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October 31 Update

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10.31.2014

Guidance Update and Video from Dr. Ed Racht

We’ve Come a Long Way:

On Sept. 30, the CDC announced the first diagnosed case of Ebola in the U.S. To steal a line from a famous advertising campaign, “We’ve come a long way, baby!” In less than 30 days, we established our leadership in EMS Ebola response. Our experts and teams in the field rallied together to develop industry-leading transport recommendations, screening protocols, PPE guidelines and training recommendations.

We have screened nearly 71,000 patients at AMR with only 69 meeting the screening requirements for a PUI.

New Videos:
Dr. Ed Racht would love to talk with each employee and answer questions about Ebola, give them a pat on the back and say thank you, but he just can’t get to every AMR location. In true Dr. Racht form, we posted a “Message from Ed” online for everyone to watch. Please take time to view this reassuring, inspiring and motivating message. Click here to watch the video: Dr. Racht’s Message to Caregivers.

The CDC and Medscape collaborated to create a “Donning and Doffing of Personal Protective Equipment (PPE)” video that we recommend showing your team. As a reminder, if our caregivers were to transport an Ebola patient, they will work with pre-trained personnel to don and doff their PPE. http://www.medscape.com/viewarticle/833907

Updated Guidance:
This week the CDC issued Interim Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public Safety Answering Points (PSAPs) for Management of Patients with Known or Suspected Ebola Virus Disease in the United States. The AMR leadership team wants to remind everyone that if we are transporting a PUI, there are two important recommendations:
 
  • Minimize potential staff exposure by limiting the number of staff supporting a transport
  • Minimize invasive procedures on any PUI
There has been a revision to the screening guidance with the “countries traveled to in West Africa” being reduced to only Guinea, Sierra Leone and Liberia. The screening flowcharts and guidance that includes them have been updated on the amr.net/Ebola website: New Day to Day PPE Guidelines:

 The global Ebola outbreak has heightened awareness and utilization of Personal Protective Equipment (PPE) of a magnitude that we haven’t experienced in healthcare for many years. As front-line caregivers, EMS providers must rapidly implement evidence-based PPE in a way that maximizes protection for employees, patients and communities while simultaneously taking steps to avoid overuse and waste of scarce PPE supplies.

As the largest EMS provider in the country, AMR has taken a leadership role in evolving PPE protocols that are based on Centers for Disease Control (CDC) and World Health Organization recommendations for the safe care of known Ebola patients. However, CDC PPE guidance only targets Known Ebola patients, with no specific guidelines for Persons Under Investigation (PUI). AMR has developed guidelines for Ebola PUI patients, who present a substantially lower risk of contagion within the U.S., modeled after the guidelines issued for Known Ebola patients.

Because of the guidance and international discussions during this outbreak, we are evolving our standards for “day-to-day” PPE. We ask all caregivers to review the new guidelines: AMR Personal Protective Equipment (PPE) Guidelines.

During the week of Oct. 27, AMR will begin ordering the “new standard” PPE and disseminating them to operations. Regional CEOs and Clinical Directors will be coordinating distribution. Currently manufactures are reporting low inventory, therefore it may take a few months to for the new equipment to be fully deployed. Until national inventory is adequate, local operations should reserve the “new standard” PPE to cases of Ebola PUI. For this reason, operations should maintain current supplies of fluid resistant gowns on ambulances until they are notified that inventories of coveralls are adequate to meet AMR’s normal inventory requirements.

Patient Privacy Reminder:
At AMR, we place the highest priority on a patient’s right to privacy. Please make sure to review the HIPAA Reminder letter and ensure your crews understand their responsibility to patient privacy.

Important Reminders:

  • EVHC Clinician Hotline - 855-448-1742
  • Visit AMR.net/Ebola for guidelines and screening tools
We continue to monitor the situation across the country. If you need additional information, please contact Scott Bourn at scott.bourn@amr.net or Ed Racht at ed.racht@evhc.net.  

 

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