Tuesday, June 2, 2020
Posted on May 8, 2020
Our community partner, NAMI, the National Alliance on Mental Illness, has released this guide with links to many local resources that may useful to patients in your community.
Some of the support classes are routinely offered and there are ideas for those who may be experiencing stress related to the COVID crisis.
Please click on the flyer to open it and feel free to share with anyone.
COVID-19 Links to Information
COVID-19 Global Dashboard from CSSE
Illinois Department of Public Health COVID-19 Statistics
Illinois Department of Public Health COVID-19 Information regarding Long Term Care Facilities
Illinois Department of Public Health COVID-19 Information regarding Hospital Utilization
Information for Healthcare Providers Regarding COVID-19 from CDC
Donning and Doffing PPE from LACoFD
Frequently Asked Questions from CDC
COVID-19 Global Dashboard from CSSE
Illinois Department of Public Health COVID-19 Statistics
Illinois Department of Public Health COVID-19 Information regarding Long Term Care Facilities
Illinois Department of Public Health COVID-19 Information regarding Hospital Utilization
Information for Healthcare Providers Regarding COVID-19 from CDC
Donning and Doffing PPE from LACoFD
Frequently Asked Questions from CDC
Posted May 6, 2020
Published April 28, 2020
Effective Immediately
Posted April 22, 2020
SwedishAmerican Hospital will no longer be able to restock or replace Fentanyl to EMS due to shortages. The same is true of Etomidate and paralytic agents Succinylcholine, Rocuronium and Vecuronium.
We can continue to restock Versed and morphine.
Please refer questions to Richard Robinson.
For a list of all medication shortages please click here.
Posted April 22, 2020
SwedishAmerican Hospital will no longer be able to restock or replace Fentanyl to EMS due to shortages. The same is true of Etomidate and paralytic agents Succinylcholine, Rocuronium and Vecuronium.
We can continue to restock Versed and morphine.
Please refer questions to Richard Robinson.
For a list of all medication shortages please click here.
RE: SwedishAmerican Certification Classes Cancelled
All certification classes offered through the SwedishAmerican EMS office including CPR, ACLS, PALS, and PHTLS have been cancelled until further notice. American Heart Association is giving a 120 day extension for any certification that expires beginning with recertification dates in March.
All June classes have now been cancelled. Linda is in the process of notifying all who were registered.
For questions contact Linda Edmunds.
All certification classes offered through the SwedishAmerican EMS office including CPR, ACLS, PALS, and PHTLS have been cancelled until further notice. American Heart Association is giving a 120 day extension for any certification that expires beginning with recertification dates in March.
All June classes have now been cancelled. Linda is in the process of notifying all who were registered.
For questions contact Linda Edmunds.
Posted Monday, April 20th, 2020
Effective Immediately:
This temporary Amendment to Refusal of Medical Care or Transport SMO has been approved by IDPH for "30 days post the current disaster situation".
Please direct any questions to Richard Robinson at SwedishAmerican Hospital EMS System.
Effective Immediately:
This temporary Amendment to Refusal of Medical Care or Transport SMO has been approved by IDPH for "30 days post the current disaster situation".
Please direct any questions to Richard Robinson at SwedishAmerican Hospital EMS System.
Please Review This SMO
Providers:
It is now more important than ever to make good decisions as we care for patients.
Region I has a policy for In-Field Termination (page 110 of the SMOs). Please visit click here and take a moment to review the SMO.
You are aware that aggressive chest compressions and ALS at the scene offers the best chance for survival and that once a decision is made to transport survival rates are very poor.
The SMO can be summarized:
1) Wear full PPE
2) Do great CPR
3) If prolonged resuscitation efforts beyond 20 minutes with full ACLS without a return of spontaneous circulation or shockable rhythm and/or capnography has remained below 10 throughout arrest consider contacting Medical Control for termination.
Following this SMO appropriately can limit exposure to providers and limit resources utilized by the receiving hospital.
If you have any questions, please contact us.
Sincerely,
John L. Underwood, DO, FACEP
EMS Medical Director
SwedishAmerican EMS System
Providers:
It is now more important than ever to make good decisions as we care for patients.
Region I has a policy for In-Field Termination (page 110 of the SMOs). Please visit click here and take a moment to review the SMO.
You are aware that aggressive chest compressions and ALS at the scene offers the best chance for survival and that once a decision is made to transport survival rates are very poor.
