EMS Response to the Coronavirus outbreak

RocketMedic

Californian, Lost in Texas
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1580619498374.gif
 

DesertMedic66

Forum Troll
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We have the 200 people who were already flown out of China in our county. 24/7 staffing with supervisors, ALS transport units, county EMS agency, and county public health.
 

Jim37F

Forum Deputy Chief
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We have the 200 people who were already flown out of China in our county. 24/7 staffing with supervisors, ALS transport units, county EMS agency, and county public health.
Aren't they quarantined at March Air Reserve Base?
 

DesertMedic66

Forum Troll
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Aren't they quarantined at March Air Reserve Base?
Yes. At first it was a voluntary quarantine however one of them attempted to leave the base which changed things to a mandatory 14 day quarantine. We have everyone on site just as a precaution. Should anyone need transport for further evaluation/treatment that is where the ALS units come in and there is also already an accepting ED for the patients.
 

Peak

ED/Prehospital Registered Nurse
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The current iso precautions are far less severe for coronavirus than Ebola.

Basically what we have been trained on at this point is airborne plus splash.
 

RedBlanketRunner

Opheophagus Hannah Cuddler
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The heck with inventing a nCoV vaccine. Would somebody please create an anti BS spray? Mitigating contagion is a stroll in the park right now, sitting next to ground zero, compared to the profiteering, conspiracy theories and misinformation getting blown far and wide.
On another forum I attempted to explain risk factors from the Risk Mitigation of Communicable Diseases in Clinical Environments manual. Does the phrase 'pissing up a rope' ring any bells?
 

Bullets

Forum Knucklehead
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Update our staff on proper donning and doffing of PPE. Inventoried our supply of such, ordered a couple more bunny suits and case of gowns. Also we just replaced all our P100 cans for our APRs like a week before the first reports, so at least we have that and everyone just got fit tested on their APRs and N95s
 
OP
RocketMedic

RocketMedic

Californian, Lost in Texas
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Seeing as how the vast majority of our disposable and semi-disposable PPE comes from Chinese manufacturers, how much is enough and where can we get more?
 

VFlutter

Flight Nurse
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The only N95 our company has available to purchase are the cheapest ones you can find. I have my own that I will use if I ever have an actual concern.
 

Summit

Critical Crazy
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Having it fit tested is key. Otherwise it is just a fancy droplet mask.
 

ThadeusJ

Forum Lieutenant
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China manufactures a significant percentage of disposable medical devices and the quality is certainly there if you go to the right facility. That being said, any company who puts their name on it and sells it still must perform their due diligence in quality control. There are delays in shipments at the manufacturing plants as well as the shipping ports. Part of the reason is the extended New Year season and the delays in sparking up the plants again.

Also, an approach adopted in Canada as a result of the 2003 SARS outbreak (where 72% of the cases were hospital acquired) was to administer oxygen through masks that had expiratory filters in their design. The CDC/WHO promotes surgical masks on patients and filters on BVMs and vents, but doesn't speak to oxygen delivery masks or CPAP/Bilevel administration. Just another line of defense in the containment that is rarely mentioned. There are a few brands available.
 

Summit

Critical Crazy
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China manufactures a significant percentage of disposable medical devices and the quality is certainly there if you go to the right facility. That being said, any company who puts their name on it and sells it still must perform their due diligence in quality control. There are delays in shipments at the manufacturing plants as well as the shipping ports. Part of the reason is the extended New Year season and the delays in sparking up the plants again.

Also, an approach adopted in Canada as a result of the 2003 SARS outbreak (where 72% of the cases were hospital acquired) was to administer oxygen through masks that had expiratory filters in their design. The CDC/WHO promotes surgical masks on patients and filters on BVMs and vents, but doesn't speak to oxygen delivery masks or CPAP/Bilevel administration. Just another line of defense in the containment that is rarely mentioned. There are a few brands available.
With negative pressure rooms, you eliminate patient to patient airborne spread, so no need for filters on the patient mask. Hcw are protected by their n95/papr
 
OP
RocketMedic

RocketMedic

Californian, Lost in Texas
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With negative pressure rooms, you eliminate patient to patient airborne spread, so no need for filters on the patient mask. Hcw are protected by their n95/papr
Except that pandemics overwhelm the handful of negative-pressure rooms available.
 

Summit

Critical Crazy
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Except that pandemics overwhelm the handful of negative-pressure rooms available.
Yes. They'll definitely overwhelm disposable filtered masks.

But sonE tricks of ventilation engineering and I can make extra neg rooms or make an entire ward neg.
 

ThadeusJ

Forum Lieutenant
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With negative pressure rooms, you eliminate patient to patient airborne spread, so no need for filters on the patient mask. Hcw are protected by their n95/papr
The masks that are being used in Canada are as a line of defense in the pre-hospital setting up to and including the care and transport of patients prior to isolation facilities. Its upon first contact when oxygen therapy is being applied. That's the problem with common respiratory etiquette protocols; They are designed for locations with unlimited resources. Many services don't even carry filters to be placed on the BVM's once the patient is intubated.
 

FiremanMike

EMS Coordinator
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Read in a narrative this week during QI.. "patient traveled from XXX (nowhere near China), didn't perform XXX treatment due to possible coronavirus".

QI - so.. did you notify anyone of a possible coronavirus exposure? (no).. did you use your PPE? (no).. Did you come back and decon the truck? (no).. "well honestly we didn't really think it was coronavirus, but there was the possibility"..

Ok, well please don't write coronavirus in the narrative and not go full measures..

smh
 
OP
RocketMedic

RocketMedic

Californian, Lost in Texas
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Read in a narrative this week during QI.. "patient traveled from XXX (nowhere near China), didn't perform XXX treatment due to possible coronavirus".

QI - so.. did you notify anyone of a possible coronavirus exposure? (no).. did you use your PPE? (no).. Did you come back and decon the truck? (no).. "well honestly we didn't really think it was coronavirus, but there was the possibility"..

Ok, well please don't write coronavirus in the narrative and not go full measures..

smh
thats how we get directives that disregard coronavorus, then get infected by same
 

FiremanMike

EMS Coordinator
648
317
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thats how we get directives that disregard coronavorus, then get infected by same
There‘s a relevant backstory with this provider that he tends to put every thought that runs through his mind into the narrative that he doesn’t really actually feel are true, and then leaves those statements unqualified..

I didn’t tell him to stop his due diligence in patient assessment and history, I told him to not document CoronaVirus on a run that he failed to do anything related to CoronaVirus (especially notifications).

”it’s possible”.. sure.. it’s possible that literally everyone with flu like symptoms has CoronaVirus, but we shouldn’t start writing “r/o CoronaVirus“ into the narrative of every patient with the sniffles.
 

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