PPE, Precautions & Paramedic Safety: COVID-19

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*** March 26th Update *** The podcast is now current as of March 26^th. Slight changes were edited and re-recorded near the end of the presentation regarding the cleaning of ambulances and the proper PPE to be worn while doing so. These changes are consistent with the policies found in the BCEHS Handbook under ‘Cleaning and Disinfection’, and have been validated by Janie Nichols, our infection control specialist. These changes include limiting PPE for routine cleaning of ambulances after COVID transports to using gloves and ACCEL wipes, ventilating ambulances for 20 minutes only after an aerosol-generating medical procedure was performed in the back, and very limited scenarios where N95's and full PPE are required for cleaning.

Resources for Cleaning & Disinfecting: https://handbook.bcehs.ca/clinical-resources/infection-prevention-and-control/cleaning-and-disinfection/

Hosts:

Gord Minaker - PCP-IV, UBC Medical Student

Kaela Richardson - Respiratory Therapist, UBC Medical Student

Guest:

Kevin Lambert - Critical Care Paramedic, Paramedic Practice Educator

Acknowledgements:

Janie Nichols, Infection Prevention Specialist

Date of Episode Release:

March 25, 2020

Episode Description & Summary:

In this episode, we review best practices regarding personal protective equipment (PPE), precautions to be taken on COVID calls, and paramedic safety in the context of COVID-19.

Please see below for a timeline of the questions we ask during this episode, and for links to resources.

Please refer to the BCEHS Handbook for latest guidelines: https://handbook.bcehs.ca

Contacts:

Clinical Questions - clinicalpractice@bcehs.ca

Podcast feedback & suggestions - podcast@bcehs.ca

Podcast Timeline:

1:03 - How is COVID-19 spread?

2:16 - What can paramedics do on a day-to-day basis?

4:21 - Are calls still being screened for “Influenza Like Illness” waits?

6:00 - What calls should we be wearing PPE on?

7:14 - What should do before we arrive on-scene to prepare?

9:23 - How should we prepare the ambulance for transport?

13:14 - Are surgical masks ever acceptable when encountering COVID cases?

14:59 - What sort of eye protection should we use?

16:35 - Should we use the buddy system for PPE?

18:19 - Reviewing Donning and Doffing

22:00 - Should we be double gloving?

22:44 - Should we wear boot covers?

24:08 - Limiting gear exposure in the ambulance during transport

26:47 - Reverse Isolation for Patients

27:49 - Who do we need to notify of COVID calls?

29:19 - Reducing the number of people exposed on calls

30:33 - When should drivers doff? What PPE should we wear in the cab of the truck?

32:36 - How should we reduce hospital exposure?

36:15 - How should we clean the ambulances?

39:50 - What PPE should we wear to clean?

44:20 - A final word from Kevin Lambert

References & Links:

BCEHS Doorway Assessment: https://handbook.bcehs.ca/covid-19/covid-19-update-march-23rd/on-scene-doorway-assessment/

Donning PPE video here: https://youtu.be/btrFMvj3Gm8

Hand Hygiene video here: https://youtu.be/J7aILlTnE78

Doffing PPE video here: https://youtu.be/Rro4RJ5Az88

Donning & Doffing Poster: https://handbook.bcehs.ca/clinical-resources/infection-prevention-and-control/ppe/donning-and-doffing/

Hand Hygiene Poster: https://handbook.bcehs.ca/clinical-resources/infection-prevention-and-control/hand-hygiene/cleaning-your-hands/

Cleaning and Disinfecting Resources: https://handbook.bcehs.ca/clinical-resources/infection-prevention-and-control/cleaning-and-disinfection/