID PPE 5

• Wear Goggles and a simple surgical Mask 6

• Use Gloves and a Gown (if available)

• Place simple surgical Mask on Patient • Conserve n95s and gowns for aerosolizing procedures 7

Personal Decon

1

1- Travel history is no longer a consideration. [a]2- Includes any symptoms of respiratory illness [b]3- By testing, or if instructed to isolate at home [l]4- Dispatch may use codes such as “red”. [a]5- COVID is likely droplet (may be airborne). [d]6- A simple surgical mask is appropriate. [d]7- Procedures such as nebs, CPAP, BVM, etc. [d]8- Decon goggles. Can reuse n95 if not soiled. [e]9- Use goggles and mask if any splash risk. [a]10- Use wipes for viral pathogens. [a]11- CDC: The time to transfer the patient andfinish your documentation is “sufficient”. [a]

1

3/31- Medical Updates coming soon3/29- Added: COVID Dashboard (pg2)3/28- Bburg has first positive case3/27- Travel Questions are now irrelevant3/26- Added: Video Tutorials (pg5)3/25- Added: Return to Work Guide (pg4)3/24- CNRV has first positive case3/22- Added: WVEMS Home Care Guide (pg5)3/21- Expanded: Resource Pages (pg6)

Release Notes• Wear Gloves and Gown 4

• Wipe surfaces & gear 4

• Allow vehicle to air out 5

Gear & Truck Decon

• Remove PPE (reuse if able) 3

• WASH YOUR HANDS• Scrub hard for 20 sec.

COVID Specific Care

Personal Decon

1. Protocol - And care guide2. At Station - And dashboard3. Tiered Dispo - Per agency4. Exposures - Return to work5. Resources - Home care guide

In This Document

4/4- PPE for All Patients; May be OK to work for 72h after exposure (pg4)4/1- Added: Care for Suspected COVID (pg1)3/31- Added: COVID Dashboard (pg2)3/27- Travel Questions are now irrelevant3/26- Added: Video Tutorials (pg5)3/25- Added: Return to Work Guide (pg4)

Release Notes

AGPs (Neb, Bi/CPAP, CPR, BVM, Intubation, Suction)• Avoid on all calls unless absolutely necessary.• Strict PPE: requires N95 (or PAPR), goggles, gown, gloves• Consider alternates: wait till ED, BIAD, video scope, etc.• Perform onscene or outside before transport if possible.• Use exhaust fan if en route. Stop AGPs before ED entry.

• Suspect COVID if any: Fever, Cough, or Dyspnea• O

2: Avoid if SpO

2 > 96% • Fever: Tylenol • Steroids: Avoid

• IVF: Avoid (if severe shock, may try 1x NS bolus, then Epi)

Care for Suspected COVID

When to Suspect COVID• Symptoms: Fever, Cough, or Dyspnea -or- (prior 24h)• Diagnosis: of COVID (by test or doctor) -or- (prior 14d)• Housemates: any symptom or diagnosis -or- (prior 14d)• Dispatch: any symptom or diagnosis of COVID

• Provider PPE: goggles, simple facemask and gloves 1

- Conserve N95s (PAPRs) & gowns (if limited) for AGPs. 2

• Patient PPE: simple facemask (place over NC / NRB)• O

2: Avoid if SpO

2 > 96% •Fever: Tylenol •Steroids: Avoid

• IVF: Avoid (if severe shock, may try 1x NS bolus, then Epi)

Use PPE for All Patients on All Calls• Every provider within 6ft. of any patient needs PPE. - Use simple facemask, eye protection and gloves. 1

- Limit number of providers to the minimum necessary. - Conserve N95s (PAPRs) & gowns (if limited) for AGPs. 2

• Place simple facemask on all patients. (over any NC/NRB)

4/4- PPE for All Patients (All calls); OK to keep working for 72h (pg4)4/1- Added: Care for Suspected COVID (pg1)3/31- Added: COVID Dashboard (pg2)3/27- Travel Questions are now irrelevant3/26- Added: Video Tutorials (pg5)3/25- Added: Return to Work Guide (pg4)3/22- Added: WVEMS Home Care Guide (pg5)

Release Notes

Providers: Start HereBefore Each Shift

• Affirmation• Take temperature• Record temperature

ON ALL CALLS:• Wear Appropriate PPE• Follow the SCOUT Model• Decon after each call

Remove PPEWash Your HandsWipe Down GearAir Out Vehicle

Decon After Calls• Use appropriate PPE for decon. • Use clean gloves with viral wipes. 4

• Leave vehicle doors open. 5

• I am using the most up to date version of this guide.- The link and QR always provide the latest update.

