AMR COVID-19 DAILY OPERATIONAL UPDATES PAGE

Operational changes and informational updates are being published daily. In an effort to keep you fully informed, we will provide these updates and any relevant events that are included in these updates here.

NOTE: Many of the subject material that is covered in these updates will be moved to the their prospective subject (ex: PPE, Decon, DICO, etc..) pages on our website.

OPERATIONAL UPDATES:

 

AMR-SDFD COVID-19 Operational Update 57  UPDATE 5-18-2020

Gibeck Humid Vent filter no longer for use with nebulizer

  • Can still use with BVM without nebulizer procedure

  • Bact-Trap filters still approved for nebulizer use

To view this document with pictures and clarification CLICK HERE

Gurney Safety and unauthorized Modifications

Nothing may be attached or tied to gurney hooks, handle

  • This is a safety hazard, may cause gurney to not secure properly and potentially prevent the magnetic safety from working to disable to raise/lower when secured to the hooks and handle

 

PPE Guidelines have been established - Please follow them

REMEMBER: A Scout always wears ALL PPE on every call until COVID is determined

  • Collaborate with engine on PPE level, call supervisor with questions after call if clarification needed

    • Concerns about PPE level on some calls have arisen

 

IMPORTANT: If you find yourself in a call with High risk procedures, back out and get your full PPE on.

 

FANNY PACKS have been received and are waiting for PPE mask canisters to distribute to crews. 

Plastic FaceShields have been issued to each ambulance. 

  • You must wear these shields with eye protection

  • Plastic face shields available at 42A, (2) per ambulance to be distributed and shared, now available for all units

NEW COVID-19 Response and Decon Protocol 5.15.20

The IMT has released a new version of the COVID-19 Response and Decon Protocol 5.15.20

This includes a provision for the use of "face shield, and/or goggles"  It is recommended that you maintain a second form of eye protection under the faceshield.

To view this document CLICK HERE

N95/N100 FFR Collection for Reuse:

Remember: We are still collecting face masks

  • Write your name on front, bottom of FFR before use. This is to ensure you get your mask back after decontamination

  • Reuse FFR as normal, per current practice

    • After high-risk procedure place mask in bag

  • When bag is full, drop off at 42A, and get a new bag and clip

DICO Frequently Asked Questions

The IMT has released an informative document outlying many commonly asked questions and clarifications.

Example: What is the difference between an “Encounter” vs. “Exposure”?

Encounter: within 6’ of a patient who screens positive for potential COVID-19

  • Full PPE (N100/N95, gown, gloves, and face shield and/or goggles) without a breach

  • Option to document on a Minor Injury Form o DICO contact is NOT required

Exposure: within 6’ of a patient who screens positive for potential COVID-19 and any of the following:

  • Missing any PPE (N100/N95, gown, gloves, or face shield and/or goggles) or a PPE breach.

  • Any aerosolized procedures including suctioning, CPAP, nebulized mediations, bag-mask ventilation, advanced airway placement, chest compressions, as well as patients with significant coughing/sneezing.

  • Extensive body contact with a patient (i.e., moving or lifting of a patient).

Please Review this document, to view CLICK HERE

EPCR Documentation of PPE Used on a Call

  • StreetEMS now requires PPE level to be documented for all providers, drop-downs are located in the “3 dots” button

DMV IS BACK IN BUSINESS!

Select DMV Offices have been reopened, Please ensure you maintain a valid license.

  • Normal St, San Marcos and Commercial (Rancho California) Offices 

  • Expired/Expiring licenses still valid through 6/30

Please ensure you maintain a valid license!

Lessons Learned Document

The IMT has released some incidents where AMR crews were not in appropriate PPE on calls. Please review this and learn from it. To view this document  CLICK HERE

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-57 CLICK HERE

------------------------------------

AMR-SDFD COVID-19 Operational Update 56  UPDATE 5-11-2020

Guidelines developed in preparation of state orders being lifted (Stage 2).

