By Greg Friese
“What is the role of EMS in a pandemic?”
Thomas Beers, the @OneTallMedic on Twitter, asked this question recently.
https://twitter.com/OneTallMedic/status/1278339087443922946
If someone asked you this, what would you say? This is how I replied to his question:
https://twitter.com/gfriese/status/1278359514350313474
1. Take care of sick people
2. Don’t get sick
3. Don’t make other people sick
4. Share and distribute public health messages
Though Beers didn’t specifically qualify the question as a “COVID-19 pandemic,” COVID-19 was top of mind for me as I answered the question.
Let’s go through each of the answers:
1. Take care of sick people
The number one role for EMS is always taking care of people who are sick and injured. Assess and treat what you find with the tools and training available to you within your scope of practice.
During the COVID-19 pandemic, EMS has capably adapted to crisis standards of care by increasing treatment in place, utilization of telemedicine and transporting patients to alternative destinations. Some of these adaptations are sure to become a permanent part of EMS in the years ahead.
2. Don’t get sick
The second most important role of EMS providers is to not get sick.
Unfortunately, staying healthy during a pandemic when there is still much to learn isn’t as easy as a three-word admonition to “not get sick.”
It has become increasingly clear though that the right PPE combination – N95 mask, gloves, eye protection and gowns – prevents transmission of COVID-19 to healthcare workers. PPE use by EMS needs to be supported by employers securing adequate supplies, a robust supply chain that is responsive to shifting volume and geographic demands, and policy requiring PPE use.
In addition, EMS providers can stay healthy with frequent handwashing, wearing a mask, as well as practicing social distancing, on- and off-duty. And don’t forget the other important things that support a robust immune system – eat well, drink plenty of water, exercise often, sleep at least seven hours per day, minimize alcohol consumption, don’t use any tobacco products, and manage the micro- stressors of life and work as they happen rather than letting them build up.
3. Don’t make other people sick
Infection control practices, like PPE, handwashing, catching your cough and disinfecting work areas, serve a dual purpose:
- To keep you healthy by reducing or eliminating opportunities for you to be exposed to the patient’s potentially infectious materials, And,
- To prevent other people from getting sick by reducing or eliminating opportunities for pathogen exposure
Follow policies and standards for cleaning the ambulance, patient cot and diagnostic equipment, such as cardiac monitors and stethoscopes, between every call.
In addition, EMS agencies have an increasing array of options for reducing pathogens with hydrogen peroxide and ultraviolet light. Regardless of the cleaning technology, it is adherence to process, training on how to correctly clean and supervision that not only allows time for disinfecting but also reinforces following procedure that makes all the difference.
4. Share and distribute public health messages
Perhaps the most surprising and simultaneously least surprising feature of the COVID-19 pandemic has been the “infodemic” or the spread of misinformation, unverified treatment claims, and aspersions about practical and easily applied solutions to slow the spread of COVID-19.
EMS can and always should be a trusted voice to the community it serves and EMS should only use its social media channels and print/television contacts to share and distribute information from the Centers for Disease Control and Prevention, World Health Organization, and state and county public health officials. If in doubt about the source or veracity of a public health message, don’t share until you can verify its authenticity.
I’d like to add a fifth role to my reply to the @OneTallMedic: Prepare for the future.
EMS leaders and field providers should have an eye to the future and be constantly asking and seeking out answers to questions like:
- What can we do now to better prepare for a surge of COVID-19 cases in our jurisdiction?
- If, and when, a COVID-19 vaccine is available, how will we secure doses for our personnel and their loved ones? Will we make vaccination a condition of employment? Can we?
- What scope of practice changes, policy revisions and training materials are needed to allow EMS providers to collect COVID-19 test samples, administer vaccines, work as a physician extender for telehealth visits, transport patients to alternative care destinations and work as a contact tracer?
- How will the 20-21 influenza season exacerbate PPE supply chain challenges, as well as decisions to treat in place or transport to a receiving facility?
- How can we continue to communicate with our community about our availability to respond and importance for the early treatment of stroke, heart attack and other time critical emergencies?
Thanks again to Thomas Beers, the @OneTallMedic on Twitter, for initiating this discussion. Share your ideas with Beers on Twitter or in the comments about what you see as the most important roles for EMS during a pandemic.
