There are five types of COVID EMS calls.
1. Patient is known COVID with confirmed positive test. EMS is notified of this prior to arrival. We wear appropriate PPE. One provider enters the house, and if the patient is ambulatory, walks them out to the ambulance. If they need a stair chair or stretcher, a second provider enters, gowned and we take the patient out to the ambulance.
2. Patient screens positive for COVID through the EMS dispatch questioning. (Fever, shortness of breath, exposure to COVID patients, etc.). EMS is informed. First provider enters as above, assesses patient and takes patient to hospital with appropriate protection.
3. Patient is unknown. EMS single provider enters house, screens/assesses patient. Patient screens positive for possible COVID. We don appropriate PPE as required.
4. Patient is unknown. EMS single provider screens/accesses patient. Screen is negative. No PPE is worn. En route to hospital, patient begins displaying signs symptoms of COVID or changes their story. We think “F!”, and quickly put mask on patient and self.
5. Patient is unknown. EMS screens patient negative. Takes patient to hospital without full PPE. At hospital patient spikes fever. Tests positive for COVID. We get a phone call saying we have been exposed.
I work as a paramedic on the road and I am the EMS coordinator at a hospital emergency department. I track all positive COVIDs brought in by EMS, and make notifications when the patients test positive. I have seen all five of these scenarios play out. (As a medic, I have been through scenarios 2-5, and hopefully not 5 to my knowledge).
The take-a-way is people are testing positive for COVID who you may not suspect have COVID. The only way to protect yourself is to wear your surgical or N95 mask for every patient contact, and put a surgical mask on every patient who rides in the back of your ambulance. That may not yet be your service standard, but it should be. Here at our hospital, we now require everyone in the building to wear a mask, patient, provider, non-clinical staff, and visitor.
Stay safe. Mask up.