Effective: 05-12-23
Supersedes:
The COVID-19 Public Health Emergency ended on May 11, 2023. As such, the Massachusetts Department of Public Health’s Emergency Order directing universal facemask use for all health care providers (including EMS agencies) is terminated and EMS personnel should return to wearing personal protective equipment (PPE) including facemasks when indicated as part of standard transmission-based precautions and evidence-based infection prevention and control policies and procedures.
Should the need arise, Brewster Ambulance Service will incorporate specific actions to be taken during periods of higher levels of community respiratory virus transmission. Such actions may involve specialized patient screening as part of Emergency Medical Dispatch and “Code Isolation” responses, limiting dispatch of first responder agencies, universal masking while on duty, physical distancing, and offering vaccination clinics.
Facemasks
Facemasks are defined as surgical or procedure masks worn to protect the mouth/nose against infectious materials and have been shown to be highly effective at preventing transmission of respiratory illnesses, including COVID-19. Homemade and cloth facemasks are not considered PPE and are not appropriate for use in the healthcare setting or by HCP.
Brewster Ambulance Service makes facemasks available to any team member who chooses to routinely don a facemask. Additionally, healthcare providers should provide facemasks to any patients or visitors who indicate a preference to wear them. Healthcare facilities should make facemask stations and hand sanitizer stations available at facility entrances and other accessible locations.
If a patient exhibits any signs or symptoms of respiratory viral illness and can tolerate it, they should have a mask applied as soon as possible to reduce droplet transmission. Viral filters have been deployed for use with Bag-valve masks (BVM).
PPE for Patients with Suspected or Confirmed COVID-19
DPH recommends that a fit-tested N95 filtering facepiece respirator or alternative and eye protection be used when caring for patients with suspected or confirmed COVID-19. If there is any contact with potentially infectious material, an isolation gown and gloves should also be used.
Respirators
N95 respirators should always be discarded after doffing, such as when leaving a patient room, during a break or before eating or drinking. Respirators contaminated with blood, respiratory secretions, or other bodily fluids must be discarded immediately.
Eye Protection
Disposable eye protection should be discarded when it is removed for any reason; it should not be reused. Reusable eye protection should be cleaned and disinfected when visibly soiled and after removal/doffing. Eye protection may be used for multiple patient care encounters under the following conditions:
Eye protection should be removed and reprocessed if it becomes visibly soiled or difficult to see through.
Eye protection should be discarded if it becomes damaged (e.g., face shield can no longer fasten securely to the provider, if visibility is obscured and reprocessing does not restore visibility).
If reusable goggles or face shields are used each facility must ensure appropriate cleaning and disinfection between uses according to manufacturer’s instructions.
After cleaning and disinfection, reusable eye protection should be stored in a designated location.
HCP should not touch their eye protection while being worn. If they touch or adjust their eye protection, hand hygiene must be performed.
Isolation Gowns
Nonsterile, disposable patient isolation gowns, which are used for routine patient care in healthcare settings, are appropriate for use by HCP when caring for patients with suspected or confirmed COVID-19 when there is any contact with potentially infectious material. HCP may also use reusable (i.e., washable) gowns made of polyester or polyester-cotton fabrics; they can be safely laundered according to routine procedures and reused. Reusable gowns should be replaced when thin or ripped, and per the manufacturer’s instructions. Gowns should be disposed of or laundered after each patient encounter.
Gloves
Gloves should be worn when there is any contact with potentially infectious material. HCP should perform hand hygiene prior to donning and after doffing gloves.
Aerosol Generating Procedures
When healthcare organizations and providers determine there are higher levels of COVID-19 in the community, HCP should don a fit-tested N95 filtering facepiece respirator or acceptable alternate product when performing aerosol generating procedures, such as open suctioning of airways or intubations except in the following circumstances when Standard Precautions may be used:
The patient has recovered from COVID-19 within the previous 30 days;
The patient is asymptomatic, and a COVID-19 test obtained within the past three days is negative.
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