California is moving into Stage 2 in the Resilience Roadmap

 

Department of Motor Vehicles: Select DMV Field Offices to Reopen to Public
The DMV will reopen select field offices across the state on Friday, May 8, 2020. Although the CA DMV will be keeping expiring commercial licenses, endorsements, and certificates valid through June 30th, we are advising you to keep your license valid, so you do not end up going over the June 30th deadline. The DMV field offices that will be opening locally in the San Diego Region are:

  • DMV Office San Diego, 3960 Normal Street, San Diego, CA 92103,

  • Industry Business Center (IBC) Rancho San Diego, located at 1530 Hilton Head Rd., El Cajon, CA 92019. This location only serves commercial drivers.

  • DMV Office San Marcos, 590 Rancheros Dr., San Marcos, CA 92069

Updated Document: COVID-19 Response and Decon Protocol 5.6.20
COVID-19 Positive Screen:

  • A positive screen is any patient with these symptoms or combination of symptoms:

    • Cough, shortness of breath or difficulty breathing

  • Or at least two of these symptoms:

  • Fever, repeated shaking with chills, muscle pain, headache, sore throat, the new loss of taste or smell

Download the new COVID-19 Response and Decon Protocol 5.6.20 CLICK HERE

Encounter vs. Exposure:

  • Encounter: within 6’ of a patient who screens positive for potential COVID-19

    • Full PPE (N100/N95), gown, gloves, and goggles) without a breach

    • Option to document on a exposure report with DICO

    • DICO contact is NOT required

 

  • Exposure: within 6’ of a patient who screens positive for potential COVID-19

    • Missing any PPE (N100/N95, gown, gloves, or goggles) or a PPE breach.

    • Any aerosolized procedures including suctioning, CPAP, nebulized mediations, bag-mask ventilation, advanced airway placement, chest compression, as well as patients with significant coughing/sneezing.

    • Extensive body contact with a patient.

    • When the scene stabilizes, contact DICO.

    • Complete Communicable Disease Exposure Report. Complete on scene (legible, include FS#), enter names of exposed crew members, take a photograph of form and email to DICO call taker who contacted you, send the form to hospital with the patient (if not possible, ensure form is delivered to the hospital ASAP).

Lessons Learned

  • Remember to do your twice daily on-duty temperature checks, link is on your iPad and checks are mandatory

  • Dispatch has implemented a Problem/Nature “Suspected COVID 19”, call may have additional notes to the complaint

    • May triage out as another complaint, this does NOT mean the call is not COVID 19 related, be aware!

  • Definition of COVID-19 exposure changed, now includes:

    • Any PPE breach, or missing any PPE on COVID pt

    • Any aerosolizing procedure, even with proper PPE

    • Extensive body contact with patient

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-56 CLICK HERE

FOCUS Mental Health Video Links 

----------------------

 

AMR-SDFD COVID-19 Operational Update 51  UPDATE 5-11-2020

Guidelines developed in preparation of state orders being lifted (Stage 2).
• San Diego Ready: Responsible COVID-19 Economic Reopening (RECOVER) CLICK HERE

 

Temperature Checks on Duty is Mandatory

Remember to do your twice daily on-duty temperature checks, link is on your iPad and checks are mandatory

DO NOT COME TO WORK IF YOU HAVE COVID SYMPTOMS

  • If symptomatic, please call off to a supervisor, we do not wish to infect patients, co-workers or their families

  •  *updated* COVID-19 symptoms per CDC: Cough or SOB, OR 2+ of fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, new loss of taste/smell

PPE Kits are no longer being made

- PPE kits no longer being made, pieces still available in bin 8, please check for Gowns!

Lessons Learned

  • Depending on the status of a patient, your first three actions should include 1. Place a mask on the patient; 2. Take a temperature; and 3. Ask COVID related questioning.

    • the tempo of your call.If needed, slow down

  • Following a medium or high level of exposure, employees will continue to work regular duty while monitoring their health status at work and at home. Should symptoms occur, notify DICO immediately.•

    • Continue to prioritize your daily health screenings.o C

    • Reference the Isolation Guideline and Isolation Protocol in the File Cloud.

  • Calls, where PPE is traditionally not worn such as welfare checks and lockouts, can quickly turn into an exposure.

  • Anticipate inaccurate information when responding to calls that were triaged through multiple dispatch centers, agencies, and by a 3rd party (i.e., Customs and Border Protection, MTS, private ambulance company, “passerby”).