The SMO can be summarized:
1) Wear full PPE
2) Do great CPR
3) If prolonged resuscitation efforts beyond 20 minutes with full ACLS without a return of spontaneous circulation or shockable rhythm and/or capnography has remained below 10 throughout arrest consider contacting Medical Control for termination.
Following this SMO appropriately can limit exposure to providers and limit resources utilized by the receiving hospital.
If you have any questions, please contact us.
Sincerely,
John L. Underwood, DO, FACEP
EMS Medical Director
SwedishAmerican EMS System
Recording from EMS WebEx Meeting Now Available
You can watch the WebEx presentation from April 3, 2020 by Richard Robinson and Dr. John Underwood by clicking on the link below.
If you have any trouble viewing the program please e-mail Cat Lewis and she will send you a direct link.
You can watch the WebEx presentation from April 3, 2020 by Richard Robinson and Dr. John Underwood by clicking on the link below.
If you have any trouble viewing the program please e-mail Cat Lewis and she will send you a direct link.
Information from the Discussion with Dr. Underwood and Richard Robinson regarding COVID-19
posted Friday, April 3, 2020
On Thursday, April 2nd and Friday, April 3rd Dr. Underwood and Richard Robinson led a WebEx discussion regarding the Region 1 COVID-19 Non-Transport Procedure and shared recommendations for EMS providers related to remaining safe during the pandemic.
The documents discussed during the presentation are listed below. The forms are posted in two formats - the pdf version can be printed and completed by hand and the fillable pdf version can be downloaded and completed electronically.
Please be advised - the COVID-19 Non-Transport Procedure has NOT be activated yet. You will receive notification from your department's leadership when the procedure has been activated for your area. All providers affiliated with SwedishAmerican have an assignment in TargetSolutions that needs to be completed regarding the procedure and associated documents. If you did not receive an assignment or are unsure about your TargetSolutions account please send an e-mail to Cat Lewis.
The recordings from the WebEx presentations are still being processed and will be posted here when they are available.
Please Contact Us if you have any trouble accessing these documents. To open them just click on the name of the document or form:
SwedishAmerican Recommendations for EMS Providers During COVID-19
Temperature Screening Forms
COVID-19 Screening Memo
SWAEMS Temperature Log
SWAEMS Fillable Temperature Log
Agency Patient Tracking Forms
EMS COVID-19 Patient Tracking Log
EMS COVID-19 Fillable Patient Tracking Log
Region 1 COVID-19 Non-Transport Procedure and Related Forms
Region 1 COVID-19 Non Transport Procedure
COVID-19 Patient Screening Form
COVID-19 Non-Transport Home Resource Information
posted Friday, April 3, 2020
On Thursday, April 2nd and Friday, April 3rd Dr. Underwood and Richard Robinson led a WebEx discussion regarding the Region 1 COVID-19 Non-Transport Procedure and shared recommendations for EMS providers related to remaining safe during the pandemic.
The documents discussed during the presentation are listed below. The forms are posted in two formats - the pdf version can be printed and completed by hand and the fillable pdf version can be downloaded and completed electronically.
Please be advised - the COVID-19 Non-Transport Procedure has NOT be activated yet. You will receive notification from your department's leadership when the procedure has been activated for your area. All providers affiliated with SwedishAmerican have an assignment in TargetSolutions that needs to be completed regarding the procedure and associated documents. If you did not receive an assignment or are unsure about your TargetSolutions account please send an e-mail to Cat Lewis.
The recordings from the WebEx presentations are still being processed and will be posted here when they are available.
Please Contact Us if you have any trouble accessing these documents. To open them just click on the name of the document or form:
SwedishAmerican Recommendations for EMS Providers During COVID-19
Temperature Screening Forms
COVID-19 Screening Memo
SWAEMS Temperature Log
SWAEMS Fillable Temperature Log
Agency Patient Tracking Forms
EMS COVID-19 Patient Tracking Log
EMS COVID-19 Fillable Patient Tracking Log
Region 1 COVID-19 Non-Transport Procedure and Related Forms
Region 1 COVID-19 Non Transport Procedure
COVID-19 Patient Screening Form
COVID-19 Non-Transport Home Resource Information
FROM DR. JOHN UNDERWOOD
EMS Medical Director
Saturday, March 28, 2020/Updated March 31, 2020
EMS Providers:
It is a difficult time for all of us and I wanted to give you my personal thoughts on how we navigate the coming COVID storm.
