Guidance for EMS on the Use of PPE in Long Term Care Facilities

The purpose of this communication is to share new guidance on the use of Personal Protective Equipment (PPE) by First Responders and EMS when entering a nursing home or rest home (long term care facility).

In alignment with the Centers for Medicare and Medicaid Services (CMS) and due to the widespread community transmission of COVID-19, the Department of Public Health (DPH) is advising all first responders, including but not limited to, fire personnel, law enforcement, and EMS personnel, to assume when responding to an event at a long term care facility that the individuals they are interacting with are infected with COVID-19. First responders and EMS personnel should don the appropriate PPE recommended for caring for individuals who are infected with COVID-19.  

There is also a document with Nursing Home Frequently Asked Questions (FAQs) for First Responders & Municipalities.

OEMS Issues Comprehensive Personal Protective Equipment (PPE) Guidance

The purpose of this communication is to share comprehensive guidance, based upon the Centers for Disease Control and Prevention (CDC) recommendations, to clarify the Personal Protective Equipment (PPE) that health care personnel (HCP) use in the clinical care areas, particularly during this time when we are optimizing our supplies.

This guidance includes information about facemasks, eye protection, isolation gowns, gloves, respirators, and PPE for COVID-19 Patient Care.

The Massachusetts Department of Public Health (DPH) continues to work with state, federal and local partners on the outbreak of Coronavirus Disease 2019 (COVID-19), caused by the virus SARS-CoV-2, and we continue to appreciate the essential role you have in responding to this evolving situation.

UPDATED INFORMATION - REGION IV PPE CACHE BEING RELEASED

The Metropolitan Boston EMS Council, Inc (MBEMSC) in 2010 purchased a regional cache of PPE using funds from a private grant.  The intent of the cache was to be able to provide Region 4 EMS services with access to PPE in the time of a severe supply chain demand issue for service providers unable to receive ordered supplies through their routine vendors during a pandemic or other incident. MBEMSC purchased enough PPE for 25,000 patient encounters.  The supply of PPE includes gowns, surgical masks, and goggles. While the cache does have N95 masks in them they will not be released, initially due to expiration. The Council is actively working with the FDA, CDC, and NIOSH to expand the shelf-life of the N95s.

As of March 16, 2020 the Metropolitan Boston EMS Council has elected to release its PPE cache based on these guiding principles:

1.     The cache is for MBEMSC EMS Services only.  While many entities across the state are short on supplies, this cache was implemented for Region-4 EMS distribution only.   As such, only the EMS services that fall within Region 4 are eligible to participate.

2.     The cache must be replenished.  When the supply chain is restored, replacement PPE will be ordered.

3.     In order to replenish the inventory, participating services will need to purchase the cache items.  Since the cache was developed with private funds (and not state/federal funds), services wishing to participate will be required to purchase the supplies they receive.  Pricing is based on industry pricing.  Items will be sold at market value incorporating estimated associated costs such as shipping/handling.

4.     Expired items will not be distributed, initially.  This only applies to N95s, which are all expired.  MBEMSC is actively working with the FDA, CDC, and NIOSH to expand the shelf-life of the N95s that are in the cache.  Likely, the only way these will be used is if all other methods of N95s and surgical masks are depleted nationally.

5.     Distribution must be equitable.  Distribution of the cache will be based on an EMS services 2019 call volume.  Many (if not all) services are facing various degrees of shortages.  To best gauge need & risk, current PPE status will not be factored into the distribution.  Instead, current PPE status is being collected to provide state and federal resources with a more accurate summary of our regional needs.

6.     Distribution will be performed once.  To facilitate the rapid release of supplies, once the quantity of supplies allocated per service is calculated, all available supplies will be released.  It is important to note that some services may not immediately need all items that they are allotted.  In the event your service is allotted supplies you do not need, please notify us prior to payment/receipt of supplies so that redistribution can be evaluated.

7.     Payment must be received before receipt of supplies.  To ensure the future replacement of the cache, once your service’s allotment has been determined, you will receive an order form with the amount due.  Prior to receiving your supplies, you will need to submit payment to MBEMSC in the form of check or money order.

In order to participate in the cache release, please submit this survey by 12:00 PM on Wednesday, 03/18/2020.  https://www.surveymonkey.com/r/MBEMSC-PPE-03162020

We’re pleased to be able to offer this service.  If you have any questions, don’t hesitate to call our Office.