• I have been monitoring my own health at home.

• I do not have any of the following:-Fever, Cough, Dyspnea, or Sore Throat 1 (prior 24h)-Diagnosis of COVID (by test or physician) (prior 14d)-Housemates with symptoms or diagnosis (prior 14d)

• In the event any of these change during my shift I will:- Don a mask, wash my hands, and isolate myself- Notify my supervisor immediately

By reporting for duty, I affirm that:

Scout p2 Med Care p3 Exposures p4 Resources p5

• PPE is required for all patients.2

• Any Provider within 6ft needs PPE.3

•Put patient mask over any NC/NRB.

GlovesSurgical Facemask

Eye ProtectionMask on Patient

Wear COVID PPE

1- Occasional chronic clearing of the throat (like seasonal allergies) is normal and healthy. [h]2- PPE is now required for all patients and any provider that will come within 6ft. of the patient. [a]3- Limit the number of exposed providers to the minimum necessary. 4- Follow directions for viral pathogen wipes. If any splash risk, wear gown, eye pro and mask. [a]5- CDC: The time to transfer the patient and finish your documentation is “sufficient”. [a]

Update

COVID EMS Response Guidehttps://qrs.ly/tdbetzc

5/18

2

2

• Remove PPE (reuse if able) 3

• WASH YOUR HANDS• Scrub hard for 20 sec.

Cloth Face 2 Cover Surgical 3 Facemask N95 4 Respirator

2- Homemade masks or scarves or tissues held over the nose and mouth.3- Certified “FDA surgical” facemask.4- N95 prefered, but any NIOSH (N, R or P) filtering facepiece respirator at any level (95,99 or 100)

cloth mask:https://twin-cities.umn.edu/sites/twin-cities.umn.edu/files/mask-front.jpgfacemask:https://upload.wikimedia.org/wikipedia/commons/thumb/1/1e/A_surgical_mask_%282017%29.jpg/1280px-A_surgical_mask_%282017%29.jpgN95:https://upload.wikimedia.org/wikipedia/commons/b/b1/3M_N95_Particulate_Respirator.JPG

Scout Model

• Face: Extend use of Surgical Facemask to entire shift.- Wear up to 8h. Replace with new when removed.

• Eyes: Reuse medical face shield, decon if soiled.• Gown: Reuse clean isolation gowns, wash after each use.

• Face: Reuse Surgical Facemask. Don/doff up to 5 times.- Record name and # of uses and store in paper bag.- Give Cloth Face Covers to patients who are low risk.

• Eyes: Use wrap-around safety glasses, decon if soiled.• Gown: Reuse non-soiled isolation gowns, wash as able.

• Utilize providers recovered from COVID or with low risks.• Use Cloth Face Cover. Wash clothes and shower as able.

None Remain - Significant Risk to Provider

Crisis - Non-Standard Care, Some Risk to Provider

Contingency - Modified Care, Minimal Impact

First Responder Self-Monitoring:• Face: Reuse Surgical Facemask for up to 5 shifts.- Store in paper bag. Write name and # of uses on bag.

• Eyes: Use wrap-around safety glasses, decon if soiled• Gown: Reuse isolation gowns and wash as able

Conventional - Standard Care, No Impact

• Face: Use Cloth Face Cover and wash as able• Eyes: Use any available eyewear, clean if soiled• Gown: Wear long sleeves and pants and wash as able

• Calculate daily PPE burn rates. Anticipate escalation.• Response may be different for various types of PPE.

- Ex. Gloves may be normal, while masks are at crisis.• Train providers in modified procedures if reusing PPE.• CDC: “... begin using PPE contingency strategies now.”