  • With the significant increase in COVID-19 cases in Baja California, responding to the U.S./Mexico International Border should be a “watch-out situation.”•

    • Over 10% of COVID-19 cases in San Diego County are in zip codes 92154 & 92173 (6’s, 30’s, 29’s, and 43’s Districts).o

    • Do not solely rely on the information on your MDC when deciding on your level of PPE.

    • Continue bringing additional PPE with you when away from your apparatus (i.e., gowns).

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-51 CLICK HERE

--------------------------------

AMR-SDFD COVID-19 Operational Update 50  UPDATE 5-05-2020

DO NOT COME TO WORK IF YOU HAVE COVID SYMPTOMS

  • If symptomatic, please call off to a supervisor, we do not wish to infect patients, co-workers or their families

  •  *updated* COVID-19 symptoms per CDC: Cough or SOB, OR 2+ of fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, new loss of taste/smell

Temperature Checks on Duty is Mandatory

Remember to do your twice daily on-duty temperature checks, link is on your iPad and checks are mandatory

PPE Kits are no longer being made

- PPE kits no longer being made, pieces still available in bin 8, please check for Gowns!

Download the New PPE Photos and Restocking Document 

SDFD PPE Photos and Restocking 05.04.2020 CLICK HERE

New Mask Re-Use Procedure Video

Demonstrates steps to take when submitting your mask for decontamination CLICK HERE

Lessons Learned

 

  • Depending on the status of a patient, your first three actions should include 1. Place a mask on the patient; 2. Take a temperature; and 3. Ask COVID related questioning.

    • If needed, slow down the tempo of your call

  • Following a medium or high level of exposure, employees will continue to work regular duty while monitoring their health status at work and at home. Should symptoms occur, notify DICO immediately.

    • Continue to prioritize your daily health screenings.

    • Reference the Isolation Guideline and Isolation Protocol in the File Operations file attached.

  • Anticipate inaccurate information when responding to calls that were triaged through multiple dispatch centers, agencies, and by a 3rd party (i.e., Customs and Border Protection, MTS, private ambulance company, “passerby”).

  • With the significant increase in COVID-19 cases in Baja California, responding to the U.S./Mexico International Border should be a “watch-out situation.”

    • Over 10% of COVID-19 cases in San Diego County are in zip codes 92154 & 92173 (6’s, 30’s, 29’s, and 43’s Districts).

    • Do not solely rely on the information on your MDC when deciding on your level of PPE. Continue bringing additional PPE with you when away from your apparatus.

  • Radio communication between a unit on scene and incoming units is critical for maintaining situational awareness and limiting additional personnel into the scene.

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-50 CLICK HERE

----------------------------

AMR-SDFD COVID-19 Operational Update 49  UPDATE 5-04-2020

You Must Wear the mask between responses, in the ambulance and in fire stations

  • Public health order is now in place, requiring anyone over 2 years old to wear a facial covering in public when with 6 ft of a non-family member

Download the Mask Public Health Order Document 

To view the Mask Public Health Order Document  CLICK HERE

New Mask Re-Use Program Procedure Video

• Demonstrates steps to take when submitting your mask for decontamination CLICK HERE

PPE Kits Are No Longer Being Made

  • PPE kits are no longer being made, individual pieces like gowns and masks can still be found in bin 8

    • Engines will still be restocking PPE 1 for 1 from ambulance

  • Please ensure you are doing your twice daily temperature check while on duty, they are mandatory

Target Solutions Child Care Survey and Mental Health Services

 

Plastic Bags to store your PPE and Uniforms Between Shifts

  • Water soluble bags now in bin 8 if you need uniform change

    • You Can throw bag directly in washing machine

 

Lessons Learned:

  • Radio communication between a unit on scene and incoming units is critical for maintaining situational awareness and limiting additional personnel into the scene.

  • Slow down the tempo of the call to ensure personnel are wearing the appropriate level of PPE.

    • When delivering an aerosolized generating treatment, take the time to don a gown before treatment.

    • Face shield or goggles continue to be the preferred level of eye protection.

    • Check your partner's level of PPE before engaging in patient care.

  • Supervisors, when working with new crew members, take the time to review and discuss expectations along with best practices.

    • Always provide your crew with a leader’s intent and recognize that not all personnel have the same level of experience when required to make sound and timely decisions.

