COVID-19 Updates - CDC for EMS Personnel
Important updates from the Centers for Disease Control and Prevention (CDC) on interim guidance for EMS personnel who anticipate close contact with individuals with suspected or confirmed novel Coronavirus 2019 (COVID-19) in the course of their work:
The interim guidance has been updated based on currently available information about COVID-19 and the current situation in the United States, which includes reports of cases of community transmission, infections identified in healthcare personnel (HCP), and shortages of facemasks, N95 filtering facepiece respirators (FFRs) (commonly known as N95 respirators), and gowns.
The full guidance is available online at https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-for-ems.html. Please share this guidance broadly with EMS personnel working for your ambulance service.
Key points from the guidance updated on March 10, 2020 include the following:
Early reports suggest person-to-person transmission most commonly happens during close exposure to a person infected with COVID-19, primarily via respiratory droplets produced when the infected person coughs or sneezes. Airborne transmission from person-to-person over long distances is unlikely.Based on local and regional situational analysis of PPE supplies, facemasks are an acceptable alternative when the supply chain is limited.When shortages have been identified, available respirators should be prioritized for procedures that are likely to generate respiratory aerosols, which would pose the highest exposure risk to EMS and healthcare personnel.Eye protection, gown, and gloves continue to be recommended. If there are shortages of gowns, they should be prioritized for aerosol-generating procedures, care activities where splashes and sprays are anticipated and high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of EMS and healthcare personnel. When the supply chain is restored, fit-tested EMS clinicians should return to use of respirators for patients with known or suspected COVID-19. Clean and disinfect the vehicle in accordance with standard operating procedures. All surfaces that may have come in contact with the patient or materials contaminated during patient care should be thoroughly cleaned and disinfected using an EPA-registered hospital grade disinfectant in accordance with the product label.The Environmental Protection Agency (EPA) has updated guidance about recommended EPA-registered disinfectants that meet the criteria for use against SARS-CoV-2, which is posted online at: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2.
Temporary AR-2-212 EMT Continuing Education Change
With the concern of COVID-2019, many facilities have cancelled their M&M Rounds and other training sessions. In response to these cancellations, and for the safety of our providers, the Department has temporarily changed AR-2-212 to allow for a provider who is renewing their certification during this renewal period to complete more of their training via Distributive Education.
· These restrictions are temporarily adjusted as follows:
o One-third (1/3) of the continuing education course hours to meet the National category may be done through Distributive Education.
o Two thirds (2/3) of the hours for the Local category can be done through Distributive Education.
o All of the hours to meet Individual category may be done through Distributive Education, in accordance with the NCCP.
As of April 1, 2020, the restrictions on distributive education will revert to the prior standard with respect to the Local category, as described above. There are no required courses or content that must be taken for this category at this time. Please keep in mind that all EMTs working for an ambulance service as EMTs have required courses in order to staff ambulances. If these courses receive OEMS Continuing Education approval numbers, they may be eligible towards renewal of an individual’s EMT certification.
Continuing Education - Special Credit Application
We are happy to share a new tool I think many will be excited to see—a form and instructions for Special Credit. This is designed for EMTs looking to receive continuing education credit for college courses (including RN/PA/MD), as well as other health education (conferences, etc.) The form asks EMTs to provide information about the courses, how they relate to EMS, and gives direction on what supporting documentation to attach.
the form has been posted on the mass.gov website, at https://www.mass.gov/service-details/ems-continuing-education and the form is at https://www.mass.gov/doc/special-credit-request-form/download.
Interim Guidance for EMS and PSAPs for the 2019 Novel Coronavirus
Image courtesy of the CDC
Please find a link to new interim guidance for EMS and PSAPs for the 2019 Novel Coronavirus issued by CDC. CDC’s Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for 2019-nCoV in the United States
You may search on the CDC.gov website for the title if you choose not to click on the link.
From the CDC: Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-nCoV)
From Mass DPH:
“The purpose of this communication is to share with you that we have confirmed Massachusetts’ first case of 2019 novel Coronavirus (2019-nCoV), identified in Boston, and to provide you with the most up-to-date guidance regarding patient screening and health department notification procedures. From Mass DPH
We reiterate that the risk to Massachusetts residents at this time remains low.
Please read and share the attached Centers for Disease Control and Prevention (CDC) documents with your colleagues and organizations.
Following the clinical evaluation, contact the Massachusetts Department of Public Health (DPH) 24/7 at (617) 983-6800 for assistance in determining if the patient meets the criteria of a Person Under Investigation (PUI) requiring testing.