Anticipate Your Daily PPE Burn Rate

add drug box stuff?

****************conventional capacity:"providing patient care without any change in daily contemporary practices"

-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/eye-protection.html-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/isolation-gowns.html

-standard PPE supply (plenty on hand, no need to calculate burn rate)-calculate burn anyway: give away whatever you can to help other agencies

"Current U.S. guidelines do not require use of gowns that conform to any standards."-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/isolation-gowns.html

"Disposable filtering facepiece respirators (FFRs) are not approved for routine decontamination and reuse as standard of care. However, FFR decontamination and reuse may need to be considered as a crisis capacity strategy to ensure continued availability"-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/decontamination-reuse-respirators.html

*************contingency capacity"may change daily standard practices but may not have any significant impact on the care delivered"

-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/eye-protection.html-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/isolation-gowns.html-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html

-save real PPE for responders only-provide cloth face coverings to asymptomatic non-responders-cloth face coverings for people not in public

-calculate PPE burn rate. prepare for crisis capacity-extend PPE beyond single contact

eyepro: implement "extended use" - "repeated close contact encounters with several different patients"

-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/eye-protection.html-don't touch it, clean it if it gets dirty

isolation gowns: use reusable "polyester or polyester-cotton fabrics" and wash themuse expired or non-certified gowns or coveralls-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/isolation-gowns.html

"FDA surgical" facemasks-"wearing the same facemask for repeated close contact encounters with several different patients without removing the facemask"-don't touch it, discard if it gets dirty

N95: save for AGPs. limit # of providers. stash for decon after any AGP.-if no AGP, can reuse up to 5 times.-https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

********************crisis capacity:"not commensurate with U.S. standards of care"

-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/eye-protection.html-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/isolation-gowns.html-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html

-use PPE that is expired-if no PPE: use type that is not medical-save respirators/gowns for AGPs

eyepro: use safety glasses instead of faceshield or goggles

isolation gowns: extend/reuse gowns

facemasks: using the same facemask by one HCP for multiple encounters with different patients but removing it after each encounter

N95: save for AGPs. limit # of providers. use a pre-sterilized one, stash for decon after any AGP.-if no AGP, can reuse up to 5 times.-https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

********************nothing left:

eyepro: use anything over the eyesisolation gowns: use non-gowns (clothes)facemasks/N95: use cloth face coverings

"All U.S. healthcare facilities should begin using PPE contingency strategies now"-https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html

Only Essential Personnel in the Hot ZoneConsider: public, BC’s, PD, etc. Move civilians and public outside of hot zone with a mask for interview

Standard PPE• Gloves• Surgical Face Mask• Eye Protection

Standard PPE• Gloves• Surgical Face Mask• Eye Protection

Fire Rescue personnel able to maintain 6 foot distance from patient / citizen and facility is NOT a high risk facility (nursing home, jail, etc.)

No PPE is Necessary

Fire Rescue personnel NOT able to maintain 6 foot distance from patient / citizen

ORentrance into high risk facility (residential

facility, nursing home, jail, etc.) must be made

Scout (1 person) dons standard PPE and makes contact with patient - or - investigates the situation.• If EMS - Provide mask to patient and administer COVID-19 Screening.• Maintain communication with other crew members

Assess patient / situation and communicate to other personnel need for additional personnel required PPE level

SickNot Sick NON EMS

• Determine resource needs from crew members.•Use minimum number of providers to treat and move patient•Enhanced PPE for aerosolizing procedures•Move to open air environment for treatment, when possible•Follow ambulance preparation guidelines for transport

Mitigate situation as necessary

• Obtain initial vital signs• If COVID patient, consider remain at home guideline• If Non-COVID Patient, continue with normal patient care guidelines

DECONTAMINATE ALL EQUIPMENT USED ON INCIDENT OR TAKEN INTO HIGH RISK FACILITY

Update

COVID EMS Response Guidehttps://qrs.ly/tdbetzc

5/18

• Not felt like a Fever• No temperature ≥100.0°F• No Cough 3

• No Trouble Breathing• No Sore Throat

• The CDC advises that risk from travel history is “primarily intended for jurisdictions not experiencing sustained community transmission.”• Per VDH: Virginia is experiencing sustained community transmission; therefore, travel history is now irrelevant.

