COVID Forces Us To Reinforce the Basics

As the world begins to buckle down and comes to a screeching halt thanks to the current pandemic caused by the novel coronavirus, garage doors at ambulance bays are still opening, tones are still dropping and ambulances are still racing down the roadways to the next emergency.

It’s business as usual for EMTs and paramedics. But on top of the usual calls and familiar emergencies, we are working tirelessly to also help the infected members of our communities while trying to keep ourselves and others safe.

The COVID-19 virus has forced the WHO to officially label this a pandemic. According to an interactive real-time map created by John Hopkins University, as of March 18, 2020, there have been 215,956 cases of COVID-19 worldwide reported since the start of the outbreak, 7,786 of which belong to the United States. Of that 7,786, there are 2,479 active cases, with 16 deaths in my state of New York.

This pandemic has caused national and state emergencies. Non-essential public places such as libraries, movie theaters, malls, gyms and amusement centers have been closed until further notice. Grocery stores are limiting their hours and major cities and highways are left looking like ghost towns as people are encouraged to practice social distancing and work from home if possible. Entire school districts have been shut down for weeks to come, and drive-through testing centers have been established throughout the country.

So, where does this leave EMS? Well, we are on the front lines of this pandemic, and we need to be ready and act smart. When others are asked to stay inside to help save lives, we are called to do the exact opposite. So, how do we prepare for this latest pandemic?

The simplest of things we can do is disinfect. Yes, we should be wiping down our ambulances before shift and in between patients and enforcing hygienic practices on a normal day. If that was not your style before the arrival of COVID-19, today is a great day to start that good habit.

Ensure that your bus is adequately stocked with bleach and/or 70% alcohol wipes. Any place that you or a patient has or will touch, should be wiped down. Another critical routine is a rig check. Ensure that you have adequate supplies, including enough oxygen and nonrebreather face masks. The nonrebreathers can act as a barrier to a person under investigation (PUI) while also supplying them with oxygen if needed.

Make sure you have important numbers written down somewhere handy, such as medical control, your local state department of health, and the number to the charge or triage nurse in the ED you will be transporting to. All these contacts will be crucial when transporting or treating a PUI.

Remember the first thing you learned in EMT school? BSI, scene safe! Well, you can implement that pretty ferociously now. According to the CDC, all EMS personnel are advised to wear a face mask, gloves, goggles and a gown when coming into contact with a PUI. A fitted respirator mask such as the N95 is also recommended. However, as we have seen, there is a nationwide shortage of masks for medical staff, so the CDC recommends using a surgical mask in lieu of a respirator until supplies are replenished.

Each ambulance should be properly equipped with a “high risk” pack of some sort, including those forms of PPE. If you do not have one within your grasp, reach out to your supervisors on call for further assistance.

I will leave you with this last piece of advice—use your best clinical judgement. If you suspect at all that your patient is a PUI, treat the case as if he or she is positive and follow the proper procedures. Always try to keep a safe distance—6 feet or more if possible. Limit the number of personnel who enter the PUI’s residence. Look for signs of fever and respiratory symptoms, and pay close attention to the patient’s history if available.

Most importantly, take care of yourselves. Get rest and plenty of nutrition and vitamins. We put ourselves on the line for the lives of others, but we must remember to keep ourselves safe and well so we can continue to provide emergency medical care to those who require it, especially during these times.

Stay healthy, be safe and wash those hands!

Caterina DeGaetano-Morris is a career EMT in Rockland County, N.Y. She is a mother, wife, and writer and plans to enter nursing school.