Thread by @gueromedico

THREAD
If I ran an #EMS Agency during #COVID19 I would:
1/x Talk to the staff, ask what their questions are and disseminate updates frequently.
The info is very dynamic, and there can be huge gaps between what’s disseminated to inhospital staff and prehospital staff.

2/x Ensure staff understand when to utilize PPE and how to don/doff it safely. We get in and out of the vehicle, from the pt compartment to the cab to drive and back again to bring the pt into the hospital. Do dry runs, this is clunky and exposure risk is highest during doffing.

3/x. Review and revise all protocols involving NIPPV, Nebs and BVMs.
Ensure that staff have the equipment to do those interventions safely or they know not to do them at all.

4/x Provide thermometers to every employee. Exposure is inevitable, twice daily temp monitoring will be necessary for virtually every EMS provider at some point. Make sure there are no barriers to home health monitoring.

5/x Ensure there is a robust follow up mechanism in place with your area hospitals for any transported patient who is found to be COVID positive. The transporting crew should be notified and appropriate monitoring commenced.

6/x Establish dedicated COVID ambulances with the minimum necessary equipment that can be easily and rapidly decontaminated between transports.

7/x Pay them a fair wage. Walking into strangers homes during a pandemic should pay well enough you don’t have to do it 80hrs a week to make ends meet.

8/x #EMS workers are at the highest risk of exposure of just about any health profession. They are often overlooked, but for their safety and to prevent iatrogenic spread of this virus they need a seat at the table during this pandemic.

8/x These are the things I’ve been thinking about as I sit in the back of a New York City ambulance in full PPE this week.

9/x What did I miss? What are other best practices for #EMS in the age of COVID?

#FOAMed #FOAMems #COVID19

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