DPH has launched a new website that provides up-to-date information on the status of 2019-nCoV for all clinicians and residents: https://www.mass.gov/2019coronavirus”
CDC HAN 47 Update 2019—nCov 02 01 2020
Identify and Asses 2019-nCov
Man Returning from Wuhan China is First Case of 2019 Novel Coronavirus Confirmed in Massachusetts
Emerson Hospital CMED
All services utilizing Emerson Hospital please be advised that the CMED connection to the emergency department has been repaired and is fully operational.
All EMS services are advised to contact the Emerson Hospital ED via the CMED radio through Boston CMED for all entry notifications, alert notifications, and medical control.
Should you have any questions regarding this please contact the regional office.
BID-Milton CODE BLACK 11/16 - 11/17/19 beginning at 20:00 Hours
Please be advised that BID-Milton will be going on Code Black beginning Saturday, 11/16/19 at 20:00 hours for scheduled construction work at their facility and it will end on Sunday, 11/17/19 at 06:00 hours. Ambulance services are being requested to seek alternate transport destinations for patients during this time frame. Further details regarding the Code Black can be found below.
Code Black– Ambulance Diversion
Event: Scheduled water shut down – Complete Facility (Domestic ONLY, does not impact fire suppression devices)
Period: Date and Time (From): Saturday, November 16, 2019 @20:00 hours
Date and Time (Until): Sunday, November 17, 2019 @ 06:00 hours
Reason:
BID-Milton is currently conducting a construction project of its new pharmacy to ensure compliance with revised USP 797 regulations. The date of this event has been selected to ensure completion of the project within the identified regulation timeframes.
As part of this project, there is a need to reconfigure the domestic water supply piping in the construction area. The hospital does not have the ability to limit water shut off to specific areas of the hospital; therefore it will be necessary to schedule a shutdown of its domestic water supply for the entire facility for the period identified previously. At the direction of the hospital’s facilities leadership no other alternative scenarios are possible specific to water supply management for this project. It is important to note: This shut down will not impact the hospital’s fire suppression devices.
Response
As described below the hospital has activated its Incident Command System process to optimize the planning, response and recovery of this scheduled event.
Impact:
Apart from the Emergency Department, it has been identified that the hospital will be able to maintain limited operational capabilities for departments that are normally open during this period. The hospital has selected this period since it is normally sees the lowest volume of patients in its Emergency Department between late Saturday evening and early Sunday morning.
Plan:
Emergency Department:
— BID-Milton is requesting ambulance diversion during this period – requesting start 2 hours (20:00 hours) prior to actual shutdown (22:00 hours) to reduce volume of high acuity patients at time of shutdown.
— Patient’s arriving by private transportation will be rapidly triaged, a medical screening exam performed and if the patient’s medical management exceeds the capability of the hospital at that time – they will be transferred by ambulance to firstly an alternative Beth Israel Lahey Health System Hospital or a non-system hospital based upon patient needs and bed availability (Other entities have been notified of potential). The hospital will work with the ambulance service to cover the cost of these transfers – rather than the patient.
— The hospital has coordinated with Brewster Ambulance Services to have an Ambulance permanently stationed at all times outside the Emergency Department to expedite patient possible transfers.
— Patients that do not require transfer will be managed and either admitted (< 20% of ED volume patients) or discharged.
Last Call For Tickets For The Region IV EMS Awards Ceremony
We are working on finalizing our count to give to the caterer for our Awards Ceremony. If you are interested in attending the Nineteenth Annual Region IV Awards Ceremony November 7, 2019 at the American Legion Post 440, 295 California Street, Newton, the deadline to order tickets is today. Tickets may be purchased for $40 per ticket by emailing ericksen@mbemsc.org.
Should you have any questions or need further information, please do not hesitate to contact us.
"Follow Up Fridays" at Tufts Medical Center
The Trauma team is doing Follow Up Fridays. The goal is to review cases with EMT’s and Paramedics who either brought a complex patient in or case review so front line EMS providers can learn and ask questions to our physicians and nursing team.
DPH Weather Related Waiver for Transport to Emergency Shelters and Cooling Centers
From DPH: Please find attached a weather related waiver from the Office of Emergency Medical Services for transport to emergency shelters and cooling centers beginning at 0800, July 19, 2019. Please refer to the MDPH WebEOC Shelter Status Board for information regarding cooling centers and shelters open in Massachusetts communities.
In the event that you may need further information or an update on this waiver, please contact Scott Cluett, at william.scott.cluett@state.ma.us.
Reminder Please Register for- Operationalizing Emergency Plans: Incident Command in Action
As you may know one of this years HMCC deliverables is to host a DPH recommended ICS courses for our region. This HMCC sponsored course conducted by the DelValle Institute will take place on May 31st from 10:00-3:00pm at the Rosemary Recreation Complex in Needham with breakfast and lunch provided. Operationalizing Emergency Plans: Incident Command in Action is designed to test regional response capabilities under an emerging infectious disease scenario with up to 30 students (6 per discipline) and 5 facilitators providing injects and support for an ICS based response within each discipline. If you are interested in becoming a facilitator please reach out to me directly. Space is limited so please register today!