I want to keep you and our patients as safe as possible.
Here are my thoughts:
TESTING
Waiting for test results is not going to help us. Illinois currently is reporting 5,058 CONFIRMED tests and 74 deaths. We know in our area it is almost impossible to get testing done and when done the results will likely not come back for 10 days.
The obvious question is how many cases of COVID are out there if we have 5,058 confirmed.
We know that in the state the number of EMS providers being quarantined is dramatically increasing and we are starting to see more EMS people testing positive.
MY ADVICE TO EMS
On every call- unless the patient’s medical condition makes it impossible:
1) Have the senior provider on the call make patient contact. If concerns of COVID the patient can come out of the house to meet EMS. In Winnebago County we have this built into our pre-arrival instructions. Check with you local 911 center to see their instructions.
2) Hand the patient a mask and have them put the mask on. This is probably the number one thing to help risk stratify EMS. There is a chart on below that will help guide you.
3). Use PPE where appropriate. Wear a procedure mask all of the time. Current guidelines (and it is difficult to keep up with “current guidelines”) say you can use a procedure mask for at least your shift and maybe longer. As long as the supply continues use the procedure mask. Care in removing the mask is essential to not contaminate it. Use the ear loops and don’t touch the inside or outside of the mask. They are very easy to contaminate. Hand washing after removed. Procedure masks are fine for everything except aerosol procedures (MAD, Nebulizers, BVM, ET tubes, etc.)
Appropriate PPE is MASK, FACE SHIELD OR GOGGLES, GOWN AND GLOVES. It is important to imperative to practice good donning and doffing technique. The buddy system on doffing may be helpful.
4) If a patient is a suspect for COVID and the providers don’t know if the patient was tested someone needs to contact the receiving hospital and find out (at SwedishAmerican ED this is the charge nurse - the phone number is 779-696-5988). They have access to a report on all COVID testing.
It is the responsibility of the agencies to have a contact person for tracking exposures. Be sure to contact the receiving hospital if you don't get the information at the time of the visit.
Be sure to document the PPE used on each call and check what type of PPE was utilized. ImageTrend Elite added a checkbox for "gown" today. ESO has this information, also.
5). Once it is determined that a COVID test was performed the individuals involved need to be risk stratified by their EMS agency. This will allow a decision to be made on work activity or 14 day quarantine.
6). Once a test comes back (keep in mind currently this is about 10 days) the EMS agency will be notified of POSITIVE RESULTS within 12 hours. Tom Pratt is our point person for notification.
The bottom line here is that testing is offering little guidance on the amount of virus in our community and is of no value to us currently on how we approach our duties. If a crew has a patient under investigation and they do not follow and document PPE compliance they will likely need to be quarantined for 14 days. Waiting for test results is not an answer for us.
Please continue to check this page frequently for further information.
EMS Medical Director
Saturday, March 28, 2020/Updated March 31, 2020
EMS Providers:
It is a difficult time for all of us and I wanted to give you my personal thoughts on how we navigate the coming COVID storm.
I want to keep you and our patients as safe as possible.
Here are my thoughts:
TESTING
Waiting for test results is not going to help us. Illinois currently is reporting 5,058 CONFIRMED tests and 74 deaths. We know in our area it is almost impossible to get testing done and when done the results will likely not come back for 10 days.
The obvious question is how many cases of COVID are out there if we have 5,058 confirmed.
We know that in the state the number of EMS providers being quarantined is dramatically increasing and we are starting to see more EMS people testing positive.
MY ADVICE TO EMS
On every call- unless the patient’s medical condition makes it impossible:
1) Have the senior provider on the call make patient contact. If concerns of COVID the patient can come out of the house to meet EMS. In Winnebago County we have this built into our pre-arrival instructions. Check with you local 911 center to see their instructions.
2) Hand the patient a mask and have them put the mask on. This is probably the number one thing to help risk stratify EMS. There is a chart on below that will help guide you.
3). Use PPE where appropriate. Wear a procedure mask all of the time. Current guidelines (and it is difficult to keep up with “current guidelines”) say you can use a procedure mask for at least your shift and maybe longer. As long as the supply continues use the procedure mask. Care in removing the mask is essential to not contaminate it. Use the ear loops and don’t touch the inside or outside of the mask. They are very easy to contaminate. Hand washing after removed. Procedure masks are fine for everything except aerosol procedures (MAD, Nebulizers, BVM, ET tubes, etc.)