  • Even if there are no initial COVID related signs and symptoms, have gowns readily accessible on emergencies so that you can adjust your level of PPE.

  • Continue to prioritize initial COVID-19 assessment questions, placing a mask on the patient, and taking an initial temperature.

  • Your comfort level should not be your guide to donning the appropriate PPE. When encountering potential COVID-19 patients, reference the medical aid zone PPE pictograph to ensure the proper level of PPE is worn.

  • With the significant increase in COVID-19 cases in Baja California, responding to the U.S./Mexico International Border should be a “watchout situation”.

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-49 CLICK HERE

---------------------------------------------

AMR-SDFD COVID-19 Operational Update 44  UPDATE 4-29-2020

Changes to Medical Triage of COVID-Incidents-Dispatch Protocol: Suspected COVID-19

  • Effective Tuesday, April 28, 2020, certain calls triaged through Metro will follow a revised protocol known as “Card 36” or the “Suspected COVID 19” protocol card.

    • Designed to rapidly identify COVID affected patients and accelerate the dispatch triage process.

    • The Problem/Nature “Suspected COVID 19” will be an indicator that the call type was triaged under this new protocol.

    • The dispatcher may add additional notes to the specific complaint within the call type.

    • Some calls may triage out to other call types (i.e., non-COVID related symptoms, immediate life threats). This does NOT mean the call is not COVID related.

    • Continue to treat calls with careful consideration for COVID related illness (i.e., call triaged out of Card 36 due to questioning).

Updated & New Documents:

  • SDFD PPE Photos & Restocking 04.27.2020

    • CPAP with Filter and In-Line Nebulizer (Option #1 – Limited Availability)

    • CPAP with Filter and In-Line Nebulizer (Incorrect – DO NOT USE)

    • N95/N100 Re-Use Procedures

    • N95/N100 Collection, Decontamination, and Reuse Information

Download the Updated PPE Photo and Restock Document 

To view the AMR-SDFD-PPE Photo and Restock Document  CLICK HERE

Updated list of COVID-19 symptoms per the CDC:

symptoms may appear 2-14 days after exposure to the virus, added symptoms are highlighted.

 

  • Fever Cough

  • Shortness of Breath

  • Chills

  • Repeated shaking with chills

  • Muscle Pain

  • Headache

  • Sore Throat

  • New loss of taste or smell

IMPORTANT: REMINDER to do your twice daily on-duty temperature checks, link is on your iPad and checks are mandatory

Reminder: N95/N100 Collection, Decontamination, and Reuse
• N95/N100 masks must be identified with your first initial, last name, permanent station/division with a permanent marker on the bottom of the mask.

Download the FFR Collection and Reutilization Program 

To view the AMR-SDFD-FFR Reutilization Program CLICK HERE

Behavioral Wellness update – Dr. Dave Bond

  • Focus' YouTube Channel CLICK HERE

    • This is a short informational video to share at home 

    • Helping our kids (and ourselves) express emotions and work with uncertainty Video CLICK HERE

------------------------------

AMR-SDFD COVID-19 Operational Update 42  UPDATE 4-27-2020

Governor Newsom issued an executive order concerning emergency child care

In response to the COVID-19 pandemic, Governor Newsom issued an executive order concerning emergency child care for children of essential workers who are not able to work remotely.
• To help determine type of care, age groups, hours, and location needed by workers please complete this short survey.


Take the Survey CLICK HERE

Child care assistance though the YMCA
Financial Assistance for Child Care Services for Essential Workers and At-Risk Population

To access this Program CLICK HERE

Personal Protective Equipment Guidelines:

  • Isolation kit with gown for all COVID patients and high-risk procedures

  • Surgical mask and issued goggles required on all calls § Upgrade to N95 and gown if COVID suspected

  • Facial coverings are to be used for duration of your shift

N95/N100 FFR Collection for Reuse:

  • Write your name on front bottom of FFR before use. This is to ensure you get your mask back after decon

    • i.e., J. McCormack – MS72A - AMR

  • Reuse FFR as normal, per current practice

    • After high-risk procedure, instead of discarding, place FFR mask in bag

    • SDFD will restock FFR masks 1 for 1 from ambulance resupply bin like normal, will place their FFRs for decon in the ambulance bag also

    • New process coming where single FFRs will be placed into sandwich paper bag before going into larger bag

  • When bag is full, drop off at 42A, and get a new bag and clip

  • Keep bag in outside compartment with trauma bag

Download the FFR Collection and Reutilization Program 

To view the AMR-SDFD-FFR Reutilization Program CLICK HERE

Lessons Learned:

  • Health checks performed at work sites are like performing an assessment on a patient. Remember to keep your distance while asking questions and taking a temperature.