Operationalizing Emergency Plans: Incident Command in Action
Friday, May 31st, 2019
10:00am – 3:00pm
Register here: https://delvalle.bphc.org/oep-ica4ab (please disregard the registration address on the flyer)
Overview: This course focuses on improving public health and healthcare agencies’ operational readiness, i.e. their ability to quickly and effectively transition from normal operations to emergency operations operating under an Incident Command System (ICS) structure, with a strict emphasis on utilizing existing Emergency Operations Plans (EOP) to guide the overall response. The course is designed to engage participants in a hands-on learning environment, and consists of a fast-paced 4-hour practical session involving a simulated pandemic flu scenario that stresses public health and healthcare systems.
Target Audience: Professionals from public health and healthcare including community health centers, EMS, long-term care facilities, hospitals and emergency management professionals.
Accreditation:
· Application has been submitted for 4 hours of OEMS credit at all levels (Basic, Advanced, and Paramedic).
· This program was designed to meet the requirements of the Massachusetts Board of Registration in Nursing, 244 CMR 5.00 for 4.8 contact hours of nursing continuing education.
· This program was designed to meet the requirements of the Massachusetts Board of Registration for Sanitarians, 255 CMR 5.00 for 4.0 contact hours of continuing education.
· This program was designed to meet the requirements of the Massachusetts Board of Registration for Health Officers, 241 CMR 4.00 for 4.8 contact hours of continuing education.
Facilitator Guidelines:
As a facilitator, your main role is to support participant learning. You may do this by:
• Provide Agency-specific injects:
Each facilitator will give a printed inject to a random participant at the table, at the appropriate time.
o Do not read these out loud.
o Monitor the group discussion to see if they respond to the inject appropriately and according to their ICS roles.
The lead instructor will read all global injects out loud.
• Stand back unless the group is missing something
• Prompt the learners with questions based on your real-world perspective
o Use questions rather than direct hints when possible
o Point out challenges they have not yet addressed
o Aim to bring about new insights
• Remind learners of their ICS role expectations and job action sheet
• Monitor the extent to which the learners are using the ICS forms and other reference documents in their binder – point them out when needed, and provide guidance on using them
Contact the DelValle Institute at delvalle@bphc.org for more information.
Reminder- Register for "Hot Topics for Preparedness"
We are pleased to invite you to attend the upcoming "Hot Topics for Preparedness" Conference that will take place on Wednesday, May 8th, from 8:30 am-4:30pm at the Granite Links Golf Club in Quincy. This full day, multidisciplinary conference will feature key and emerging emergency preparedness topics and presentations and is open to MRPC Stakeholders as well as hospital emergency department staff, Ambulatory Care Facilities, EMS, Police and Fire. The conference is sponsored by the MRPC and is a joint planning effort of the MRPC and the Metro Boston EMS Council.
Breakfast and lunch will be provided, and nursing CEU's, CME's and OEMS hours have been applied for with additional information to come. Register for Hot Topics for Preparedness by close of business this Friday May 3rd, 2019. To register please click here and if you have any questions please don't hesitate to ask.
Lawrence Memorial ED - Permanently Closed
If you are not already aware the Lawrence Memorial Hospital permanently closed its Emergency Department today at noon. The hospital’s Urgent Care, used for more minor injuries and illnesses, remains opened with extended hours. As always, if you are experiencing a life threatening medical emergency, do not hesitate to dial 9-1-1. Services are advised to update their crews regarding potential changes for point of entry in this area.
If you are not already aware the Lawrence Memorial Hospital permanently closed its Emergency Department today at noon. The hospital’s Urgent Care, used for more minor injuries and illnesses, remains opened with extended hours. As always, if you are experiencing a life threatening medical emergency, do not hesitate to dial 9-1-1. Services are advised to update their crews regarding potential changes for point of entry in this area.
There is still TIME! - From our friends at McNeilly EMS Educators
Are you a procrastinator? If so, we can help!Sign up for our last minute NCCR and Con-Ed classes now through March 31st, 2019.
NCCR - BLS 20 Hours
Start dates:
3/11/19 - Belmont - 8:00am - Register Here
3/25/19 - Danvers - 5:30pm - Register Here
NCCR - ALS 30 Hours
Location: Amesbury
Start time: 9am
3/25/19 - Component A
3/26/19 - Component B
3/27/19 - Component C
3/28/19 - Component D
3/29/19 - Component E
3/30/19 - Component F
