CDC COMMENDATIONS

1. Know how it spreads
   • There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19)
   • The best way to prevent illness is to avoid being exposed to this virus
   • The virus is thought to spread mainly from person-to-person
     • Between people who are in close contact with one another (within about 6 feet)
     • Through respiratory droplets produced when an infected person coughs or sneezes
   • These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs
2. Take steps to protect yourself
   • Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
   • If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
   • Avoid touchingyour eyes, nose, and mouth with unwashed hands.
   • Avoid close contact with people who are sick
   • Put distance between yourself and other people if COVID-19 is spreading in your community. This is especially important for people who are at higher risk of getting very sick
3. Take steps to protect others
   • Stay home if you are sick, except to get medical care. Learn what to do if you are sick
   • Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow.
   • Throw used tissues in the trash.
   • Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.
   • If you are sick: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it causes trouble breathing), then you should do your best to cover your coughs and sneezes, and people who are caring for you should wear a facemask if they enter your room. Learn what to do if you are sick.
   • If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers.
   • Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
   • If surfaces are dirty, clean them: Use detergent or soap and water prior to disinfection

EMS TRANSPORT VEHICLES CLEANING

The following are general guidelines for cleaning or maintaining EMS transport vehicles and equipment after transporting a PUI:

• After transporting the patient, leave the rear doors of the transport vehicle open to allow for sufficient air changes to remove potentially infectious particles.
  • The time to complete transfer of the patient to the receiving facility and complete all documentation should provide sufficient air changes
• When cleaning the vehicle, EMS clinicians should wear a disposable gown and gloves. A face shield or facemask and goggles should also be worn if splashes or sprays during cleaning are anticipated.
• Ensure that environmental cleaning and disinfection procedures are followed consistently and correctly, to include the provision of adequate ventilation when chemicals are in use. Doors should remain open when cleaning the vehicle.
• Routine cleaning and disinfection procedures (e.g., using cleaners and water to pre-clean surfaces prior to applying an EPA-registered, hospital-grade disinfectant to frequently touched surfaces or objects for appropriate contact times as indicated on the product’s label) are appropriate for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in healthcare settings, including those patient-care areas in which aerosol-generating procedures are performed.
• Products with EPA-approved emerging viral pathogens claims are recommended for use against SARS-CoV-2. Refer to List Nexternal icon on the EPA website for EPA-registered disinfectants that have qualified under EPA’s emerging viral pathogens program for use against SARS-CoV-2.
• 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 (e.g., stretcher, rails, control panels, floors, walls, work surfaces) should be thoroughly cleaned and disinfected using an EPA-registered hospital grade disinfectant in accordance with the product label.
• Clean and disinfect reusable patient-care equipment before use on another patient, according to manufacturer’s instructions.
• Follow standard operating procedures for the containment and disposal of used PPE and regulated medical waste.
• Follow standard operating procedures for containing and laundering used linen. Avoid shaking the linen

PREVENTATIVE TRANSFER COMPLIANCE

AS A CONSEQUENCE OF THE COVID-19 PANDEMIC, THE FOLLOWING ARE PREVENTATIVE RECOMMENDATIONS FOR FIELD PERSONNEL:

• YOU ARE SICK DO NOT COME TO WORK
• SANITIZE ALL TOUCHPOINTS ON THE AMBULANCE AND STRETCHER BEFORE AND AFTER ALL TRANSFERS
• USE APPROPRIATE PPE (SOME EQUIPMENT WILL NOT BE AVAILABLE UNTIL SUPPLY CHAIN IS RESTORED)
• UPON ENTERING PATIENTS HOME, MAINTAIN A SAFE DISTANCE (3-6FT), GET VERBAL MEDICAL HISTORY FOR THE LAST 48 HOURS FOR PATIENT AND ALL CAREGIVERS. (FLU LIKE SIGNS AND SYMPTOMS)
• TAKE TEMPERATURE OF PATIENT AND CAREGIVERS.
• WHEN ARRIVING AT PATIENTS APPOINTMENT, DO NOT TRANSFER PATIENT UNTIL TREATMENT ROOM IS READY UNLESS OTHERWISE INSTRUCTED AND PRACTICE SOCIAL DISTANCING (3-6 FT).

Some people infected with the virus have no symptoms. When the virus does cause symptoms, common ones include low-grade fever, body aches, coughing, nasal congestion, runny nose, and sore throat. However, COVID-19 can occasionally cause more severe symptoms like high fever, severe cough, and shortness of breath, which often indicates pneumonia.

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PATINET ASSESSMENT

• If the patient is suspected of having COVID-19, EMS clinicians should put on appropriate PPE before entering the scene. EMS clinicians should consider the signs, symptoms, and risk factors of COVID-19
• If information about potential for COVID-19 has not been provided by the patient or caregiver, EMS clinicians should exercise appropriate precautions when responding to any patient with signs or symptoms of a respiratory infection. Initial assessment should begin from a distance of at least 6 feet from the patient, if possible. Patient contact should be minimized to the extent possible until a facemask is on the patient. If COVID-19 is suspected, all PPE as described below should be used. If COVID-19 is not suspected, EMS clinicians should follow standard procedures and use appropriate PPE for evaluating a patient with a potential respiratory infection.
• If available, a facemask should be worn by the patient for source control. If a nasal cannula is in place, a facemask should be worn over the nasal cannula. Alternatively, an oxygen mask can be used if clinically indicated. If the patient requires intubation, see below for additional precautions for aerosol-generating procedures.
• During transport, limit the number of providers in the patient compartment to essential personnel to minimize possible exposures.
• Drivers, if they provide direct patient care (e.g., moving patients onto stretchers), should wear all recommended PPE. After completing patient care and before entering an isolated driver’s compartment, the driver should remove and dispose of PPE and perform hand hygiene to avoid soiling the compartment.
  • If the transport vehicle does not have an isolated driver’s compartment, the driver should remove the face shield or goggles, gown and gloves and perform hand hygiene. A respirator or facemask should continue to be used during transport.
• All personnel should avoid touching their face while working.
• On arrival, after the patient is released to the facility, EMS clinicians should remove and discard PPE and perform hand hygiene. Used PPE should be discarded in accordance with routine procedures