  • Continue to limit the number of personnel involved in the initial assessment and throughout the call. Utilize a scout when appropriate.

  • Carry gowns with you when traveling a distance from the apparatus. PPE should be easily accessible by all crew members throughout the call.

  • Notes on the MDC regarding potential COVID-19 hazards should not be solely relied upon when
    entering a scene. Continue making your scene survey and scene safety a top priority upon arrival.

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-44 CLICK HERE

---------------------

AMR-SDFD COVID-19 Operational Update 38  UPDATE 4-22-2020

N95/N100 Particulate Respirator Reuse Program

As everyone is aware, with the dwindling supply of PPE, we are looking at the possibility of having to re-utilize or N95 and N100 masks.

SDFD has purchased a Hydrogen Peroxide Sanitizer to sanitize our used masks.

Where to Store your Used Masks

Please start collecting serviceable used N95 and N100 masks in the Brown paper bag (folded and clipped) stored in the Trauma bag compartment on the apparatus.

REMEMBER: Please turn the bag into supply when it is near full and get a replacement bag.

Proper Positioning of the HEPA Filter and ETCO2 Device:

The Medical Director has clarified the proper positioning of the HEPA Filter and ETCO2 device.
 

  • The proper positioning of the devices are as follows

    • Patient — Mask/Tube/King/etc. — HEPA Filter — EtCO2 device — rest of ventilation apparatus/delivery system

  • For in-line nebulized treatments, the positioning of the HEPA filter is shall be;

    • Patient-Mask/Tube/King/etc. – ETCO2 device- in line nebulizer-HEPA Filter- rest of ventilation apparatus/delivery system

Lessons Learned:

  • Continue to educate bystanders, including other City employees, on the proper PPE and social distancing on scene with crews.

  • When the MDC states “COVID POSITIVE” anticipate and/or request instructions from the unit already on scene via the tactical channel.

    • If unable to raise the on-scene unit, send in your scout to conduct a scene survey and coordinate.

  • For continuity, ensure both HEPA filters are stored with the EKG monitor NOT in the airway bag.

  • If you remove a piece of PPE when disengaging from patient care (i.e., support or contamination reduction zone) don’t forget to don it if you find yourself re-engaged with the call.

  • Be cognizant when entering medical facilities for areas that may be designated for COVID-19 related patients (i.e., quarantined area).

    • Confirm with staff prior to entering areas that may require higher levels of PPE.

  • Not wearing a face mask or respirator will place you into CDC’s high-risk exposure category if interacting with a suspected or known COVID-19 patient that was not wearing a facemask.

    • This applies even if the patient is asymptomatic (i.e., no fever or cough).

    • Maintain your situational awareness on “routine calls” (i.e., traffic accidents, lock out, ringing alarm) that can quickly develop into a potential exposure.

    • Treat all calls with precautionary measures to limit any unnecessary exposures.

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-38 CLICK HERE

SDFD Photos & Restocking 04.21.2020

  • New pictures for options when using the Humid Vent Filter, Humid Vent Filter with In-Line Nebulizer, Options for using the BACT-TRAP Mini, BACT-TRAP Mini Filter with In-Line Nebulizer

  • Pictures of re-usable face shield for all first responder apparatus

  • Distribution to begin on April 21, 2020

  • The re-usable face shields are constructed of plastic. The adjustable Velcro elastic headband is constructed of synthetic fiber.

  • The forehead comfort pad is a non-porous, closed cell foam which restricts absorption of water, air and gases.

  • The re-usable face shields shall be cleaned in the same manner as goggles.

  • The preferred eye/face protection for suspected/confirmed COVID-19 patients are:

  • Goggles (Better)

  • Disposable Surgical Mask with face shield (Good)

NOTE:​ Re-Usable Face Shield (Best) (AMR this is on Order and not yet Issued)

Note: Goggles may be used in conjunction with the Re-Usable Face Shield.