Appropriate PPE is MASK, FACE SHIELD OR GOGGLES, GOWN AND GLOVES. It is important to imperative to practice good donning and doffing technique. The buddy system on doffing may be helpful.
4) If a patient is a suspect for COVID and the providers don’t know if the patient was tested someone needs to contact the receiving hospital and find out (at SwedishAmerican ED this is the charge nurse - the phone number is 779-696-5988). They have access to a report on all COVID testing.
It is the responsibility of the agencies to have a contact person for tracking exposures. Be sure to contact the receiving hospital if you don't get the information at the time of the visit.
Be sure to document the PPE used on each call and check what type of PPE was utilized. ImageTrend Elite added a checkbox for "gown" today. ESO has this information, also.
5). Once it is determined that a COVID test was performed the individuals involved need to be risk stratified by their EMS agency. This will allow a decision to be made on work activity or 14 day quarantine.
6). Once a test comes back (keep in mind currently this is about 10 days) the EMS agency will be notified of POSITIVE RESULTS within 12 hours. Tom Pratt is our point person for notification.
The bottom line here is that testing is offering little guidance on the amount of virus in our community and is of no value to us currently on how we approach our duties. If a crew has a patient under investigation and they do not follow and document PPE compliance they will likely need to be quarantined for 14 days. Waiting for test results is not an answer for us.
Please continue to check this page frequently for further information.
FROM DR. JOHN UNDERWOOD
EMS Medical Director
March 31, 2020
Please review this chart below regarding the use of PPE and Risk Stratification that was issued on March 7, 2020 by the CDC. There is a link below the chart for the entire published article or you can read it by clicking here. We will be discussing this information through a WebEx later this week. You will get details for this discussion via e-mail on Wednesday, April 1, 2020.
Please check this page frequently for updated information.
EMS Medical Director
March 31, 2020
Please review this chart below regarding the use of PPE and Risk Stratification that was issued on March 7, 2020 by the CDC. There is a link below the chart for the entire published article or you can read it by clicking here. We will be discussing this information through a WebEx later this week. You will get details for this discussion via e-mail on Wednesday, April 1, 2020.
Please check this page frequently for updated information.
Updated Information from IDPH
March 26, 2020
March 26, 2020
PPE Update
March 21, 2020
March 21, 2020
SwedishAmerican Hospital Updated Visitor Guidelines
To: Providers and Associates
From: Jennifer Maher, CEO, SwedishAmerican Health System and COVID-19 Incident Commander
3/21/20 11:50 AM
Here’s the latest briefing on COVID-19.
Updated Visitor Guidelines: Hospital and Clinics
To help reduce the spread of COVID-19 and to coincide with the Governor’s Shelter in Place Order, effective today Saturday, March 21 at 5:00 pm, enhanced visitor guidelines will be implemented at SwedishAmerican. These guidelines are part of our ongoing efforts to protect the health and wellbeing of our patients, staff and care providers as we navigate the COVID-19 situation.
Visitor Guidelines: Inpatient
No inpatient visitors will be allowed, except for healthcare decision makers and visitors of end-of-life patients.
Visitor Guidelines: Pediatrics/NICU
Two primary support persons per patient will be allowed. Patient siblings or anyone under 18 are not allowed.
Visitor Guidelines: Labor & Deliver/Mother Baby
One primary support person per patient will be allowed. Patient siblings or anyone under 18 are not allowed.
Visitor Guidelines: Clinic Appointments
No visitors for clinic appointments, except one support person can accompany a cognitively disabled or physically impaired patient.
Healthcare decision makers, support persons and visitors of end-of-life patients who are currently experiencing or recently experienced any acute respiratory symptoms, such as a cough or shortness of breath, are not permitted
To: Providers and Associates
From: Jennifer Maher, CEO, SwedishAmerican Health System and COVID-19 Incident Commander
3/21/20 11:50 AM
Here’s the latest briefing on COVID-19.
Updated Visitor Guidelines: Hospital and Clinics
To help reduce the spread of COVID-19 and to coincide with the Governor’s Shelter in Place Order, effective today Saturday, March 21 at 5:00 pm, enhanced visitor guidelines will be implemented at SwedishAmerican. These guidelines are part of our ongoing efforts to protect the health and wellbeing of our patients, staff and care providers as we navigate the COVID-19 situation.