• I am using the most up to date version of this guide.- The link and QR always provide the latest update.

• I have been self-monitoring my own health at home. 1

• I satisfy all of the criteria listed here. 2

• In the event any of these change during my shift I will:- Put a mask on, wash my hands, and isolate myself- Notify my supervisor immediately

In the prior 24h

Virginia itself is now a High Risk Area 4

By reporting for duty, I affirm that:

1- Consider calling Medical Control for advice if the patient is stable and has only one risk factor. 2- N95 or better (like PAPR etc) required, eye pro also appropriate, impervious gown preferred. [a]3- Coordinate with ED staff if you must continue (ex: CPR/BVM). They may need to clear the hall.

In the prior 14d• Not diagnosed w/ COVID 4

• No housemates w/ COVIDsymptoms or diagnosis

• No medium or high riskexposures to COVID 4

Medical Care

In the prior 14d• No travel to high risk area• No med/high exposures 3

• Not diagnosed w/ COVID 4

• No household membersdiagnosed w/ COVID

1- This is “Self-Monitoring with Delegated Supervision” per the CDC. (And yes, CDC says 100.0°F.) [i]2- Isolated chronic and/or occasional clearing of the throat (like seasonal allergies) is not concerning. [h]3- Return to work after a medium or high risk exposure may require testing of the source patient. [i]4- Return to work after COVID is complex. You may require negative testing. Refer to page 4. [j]5- Includes states w/ 500+ cases (or widespread transmission) & countries w/ a Level 3 notice. [f,g]

3

3

• USA: Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Louisiana, Maryland, Massachusetts, Michigan, New Jersey, New York, NORTH CAROLINA, OHIO, Oklahoma, OREGON, Pennsylvania, Tennessee, TEXAS, RHODE ISLAND, UTAH, Washington, WISCONSIN - 3/26• World: Australia, Brazil, Canada, Chile, China, Ecuador, India, Indonesia, Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland, Monaco, San Marino, Vatican City, Iran, Ireland, Israel, Japan, Malaysia, Pakistan, Philippines, Qatar, Romania, RUSSIA, Saudi Arabia, Singapore, South Africa, South Korea, Thailand, Turkey, England, Scotland, Wales, And Northern Ireland - 3/25• Boat: Any travel on a Cruise Ship or River Boat

High Risk Areas 5 (new BOLD, recent CAPS)

Virginia itself is a High Risk Area

COVID Dashboard

1,082k -4/4

2.4k -4/4

278k -4/4

5

5

Cases3,333

Hospitalizations Deaths

563 63Updated4/7/2020

For Thomas Jefferson Health District:Lab confirmed & clinically diagnosed cases: 95 (+5)- 20 in Charlottesville- 46 in Albemarle County- 9 in Fluvanna County- 2 in Nelson- 14 in Louisa County- 4 in Greene County

Personnel Exposed Departments Reporting

107 42

Total in Quarantine Personnel Diagnosed

145 0

• Age > 60 • Pregnant• Diabetes • Heart Disease• Lung or Kidney Disease• Immunosuppressed

History Risks• Pulse > 110 • SpO2 < 95%• Resps > 22 • SBP < 100mmHg

• Temp > 100• Acute Altered LOC

Exam Risks

Care for Symptomatic COVID• Suspect COVID if any: Fever, Cough, Dyspnea, or GI1 • Oxygen administration: Facemask over any NC/NRBCOVID-19 Self Care Guidelines (Must meet all conditions)

• Pt must be A&O • BP 100 - 180 Systolic• No respiratory distress •HR 50 - 120 bpm• SPO2 < 92% room air • Age > 65• Resp Rate < 10 > 25 without accessory muscle usage• Oral fluid intake without vomiting• No other complaints beyond general illness/flu-like• No high-risk medical conditions including pregnancy • No chronic medical conditions: Heart, lung disease, liver, neurologic, metabolic disorders, current cancer patient (in treatment or not), dialysis or recent transplant