Download the PPE Photos and Restocking 4-21-2020 Update

To view the AMR-SDFD-SDFD PPE Photos and Restocking 04.21.2020- CLICK HERE

------------------------------------

AMR-SDFD COVID-19 Operational Update 35  UPDATE 4-20-2020

Facial Coverings must be worn at all times on shift!!

  • Facial coverings are to be used for duration of your shift

  • Must wear at all times unless in station in your dorm

  • This included while riding in the front cab of ambulance

  • Re-usable cloth masks available at 42A, 2 per person

Rolls of Visqueen are available to seal off the front and back of the Ambulance!!

  • Visqueen is available in your PPE bin, for you to seal off the front and back of the ambulance. 

Station Car Crews must NOT wear uniform to work!!

  • Station units are being asked to please leave your uniforms at station and arrive/leave in plain clothes

HEPA Filters Placement

  • The Hepa Filters are to be placed closest to patient and EtC02 sensor goes on after that.

Fogging of glasses and goggles:

  • Anticipate rotating out personnel if fogging of goggles becomes a safety concern

    • Be cognizant of cross contamination when re-adjusting your mask and goggles

  • Tips for preventing fogging of glasses and goggles

    • Ensure a tight seal over the bridge of the nose

    • Wash your glasses/goggles with soapy water and let them air dry

    • Move your classes towards the tip of your nose

    • Add anti-fog wipes, sprays or creams on your lenses (IMT Logistics is in the process of procuring)

    • Clean your glasses with a dab of shaving foam or cream

    • Video: How to wear your face mask without fogging up your glasses

P-801 (3)(a) – Temporary Exemption/Waiver Granted for Mandatory Two medics on calls

  • Two paramedics will not be required to be dispatched to an ALS response Granted through May 15, 2020 (with possibility of extension)

  • Part of a strategy to contain and mitigate the COVID-19 pandemic

  • One paramedic may be dispatched to ALS responses via first responder OR ground transport vehicle, as available

  • When ALS ambulances are unavailable, SDFD will send a second first responder with a BLS ambulance to CPR calls

  • Captains can still request additional resources, if required

Balance During Covid-19 Webinar

Webinar specially prepared for first-responder spouses or significant others

All AMR and SDFD families are invited to join this meeting.

  • SUNDAY, APRIL 26 • 2PM

  • ZOOM MEETING ID: 922 2233 6270

  • password: lets_talk

Download Balance During Covid 19 Webinar Flyer

SDFD/AMR Balance During Covid 19 Webinar Flyer CLICK HERE

Other Important Items

  • Be cognizant when entering medical facilities for areas that may be designated for COVID-19 related patients (i.e., quarantined area).

  • Not wearing a face mask or respirator will place you into CDC’s high-risk exposure category if interacting with a suspected or known COVID-19 patient that was not wearing a facemask.

  • This applies even if the patient is asymptomatic (i.e., no fever or cough).

  • Maintain your situational awareness on “routine calls” (i.e., traffic accidents, lock out, ringing alarm) that can quickly develop into a potential exposure.

  • Treat all calls with precautionary measures to limit any unnecessary exposures.

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-35 CLICK HERE

 

 

-----------------------

AMR-SDFD COVID-19 Operational Update 33  UPDATE 4-17-2020

Important Reminder: do not report to fire station units in uniform!!

  • Station Car Crews are NOT allowed to enter fire Stations in uniform. Please go to the station in street clothes and change before your shift.

  • No Exceptions 

New SDFD Isolation Guidelines Complete 04.16.2020

Please refer to this very informative guide on COVID-19 exposure and Isolation.  AMR employees remember to contact the duty supervisor and the DICO Team for direction on shift removal and testing followup.

Download the Isolation Guidlines

SDFD Isolation Guideline Complete 04.16.2020 CLICK HERE

How NOT to Wear a Mask  04.16.2020

The COVID IMT has released a new Pictogram of how NOT to wear your mask or on-duty face coverings.

Please remember that these covers are required while on duty (including inside the ambulance cab) and the reusable cloth face coverings are not to be used on calls

Please protect the spread to others and wear the mask!!