Visitor Guidelines: Inpatient
No inpatient visitors will be allowed, except for healthcare decision makers and visitors of end-of-life patients.
Visitor Guidelines: Pediatrics/NICU
Two primary support persons per patient will be allowed. Patient siblings or anyone under 18 are not allowed.
Visitor Guidelines: Labor & Deliver/Mother Baby
One primary support person per patient will be allowed. Patient siblings or anyone under 18 are not allowed.
Visitor Guidelines: Clinic Appointments
No visitors for clinic appointments, except one support person can accompany a cognitively disabled or physically impaired patient.
Healthcare decision makers, support persons and visitors of end-of-life patients who are currently experiencing or recently experienced any acute respiratory symptoms, such as a cough or shortness of breath, are not permitted
Updated Information from Mercyhealth Hospitals
Effective immediately, Mercyhealth Hospitals has implemented changes to visitor policies (see email from Dr. MacNeal below). Unfortunately this will include those who ride with patients in the ambulance. This will be in place at all of our campuses (Rockton Ave/Riverside/Harvard/Walworth/Janesville.) There may be exceptions allowed as noted but will need approval first as listed. If you could get this information out to your respective EMS agencies who may transport patients to any of our locations.
Thanks all….Don
Don Crawford EMT-P, Lead Instructor I
EMS System Coordinator
Mercyhealth Prehospital & Emergency Services Center Rockford
Office – 815-971-6838
Cell – 815-742-4456
From: MacNeal, James
Sent: Saturday, March 21, 2020 9:47 AM
Subject: EMS Transports
Good Morning,
Please immediately stop bringing anyone to the hospital other than the patient. There are no visitors allowed and anyone that rides with the patient and an ambulance will not be allowed to be with the patient. We are very sorry that we are in this situation, but we must take these steps to protect everyone.
Thanks,
Dr. MacNeal
Visitor Restrictions
Mercyhealth has implemented new visitor restrictions for the safety of our patients and staff. It is every resident’s responsibility to follow the rules and recommendations set forth by the CDC, local health departments and Mercyhealth. It will take everyone doing their part to protect our community.
Visitors are not allowed at this time. Exceptions upon approval may include:
· Pediatric patients—two visitors at a time upon approval*
· Women in labor—one visitor at a time upon approval*
· Adult patients undergoing surgery/procedure—one visitor at a time upon approval*
· Patients who require assistance with medical decision making*
· End-of-life situations*
· No visitors under age 18.
Effective immediately, Mercyhealth Hospitals has implemented changes to visitor policies (see email from Dr. MacNeal below). Unfortunately this will include those who ride with patients in the ambulance. This will be in place at all of our campuses (Rockton Ave/Riverside/Harvard/Walworth/Janesville.) There may be exceptions allowed as noted but will need approval first as listed. If you could get this information out to your respective EMS agencies who may transport patients to any of our locations.
Thanks all….Don
Don Crawford EMT-P, Lead Instructor I
EMS System Coordinator
Mercyhealth Prehospital & Emergency Services Center Rockford
Office – 815-971-6838
Cell – 815-742-4456
From: MacNeal, James
Sent: Saturday, March 21, 2020 9:47 AM
Subject: EMS Transports
Good Morning,
Please immediately stop bringing anyone to the hospital other than the patient. There are no visitors allowed and anyone that rides with the patient and an ambulance will not be allowed to be with the patient. We are very sorry that we are in this situation, but we must take these steps to protect everyone.
Thanks,
Dr. MacNeal
Visitor Restrictions
Mercyhealth has implemented new visitor restrictions for the safety of our patients and staff. It is every resident’s responsibility to follow the rules and recommendations set forth by the CDC, local health departments and Mercyhealth. It will take everyone doing their part to protect our community.
Visitors are not allowed at this time. Exceptions upon approval may include:
· Pediatric patients—two visitors at a time upon approval*
· Women in labor—one visitor at a time upon approval*
· Adult patients undergoing surgery/procedure—one visitor at a time upon approval*
· Patients who require assistance with medical decision making*
· End-of-life situations*
· No visitors under age 18.
March 19, 2020
Updated March 30, 2020
RE: SwedishAmerican Certification Classes Cancelled
Effective immediately, all certification classes offered through the SwedishAmerican EMS office including CPR, ACLS, PALS, and PHTLS have been cancelled until further notice. American Heart Association is giving a 60 day extension for any certification that expires during this time frame.
All April classes have be cancelled. Linda is in the process of notifying all who were registered.
