Author: Steve Weigold

COVID Points for EMS

• Aerosol-generating procedures (AGPs) can be lifesaving.  They also present risks to everyone in the vicinity when the patient has a highly contagious disease.
• AGPs include CPAP, CPR, nebulizers, intubation, Bi-PAP, suctioning, and high-flow O2 by mask.
  • When using a NRM or cannula, place a mask on the patient over the O2 apparatus.
  • If using a BVM, consider placing a towel on the airway to contain aerosol.
• Yes, you need to conserve PPE. But if you’re performing an AGP, you and anyone in the back of the ambulance need to be in N95s or PAPRs.
• Always call the ED for every suspected COVID patient!
  • Make sure you follow the receiving facility’s entry instructions. Hospital personnel may choose to meet you on the ramp to mitigate AGPs; as an example, the may add a HEPA filter between an ETT or trach tube and the BVM.
• All AGPs require notification, even if you’re transporting from a facility who says that they contacted the receiving hospital. 
  • Notify the hospital about AGPs whether you suspect COVID or not.
• When you arrive at the hospital, AGPs need to stop during the brief transit from the ED entrance to the room so we aren’t spraying the air with aerosols generated by the procedure. 
  • The exception is CPR (don’t stop that!), but even bagging can be stopped for the 30 seconds or so until you get into a room where hospital personnel are in PPE.

Yoda’s COVID Points are brought to you by Dayton MMRS with approval from the Region 3 RPAB Chair.  We gratefully acknowledge the help and support of GMVEMSC, and public health, public safety, emergency management and other agencies and individuals throughout the region. 

Please send suggestions for future Yoda Points to david.gerstner@daytonohio.gov.