Download the How NOT to wear the Mask Pictogram

SDFD/AMR How NOT to Wear a Mask  04.16.2020 CLICK HERE

NEW Infectious Control PPE Photos and Restocking Guide 04-16-2020

The COVID IMT has released a new Infectious Control PPE Photos and Restocking Guide.

It contains images of our PPE and treatment support items with configurations.

 

Please take a moment to review this File.

Download the NEW Infectious Control PPE Photos and Restocking Guide

SDFD/AMR NEW Infectious Control PPE Photos and Restocking Guide  04.16.2020 CLICK HERE

COVID19 PPE ZONES Final v2

The IMT has produced an updated COVID-19 PPE Zone document (V2) 

Please replace your original with this on on your ambulance and phone.

Download the COVID19 PPE ZONES Final v2

SDFD/AMR NEW COVID19 PPE ZONES Final v2  04.16.2020 CLICK HERE

N95/N100 Particulate Respirator Reuse Program

As everyone is aware, with the dwindling supply of PPE, we are looking at the possibility of having to re-utilize or N95 and N100 masks.

SDFD has purchased a Hydrogen Peroxide Sanitizer to sanitize our used masks.

Where to Store your Used Masks

Please start collecting serviceable used N95 and N100 masks in the Brown paper bag (folded and clipped) stored in the Trauma bag compartment on the apparatus.

Download the N95/N100 Particulate Reuse Program Document

N95/N100 Particulate Reuse Program Document CLICK HERE

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-33 CLICK HERE

---------------------

AMR-SDFD COVID-19 Operational Update 29  UPDATE 4-14-2020

Important Reminder:  Replace your Cloth Mask with the appropriate respirator (i.e., N95/N100) prior to patient contact

  • Replace your reusable cloth mask with the appropriate respirator (i.e., N95/N100) prior to patient contact.

  • Check your crew members prior to patient contact to ensure the appropriate PPE is donned every time.

MASK USE DECISION MAKING

Surgical Masks can be used on all patients (COVID suspected included) Except:

 

N95 Mask SHALL be used on all calls where High-Risk Procedures are used:

 

  • CPR

  • BVM

  • CPAP

  • Nebulized RX

  • High-Flow 02 via NRB mask (remember to put surgical masks over these treatment deliveries)

GOWN USE DECISION MAKING

IMPORTANT!! If you are within 6 feet of a known or suspected COVID-19 patient you should be wearing a gown.

 

  • Not wearing a gown is categorized as a low-level exposure by the CDC and San Diego County EMS.

Download the Daily PPE Protocol Update

To view the AMR-SDFD-Operational COVID-19-Response and Decon Protocol and PPE Zones 4.5.2020- CLICK HERE

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-29 CLICK HERE

N95/N100 Particulate Respirator Reuse Program

Maintaining availability of N95/N100 Filtered Face Respirators Through Sterilization

  • SDFD purchased a Hydrogen Peroxide vapor sanitization machine for FFR decontamination

    • Machine will not be delivered for about a month

    • Bags will be distributed tomorrow to start collecting FFRs for storage, anticipating more FFR shortages

Masks will only be sanitized if unable to get new FFRs

Download the N95/N100 Particulate Reuse Program Document

To view the AMR-SDFD-Particulate Respirator Sanitization Program- CLICK HERE

---------------------------------

AMR-SDFD COVID-19 Operational Update 28 UPDATE 4-12-2020

Important Reminder:

  • Replace your reusable cloth mask with the appropriate respirator (i.e., N95/N100) prior to patient contact.

  • Check your crew members prior to patient contact to ensure the appropriate PPE is donned every time.
     

PPE Pictograph “COVID Medical Aid Zones”:

  • Please reference the pictograph to assist you in determining the level of PPE, tasks and the number of personnel within the three zones of a medical aid.

Download the COVID Medical Aid Zones 

To Download the PPE Pictograph “COVID Medical Aid Zones” CLICK HERE

Lessons Learned:

  • Common occurrence/repeating lesson learned:

    • Assume that all patients may have COVID-19 and place a surgical mask on them immediately, even if there are no indicators of COVID-19 from the dispatch notes or from initial information given by family/bystanders at the scene.