For questions contact Linda Edmunds.
Updated March 30, 2020
RE: SwedishAmerican Certification Classes Cancelled
Effective immediately, all certification classes offered through the SwedishAmerican EMS office including CPR, ACLS, PALS, and PHTLS have been cancelled until further notice. American Heart Association is giving a 60 day extension for any certification that expires during this time frame.
All April classes have be cancelled. Linda is in the process of notifying all who were registered.
For questions contact Linda Edmunds.
Posted March 19, 2020
From Dr. John Underwood:
Monday, March 16, 2020
LIMITING COVID AEROSOL
Limiting the spread of COVID and exposure needs to be a high priority for protecting both EMS and ED environments.
Many of the procedures that we do in EMS produce aerosol spread. We are all aware that ET tubes, BVM and CPAP produce aerosols. Also be aware that nebulizer treatments cause aerosol spread. This exposes EMS and ED to increased risk.
If medically possible avoid unnecessary nebulizer. If a nebulizer is necessary it should be discontinued prior to bringing a patient with moderate or high risk of COVID into the ED and negative pressure atmosphere.
John Underwood, DO, FACEP
SwedishAmerican EMS System
Monday, March 16, 2020
LIMITING COVID AEROSOL
Limiting the spread of COVID and exposure needs to be a high priority for protecting both EMS and ED environments.
Many of the procedures that we do in EMS produce aerosol spread. We are all aware that ET tubes, BVM and CPAP produce aerosols. Also be aware that nebulizer treatments cause aerosol spread. This exposes EMS and ED to increased risk.
If medically possible avoid unnecessary nebulizer. If a nebulizer is necessary it should be discontinued prior to bringing a patient with moderate or high risk of COVID into the ED and negative pressure atmosphere.
John Underwood, DO, FACEP
SwedishAmerican EMS System
COVID Update
From: John L. Underwood, DO, FACEP
EMS Medical Director
SwedishAmerican EMS System
Date: March 16, 2020
What we know:
1. COVID is here
2. It will increase before it improves
3. Most but not all patients are symptomatic
What you need to know:
1.The virus is primarily spread by droplets
2. Routine methods minimize the spread:
a. Cover your cough
b. Wash your hands
c. Avoid close contact (6 feet social distance)
d. Keep contact surfaces clean- tabletops, door knobs etc.
e. If you are sick, isolate yourself from others.
3.For most people the disease is not life threatening, but appears to have a mortality rate of 10 to 20 times that of influenza.
What you need to do:
1. Make sure that 911 is asking if the caller has fever and cough. In Winnebago County we are still asking about travel but with community transmission this is not so important.
2. When you arrive at the scene, even if no history of fever and cough, begin your examination with social distance.
3. When there is a history of fever and cough (unless the patients condition requires emergent intervention) only one caregiver should enter the room in appropriate PPE
a. N95 mask
b. Gloves
c. Gown
d. Face shield
4. If the patient can walk, have them walk to to ambulance
5. Only the caregiver with PPE in the back with the patient
6. Driver should be isolated with window closed to patient care area if possible
7. Ventilate the patient care area. Do not put system on recirculate.
8. If possible avoid procedures that produce aerosol (ET tubes, bag valve mask, and nebulizer treatments).
9. When you arrive at the hospital, notify the staff that you have a patient under consideration from COVID
10.Wait in the ambulance until staff comes out and is prepared to accept the patient.
11.The ambulance should be disinfected by IDPH guidelines without exposing other staff.
The risk of exposure has to be minimized. Lack of such precautions can result in 14 day quarantine for observation. If there were too many of these exposures, we will be unable to deliver the service to our community that we are all desire.
Communicate with everyone in your community. You are the front lines and can make a significant impact.
From: John L. Underwood, DO, FACEP
EMS Medical Director
SwedishAmerican EMS System
Date: March 16, 2020
What we know:
1. COVID is here
2. It will increase before it improves
3. Most but not all patients are symptomatic
What you need to know:
1.The virus is primarily spread by droplets
2. Routine methods minimize the spread:
a. Cover your cough
b. Wash your hands
c. Avoid close contact (6 feet social distance)
d. Keep contact surfaces clean- tabletops, door knobs etc.
e. If you are sick, isolate yourself from others.
3.For most people the disease is not life threatening, but appears to have a mortality rate of 10 to 20 times that of influenza.