Aerosol Generating Procedures (AGPs)• Includes: Nebs, Bi/CPAP, CPR, BVM, Intubation, Suction- Avoids APGs on all calls unless absolutely necessary

• Consider alternatives: Wait until ED, BIAD, Video Scope, etc. • If AGP is needed, anyone within 6ft must wear PPE:- N95 respirator, face shield/eye pro, isolation gown

gloves.2 • Perform at scene or outside before transport if possible.• Use exhaust fan if en route. Stop AGPs before ED entry.3

Update

COVID EMS Response Guidehttps://qrs.ly/tdbetzc

5/18

Early w/ Test: OR Early No Test:- No fever x24h & - No fever x72h &

- 2x neg. tests & - 7d from start &- Symptoms better - Symptoms better• Requires PCP & DICO approval 5

4

Exposures

1- Cough only applies if the subject had NO mask on. The subject coughing inside their mask is OK.2- Risk from NO mask only applies to “prolonged close contact”. Brief contact with no mask is low risk. [i]3- Scrub any exposed skin and launder any clothes that are obviously soiled with fluids. [k]4- May continue work (with facemask) for up to 72h while waiting for source test. Isolate if pos. [i]5- Wear a mask at work x14d from start of symptoms. [j]

Return to work after having COVID

Provider:Fluids or

Coughed on 1Patient:

NO Mask 2Patient:

Mask ASAP

NO Mask 2 Med/HighTest Source

Med/HighTest Source

Low/Med/HighCall Dico

Mask butNO Goggles

Med/HighTest Source

Med/HighTest Source

Low:Decon

Mask & Goggles

Low: Shower& Change

Low:Decon

Low:Decon

Exposure Risks

• If there is any doubt about a potential exposure: - Don a mask, wash your hands, and isolate yourself.• Evaluate simple exposures using this guide & FAQ.• Contact your supervisor. If any further questions:

- Contact Designated Infection Control Officer (DICO)

First Steps

• Decon: Shower & Change 3

• Known COVID: Isolate 14d

• Maybe COVID: Test Source -Can complete shift

Med / High Risk? Test Source Patient• DICO: Rapid Test Source 4

- Negative: Return to duty - Positive: Isolate 14d

• Quarantine until results

4

Standard Return:- No fever x72h &- 14d from start &- Symptoms gone• No Restrictions

• Decon: Shower & Change 3

• Inform DICO, Test Source.• Go home & self-monitor. - Minimal risk to others 4

Med / High Risk? Self - Monitoring• Everything is likely OK. 4

• No work x14d or pt neg.• If any fever, cough, etc: - Call PCP & DICO

Update

COVID EMS Response Guidehttps://qrs.ly/tdbetzc

5/18

5

Resources

• This document• https://qrs.ly/tdbetzc

EMS Response Guide

1- Cases from 1700 yesterday (by home address). 1st cases: ROA- 3/19, NRV- 3/24, Bburg- 3/27

5

• YouTube series about the LEO / Fire Guide.• https://bit.ly/COVID911videos

LEO / Fire Video Tutorials

• Similar response guide, but for Fire.• https://qrs.ly/2ebetzl

LEO & Fire Response Guide

• YouTube series about these EMS guidelines.• https://bit.ly/COVIDEMSvideos

COVID EMS Video Tutorials

• EMS Protocol for Outbreak Response• https://bit.ly/WVEMSCOVID

WVEMS COVID Protocol

• Information to leave with non-transport pts.2

• https://qrs.ly/g1betyq

Self Care GuidelinesCOVID in VA

• Map and stats now included in dashboard on Page 2.

1- Updated from http://www.vdh.virginia.gov/coronavirus/ 4/21/2020 17:052- Consider printing several before shift to hand out on appropriate calls. Try printing double sided.