  • Consider standing back until necessary information is gathered by the call taker when you have a short response time.

  • to any of the COVID questions.Family stated to members of a crew that they believed the patient would have not been treated if they told ECDC “Yes”

    • Realize that it may be difficult for ECDC to obtain relevant COVID information.

  • For your situational awareness, calls originating from SDPD’s dispatch (that are not transferred over to ECDC) may have missing information.

    • These calls are not necessarily triaged for COVID-19.

  • Remember to utilize an in line Hepa-Filter with a BVM, prior to placing an advanced airway.

  • Utilization of Masks:

    • N95/N100 is the preferred mask, especially for any aerosolized procedures.

    • With several types of masks available it is important to take the time to ensure you are not wearing a department issued cloth reusable mask on emergency responses.

    • Check your partner before conducting patient assessment and treatments.

  • If an exposure report is required on an 11-44, the DICO will process the report.

    • It does not need to go through PD or the Medical Examiner.

    • The Health and Safety Office will conduct any follow up.

  • Several low-level exposures have occurred due to crew members conducting patient assessments without gowns.

    • The level of PPE must always be your priority prior to approaching a patient.

  • If you are within 6 feet of a known or suspected COVID-19 patient you should be wearing a gown. Not wearing a gown is categorized as a low-level exposure by the CDC and San Diego County EMS.

  • Advise incoming responding crews if additional PPE is required prior to their entering of the scene.

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-28 CLICK HERE

 

 

 

-------------------------

AMR-SDFD COVID-19 Operational Update 26 UPDATE 4-10-2020

DO NOT COME TO WORK IF YOU HAVE COVID SYMPTOMS 
If symptomatic, please call off to a supervisor and make sure they contact the DICO, we do not
wish to infect patients, co-workers or their families

 

Personal Protective Equipment Guideline: 

  • Isolation kit with gown for all high-risk procedures

  • Facial coverings are to be used for duration of your shift

    • Must wear at all times unless in station in your dorm

    • Re-usable cloth masks available at 42A

 

S-415(a): 

  • Medic units only, per county policy paramedic assessment

  • Please complete TargetSolutions training ASAP

    • 112/Bridged and 43/Medics still need to complete the assignment as of yesterday afternoon

Safety Message: 

  • All patients receive a surgical mask if tolerated

  • Wear surgical mask, goggles and gloves on all calls

    • N95/N100 for high risk patients and skills

    • Several low-level exposures have occurred because of crew members engaging without gowns. 

  • Continue to prioritize your level of PPE prior to engaging in patient care.

    • Advise incoming responding crews if additional PPE is needed prior to them entering the scene.

  • To avoid unnecessary fogging of goggles, ensure you get a good face/nose seal on your mask.
     

Download the Daily Operational Update

To view the AMR-SDFD-Operational COVID-19-Daily-Update-25 CLICK HERE

 

California Health Advisory Update #11: Corona virus Disease 2019 (COVID-19)

  • COVID-19  Infectious Potential Report

  • Patients with COVID-19 are considered infectious 48 hours prior to symptom onset as per the Centers for Disease Control and Prevention (CDC)

  • CDC Community Spread Report

Download the CAHAN-Alert

To view the Californai Heath Advisory Alert CLICK HERE

 

GMR Emerging Infectious Diseases Web Page Update 

  • COVID-19 Pay Reference Guide

    • Exposure Definitions

    • Contact Definitions

    • The Centers for Disease Control, local Public Health Departments and community protocols

Download the Daily Operational Update

GMR Emerging Infectious Diseases Web Page Update CLICK HERE

 

Expiring EMT/Paramedic/CPR/ACLS Certifications

  • Governor of the State of California issued an Executive Order N-39-20

  • All EMS personnel (EMT, AEMT, and Paramedic) with licenses or certifications (or local accreditation) expiring in March, April, or June of 2020 shall have their license or certification expiration dates extended until July 31, 2020.

 

Download the Daily Operational Update

Expiring EMT/Paramedic/CPR/ACLS Certifications CLICK HERE

GMR COVID-19 Ground Ambulance Decontamination Guide

  • Vehicle Decontamination Guidelines

  • Tri-jet fogger Use Instructions

Expiring EMT/Paramedic/CPR/ACLS Certifications CLICK HERE