We are currently experiencing an event that many of us as company officers likely never imagined we would face – or thought we needed to prepare for.
Whether you’re in a big metropolitan fire department or a small rural volunteer department, if you are providing EMS or first responder-type services, you need to learn as much as you practically can about the COVID-19 pandemic in the shortest amount of time as possible. It is, after all, your responsibility to protect yourself and your members en route, on scene and after the response. You accepted the position of a company officer; now it’s time to truly and effectively act the part.
As a company officer or EMS provider, you need to be ready to protect your members, even if your department is not ready or hasn’t revised its response protocol. The best way to do this is to simply limit your exposure as much as possible. With this in mind, here are some tips for how to distance and shield yourself from patients who may have COVID-19.
Step-by-step response protection
Use one firefighter or medic to make patient contact. This one firefighter will remain 6 feet away from the patient while making initial contact. Confirm that the patient meets the CDC’s definition of a potential COVID-19 patient, and then take every precaution recommended by the CDC to prevent additional exposure to yourself and your members.
Department leadership should also communicate with the dispatch center and include a COVID-19 screening in the call-taker’s question protocol and forward that information to units being dispatched. If this is not the case in your department, you as the officer, need to ask questions en route to avoid any surprises on scene that may lead to an exposure of your entire crew.
If you are on an engine, only one member should enter the house wearing CDC-required PPE, consisting of N95 mask, glasses and gloves. Remain 6 feet away from the patient and assess the patient.
If additional care will be required, exit the house and don the CDC-recommended gown or protective suit. The additional members on the engine should continue to remain outside the house until the transport unit arrives.
If you are assigned to the transport ambulance, again, only one member should make patient contact wearing the same minimal equipment consisting of mask, glasses and gloves. If you will be required to provide additional treatment, don the CDC-recommended gown or suit. The driver of the transport unit should not participate in patient care, if possible, to reduce potential contamination of the passenger compartment.
If the patient is ambulatory, have them walk to the transport unit. Have them sit on the bench during transport as well. Then walk them into the hospital.
If the patient meets the criteria set forth by the CDC for potential COVID-19 exposure, place a simple surgical mask on the patient as well, in addition to your PPE. This may seem odd and out of the norm, but this is for your safety, the safety of your family and friends and the nation at the moment.
In addition, transporting units should notify the hospital well in advance that they are transporting a COVID-19 patient to their facility. Do not remove the patient from the ambulance until the hospital staff has determined how they are going to approach the situation regarding their protocols. The attendant should remain in the ambulance with the patient, and the driver should go inside and advise the staff that they have arrived with the COVID-19 patient.
After transport, the transport unit should remain out of service until properly decontaminated.
When decontaminating the patient care compartment, one member should don a new gown, gloves, mask and eye protection. Use proper doffing methods to remove the PPE to avoid additional contamination. Then wash hands per CDC guidelines before entering the passenger compartment to return to service.
When you return to the station, fill out an exposure form and a workers’ compensation claim. I mention this because in one department I work for, it must be filed within 24 hours of the incident or it will be denied.
A final tip related to patient care: Treat all medical calls as a potential COVID-19 response. I responded to a patient that initially denied any of the COVID-19 criteria questioning by dispatch, yet had shortness of breath and a temperature of 103 degrees on assessment. People are afraid they will be treated differently, so they might deny or flat-out lie during questioning. Keep this in mind, and assume everyone might have the virus.
Time to be proactive!
It’s essential that you take every precaution to protect yourself, your crew and your family. As company officers, we are going to have to step up where our organizational leadership may have fallen short for our members and be as proactive as we possibly can.
Stay safe and keep your members safe.