COVID in VA 1

https://www.vdh.virginia.gov/coronavirus/

CDC PPE Procedure• CDC recommended PPE don/doff procedure•www.cdc.gov/hai/pdfs/ppe/PPE-Sequence.pdf

Data no longer reported by VDH 3,77530,388 1,009

Update

COVID EMS Response Guidehttps://qrs.ly/tdbetzc

5/18

Updated 4/21 22:11

a- [3/10/20] https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-for-ems.htmlb- [3/24/20] https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-criteria.htmlc- [3/30/20] https://www.cdc.gov/coronavirus/2019-ncov/php/risk-assessment.htmld- [4/1/20] https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.htmle- [3/27/20] https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.htmlf- [4/4/20] http://www.vdh.virginia.gov/coronavirus/g- [4/4/20] https://www.ecdc.europa.eu/en/geographical-distribution-2019-ncov-casesh- [6/21/19] https://www.mayoclinic.org/symptoms/cough/basics/definition/sym-20050846i- [3/7/20] https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.htmlj- [3/16/20] https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/hcp-return-work.htmlk- [3/2/20] https://www.cdc.gov/coronavirus/2019-ncov/community/first-responders.htmll- [3/30/20] https://www.cdc.gov/coronavirus/2019-ncov/php/public-health-recommendations.html

Copyright 2020 by: Drs. B. Ekey, A. LePera & E. Stanley, BVRS OMDs: blacksburgrescue.orgAttribution-ShareAlike 4.0 (CC BY-SA 4.0) https://creativecommons.org/licenses/by-sa/4.0/

First Responder Self-Monitoring:

6

Q: What is this document? These are the most current CDC guidelines adapted for EMS Responders who will physically interact with potential COVID patients. They are streamlined for daily use. [k]

Q: Where can I find more help? Check out the YouTube video tutorial series linked on the resources page. https://bit.ly/COVIDEMSvideos

Q: Is this the most current information? If you are reading this directly from the internet, then yes. But if this is a paper copy, you should check the link above for the most current version. COVID is a rapidly evolving situation and this document updates very frequently. https://qrs.ly/tdbetzc

Q: What counts as a fever? It can be subjective or objective. It is not necessary to take a temp. [i]

Q: What counts as a cough? Any sudden increase in cough strength, frequency and/or production (like a cold or the flu). Isolated chronic and/or occasional clearing of the throat (like seasonal allergies) is not concerning. [h]

Q: Do I really need a mask? Yes. This is the absolute minimum. Do not come within six feet of a potential COVID patient without at least a simple facemask. Also place a mask on the patient as soon as possible. [d]

Q: Is it mandatory to wear a fitted mask (n95), goggles and a gown? Mostly. The CDC suggests you use these if available. A simple facemask is appropriate if an n95 is not available (or if you are not fit tested). Goggles are important, especially if the patient cannot (or will not) wear a mask. [d]

Q: Will hand washing really help? Yes. More than any other recommendation, hand washing is the easiest and most effective way to control transmission. [d]

Q: Should I get tested for COVID? Usually no. Even if you are exposed, it is much better to test the patient suspected of COVID than it is to test the first responder. [i]

More Info & FAQs6

Q: Is my uniform contaminated? No. CDC decon for first responders concentrates on hard surfaces. But make sure to wipe down any contaminated gear such as your radio. Clean and/or launder any fabrics (pants, jacket, etc.) that are obviously contaminated with body fluids. [a]

Q: Is my truck contaminated? No. CDC decon for vehicles concentrates on allowing clean air to circulate and wiping down all hard surfaces. Specifically: “The time to complete transfer of the patient to the receiving facility and complete all documentation should provide sufficient air changes.” Clean and/or disinfect any fabrics (seatbelts, etc.) that are obviously contaminated with body fluids. [a]

Q: Is my family at risk? No. CDC does not recommend any special management for people exposed to asymptomatic people with potential exposures (ie. contacts of contacts). [c]

Q: What counts as a med/high risk exposure? When can I come back to work? Ask your supervisor or Designated Infection Control Officer (DICO). [j]

Q: Where do the case numbers come from? The VDH is the most accurate source for case numbers for the state of Virginia. Data for the USA/World has several potential sources. The ECDC records data slightly faster than the CDC/WHO, and publishes the most up to date numbers every morning at 0500 EST. The ECDC numbers are slightly higher because they are more current than CDC/WHO reports. [f,g]

Q: Can I share this document? Yes! These pages (and attachments) are published to be freely available to any first responder that may find them useful.