6 ways to avoid taking the flu home

Routine vaccination is essential for protecting individuals and communities from influenza during the pandemic

December 09, 2019 12:22 PM •

It’s easy to groan when the pager squawks out yet another “sick person, possible flu” call, but these folks can be really ill and they need our help. However, they can also easily spread that illness to us and our families.

To better understand EMS agency vaccination mandates and provider practices, and how these might impact influenza and COVID-19 vaccination amongst frontline personnel, we surveyed EMS providers, supervisors and chiefs. More than 500 responses have provided insights into EMS vaccination policies, practices and perceptions. Read the results and weigh in: will you be vaccinated?

This article was originally posted Dec. 9, 2019. It has been updated with new information.

We don’t yet know how COVID-19 will impact the 2020/2021 influenza season. The Centers for Disease Control and Prevention closely monitors flu activity across the country and posts “Influenza-Like Illness” activity maps, updated each week, and has released Interim Guidance for Immunization Services During the COVID-19 Pandemic, noting:

Efforts to reduce transmission of COVID-19, such as stay-at-home and shelter-in-place orders, have led to decreased use of routine preventive medical services, including immunization services. Ensuring that routine vaccination is maintained or reinitiated during the COVID-19 pandemic is essential for protecting individuals and communities from vaccine-preventable diseases and outbreaks.

The flu usually peaks in January or February. The CDC estimates that from Oct. 1, 2019, through Apr. 4, 2020, the flu accounted for 39–56 million illnesses, 18-26 million medical visits, 410,000-740,000 hospitalizations and 24,000-62,000 deaths in the U.S.

It’s easy to groan when the pager squawks out yet another “sick person, possible flu” call, but these folks can be really ill and they need our help. But they can also easily spread that illness to us and our families.

Top takeaways on recommendations to reduce the transmission of influenza

Here are six ways providers can protect themselves and their families during flu season.

1. Seasonal influenza vaccination

The CDC and the Advisory Committee on Immunization Practices stand behind the safety and efficacy of the influenza vaccine and recommend that all people aged 6 months and older, including healthcare providers, be vaccinated. Many healthcare employers require vaccination. It is ideal to get it early in the fall so that the body can build antibodies, but a dose can still be effective if received later.

2. Personal protective equipment

The use of personal protective equipment by EMS providers has increased dramatically since the start of COVID-19, and may impact influenza infection rates.

The flu virus is generally spread by large droplets produced when a person coughs, sneezes or talks. Standard and droplet precautions should be implemented, including wearing a surgical mask and eye protection. If the patient is not having difficulty breathing, it is also recommended to have them were a surgical mask.

The virus may also be transported in aerosol (smaller droplet) form, so the CDC recommends that if healthcare providers are performing aerosol-generating procedures, they wear N95 masks. In the EMS setting, this may include suctioning, airway management or giving a nebulizer treatment, especially if it causes the patient to cough.

3. Management of influenza

Prehospital care of a patient suspected to have influenza is limited to supportive interventions. Poor oxygenation and respiratory failure are often seen in the flu. Provide supplemental oxygen and use standard respiratory support as appropriate and per your protocols. These may include CPAP or BiPAP, assisted ventilations and advanced airway placement.

Patients with the flu are often dehydrated, so insertion of an IV and infusion of crystalloid fluids are usually appropriate.

4. Notify the receiving hospital

When calling in your pre-arrival report, be sure to relay your concerns of influenza and COVID-19 so staff can prepare accordingly.

5. Hand hygiene

Hands should be washed, or alcohol-based hand sanitizers used frequently, including before and after patient contact, even if gloves were worn. If hands are visibly soiled, they should be washed with soap and water.

6. Post-transport decontamination

After the transport, your ambulance will need to be wiped down with an approved sanitizing cleaner. This should include the stretcher, monitoring equipment, BP cuff, stethoscope and any surface that may have been exposed. Large droplet precautions usually include a radius of 6 feet around the patient, so this includes most everything in the back of the ambulance.

After wiping everything down, consider using a UV sterilizing lamp, also known as ultraviolet germicidal irradiation, to further sanitize the back of the ambulance. Portable and handheld units are available in many emergency departments.

Stay safe out there.

Additional resources for influenza prevention, management

Learn more about universal precautions and other measures to prevent the spread of influenza and how to manage influenza patients with these resources from EMS1, the CDC and the World Health Organization:

Michael Fraley, BS, BA, NRP

Michael Fraley has over 30 years of experience in EMS in a wide range of roles, including flight paramedic, EMS coordinator, service director and educator. Fraley began his career in EMS while earning a bachelor’s degree at Texas A&M University. He also earned a BA in business administration from Lakeland College. When not working as a paramedic or the coordinator of a regional trauma advisory council, Michael serves as a public safety diver and SCUBA instructor in northern Wisconsin.