Bureau of EMS & Trauma System: EMS Guidance COVID-19

March 27, 2020 - EMS Guidance COVID-19

Hospital Notification of Possible Exposure:  Due to several factors, including the increase in Suspect COVID-19 cases to hospitals, delay in obtaining test results and reduced staff availability, hospitals may no longer be able to notify EMS agencies the testing status of suspect COVID-19 cases.  

• The Arizona Department of Health Services believes that the volume of suspect COVID-19 EMS transport volume will – in select communities – increase significantly over the next several weeks.  Every patient with fever and/or cough and dyspnea should be treated as if they have a COVID-19 infection.

Updated Guidance for Exposed Healthcare Workers and EMS Personnel: If healthcare personnel have a known or suspected exposure to COVID-19, considerations include:

• Healthcare workers and EMS personnel should be screened for symptoms prior to working and can continue to work while asymptomatic.
• If there is enough personal equipment supply, consider wearing a face mask while at work for 14 days after the exposure.

State Disaster Medical Advisory Committee:  In response to the COVID-19 pandemic, the Arizona Department of Health Services (ADHS) has convened the State Disaster Medical Advisory Committee (SDMAC).  On March 24, 2020, guidance for personal protective equipment (PPE) preservation and testing prioritization was approved in accordance with the Arizona Crisis Standards of Care Plan. 

1. Recommendation: Shift to Contingency PPE, Prepare for Crisis Measures

Standards for PPE use should be shifted from conventional to contingency measures; organizations should prepare for crisis measures.  Recommendations for contingency use of different elements of PPE include extended use strategies. Further details can be found online under CDC’s Strategies for Optimizing the Supply of PPE.  

         2. Recommendation: Set Testing Prioritization 

Given limited testing supplies, both reagents and swabs, and limited PPE, the SDMAC approved the following testing priorities.  The goal of testing should be to limit introduction of COVID-19 in healthcare and congregate settings and vulnerable populations.

• Public health and healthcare professionals should prioritize testing among three specific groups until sufficient and consistent PPE, testing supplies and capacity are widely available:
• Healthcare workers, first responders, and employer-identified critical infrastructure personnel with COVID-19 symptoms
• Individuals living in congregate settings with symptoms of COVID-19
• Individuals hospitalized with respiratory symptoms  

• Community-based COVID-19 testing (drive-through, walk-up, etc.) should be focused on making tests available to the three priority groups above.

• Healthy individuals and those with mild disease do not require testing. These individuals should practice social distancing and follow the recommendations of their local and state public health authorities.

 

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