What you need to do:
1. Make sure that 911 is asking if the caller has fever and cough. In Winnebago County we are still asking about travel but with community transmission this is not so important.
2. When you arrive at the scene, even if no history of fever and cough, begin your examination with social distance.
3. When there is a history of fever and cough (unless the patients condition requires emergent intervention) only one caregiver should enter the room in appropriate PPE
a. N95 mask
b. Gloves
c. Gown
d. Face shield
4. If the patient can walk, have them walk to to ambulance
5. Only the caregiver with PPE in the back with the patient
6. Driver should be isolated with window closed to patient care area if possible
7. Ventilate the patient care area. Do not put system on recirculate.
8. If possible avoid procedures that produce aerosol (ET tubes, bag valve mask, and nebulizer treatments).
9. When you arrive at the hospital, notify the staff that you have a patient under consideration from COVID
10.Wait in the ambulance until staff comes out and is prepared to accept the patient.
11.The ambulance should be disinfected by IDPH guidelines without exposing other staff.
The risk of exposure has to be minimized. Lack of such precautions can result in 14 day quarantine for observation. If there were too many of these exposures, we will be unable to deliver the service to our community that we are all desire.
Communicate with everyone in your community. You are the front lines and can make a significant impact.
To: All Region 1 EMS Providers and Hospitals
From: Mercyhealth System
Northwestern Medicine Kishwaukee Hospital EMS System
OSF Northern Region EMS System
SwedishAmerican Hospital EMS System
Re: Patients with Possible COVID-19 Virus Exposure/Infection
Date: March 6, 2020
The EMS Medical Directors and EMS Coordinators of Region 1would like to communicate the process for transporting and receiving suspected patients with possible exposure and/or symptoms of COVID 19.
IDPH has communicated to all via email on how to manage these types of patients in the pre-hospital setting as well as how to protect EMS providers if a patient encountered is suspected of or has a history of the COVID 19 (memo below).
Please follow those IDPH recommendations for the safety for EMS agencies, providers, and emergency department staff.
At this time we recommend all EMS providers and hospital Emergency Departments utilize the following guidelines:
1. Please provide early notification to the receiving facility on inbound medical report that you have a patient that you suspect may have the COVID-19 virus or has been in contact/has symptoms of the COVID-19 virus.
2. The emergency department staff should be notified to prepare a room for this patient.
3. Once the EMS provider arrives at the emergency department please wait in the ambulance in the ambulance bay and do not unload the patient until someone from the ED comes out or provides direction to assist the crew to the proper room.
4. Please be sure that the patient has a surgical/procedure mask in place before the ED staff escorts you to the assigned room in the ED.
5. If following the ED exam and testing the patient tests positive for the COVID-19 virus the transporting agency leadership will be notified by the hospital/EMS System and will be advised on next steps.
If you have any additional questions, please feel free to contact your EMS Systems Coordinator.
From: Mercyhealth System
Northwestern Medicine Kishwaukee Hospital EMS System
OSF Northern Region EMS System
SwedishAmerican Hospital EMS System
Re: Patients with Possible COVID-19 Virus Exposure/Infection
Date: March 6, 2020
The EMS Medical Directors and EMS Coordinators of Region 1would like to communicate the process for transporting and receiving suspected patients with possible exposure and/or symptoms of COVID 19.
IDPH has communicated to all via email on how to manage these types of patients in the pre-hospital setting as well as how to protect EMS providers if a patient encountered is suspected of or has a history of the COVID 19 (memo below).
Please follow those IDPH recommendations for the safety for EMS agencies, providers, and emergency department staff.
At this time we recommend all EMS providers and hospital Emergency Departments utilize the following guidelines:
1. Please provide early notification to the receiving facility on inbound medical report that you have a patient that you suspect may have the COVID-19 virus or has been in contact/has symptoms of the COVID-19 virus.
2. The emergency department staff should be notified to prepare a room for this patient.
3. Once the EMS provider arrives at the emergency department please wait in the ambulance in the ambulance bay and do not unload the patient until someone from the ED comes out or provides direction to assist the crew to the proper room.
4. Please be sure that the patient has a surgical/procedure mask in place before the ED staff escorts you to the assigned room in the ED.
5. If following the ED exam and testing the patient tests positive for the COVID-19 virus the transporting agency leadership will be notified by the hospital/EMS System and will be advised on next steps.
If you have any additional questions, please feel free to contact your EMS Systems Coordinator.
