These are all of the previous posts:
Do not put your unit in service if you are short supplies. Please contact your supervisor if you need an item. You have access to restock through your supervisor.
We have fogger machines we are using to supplement your ambulance cleaning on some very specific call types. It is not a replacement for your traditional, it is in addition. Please note the solution is hard to get so we will do it while we can. The recommendation for fogging comes from your field supervisor
Please make sure you are following Lukes/GMR’s recommendation on reusing masks when they have not been compromised and or exposed. It is critical that we keep good inventory .
Open Crew chief spots. Please submit your request Stations 9,14 and 18
Under no circumstance should your vehicle be in service if you are short equipment, this includes ppe. Advise dispatch immediately if you were to ever run out of something. If you respond to a call without equipment that is a violation of your responsibilities.
Crews should have ppe with them available to put on for all calls. You never know when it is needed, this includes a surgical mask for the patient.
Make sure you always have spare uniforms with you. We do have washing stations for exposed clothes at multiple stations. Contact your sup if you have a uniform exposure that requires immediate washing, showering and changing
Compton is looking at changing their response approach. We are looking at the request and will advise of any changes.
This is a guide as to the care and transport of the suspected COVID-19 patient coming to Cedars- Sinai.
Prior to entry to the ED, the provider should doff the PPE and follow the plan for hand-off with the nurse triaging the patient.
Los Angeles County is experiencing an outbreak of the severe acute respiratory syndrome (SARS) – 2 coronavirus known as COVID-19. Based on the current outbreak, most infected persons experience mild illness and fully recover. Those at high risk for severe illness and/or complications are patients who are elderly or have underlying medical conditions. The Centers for Disease Control and Prevention recommends that low risk patients potentially infected with COVID-19 experiencing mild disease self-isolate at home unless symptoms worsen.
Current EMS Policy is:
A. Low-risk patients with mild symptoms of respiratory infection (e.g., fever, cough, upper
respiratory illness) should be advised that their current condition does not require transport to
the emergency department.
B. If the patient or the patient’s legal representative requests that the patient be transported after
assurance that the transport is not needed, EMS personnel should honor the request and
transport to the Most Accessible Receiving Facility (MAR) for adults and to the closest
Emergency Department Approved for Pediatrics (EDAP) for children.
1. EMS personnel transporting patients with suspected COVID-19 shall notify the receiving
facility in advance prior to arrival and may be directed to a screening area other than the
2. EMS personnel who are assessing, treating or transporting a patient with suspected
COVID-19 shall use appropriate PPE at all times to include a N95 mask, gown, gloves
and eye protection. Additionally, place a surgical mask on the patient.
3. On arrival at the hospital and after the transfer of care, doff your PPE and most
importantly wash your hands using soap and water.
We are expecting a significant number of respiratory infection patients over next few weeks. In order to reduce the spread of contamination through the ED, we are requesting that EMS personnel doff their PPE outside of the ambulance bay doors, transfer the more symptomatic patients to a clean gurney and notify the charge nurse of their arrival. Based on their symptoms, the charge nurse will designate the patients accordingly to:
A. Transport mildly symptomatic (walkable) patients to the Tent for triage and assessment.
B. Those that more symptomatic will wait outside of the ambulance bay until the bed is
clean so that they may proceed directly to their bed. Patients who are getting nebulizers
(even though they are trying to push for MDI in mildly symptomatic patients), they will
be required to discontinue this prior to entering the ED.
If the patient did use an MDI via paramedics, please make sure you get them from the paramedics. Studies show that MDI via spacers is just as efficacious as nebulizers. We expect to see an increase in shortage of MDIs going forward. If a patient is getting oxygen, it is recommended that a surgical mask be placed over the mouth and nose to prevent transmission.
Many patients in severe respiratory distress will likely only have a king airway or no intubation at all. It is imperative that the MICN ask the paramedics the type of airway the patient has before ED arrival so we can be prepared beforehand. Once the patient is intubated in the ED, it is recommended that hole be placed in the surgical mask and have the ET tube go through it. This will also help prevent transmission.
Although this policy may increase the “wall time” of the paramedics, it is imperative that these measures be taken in order to prevent the transmission of this disease.
Amar Shah MD, MPH, FACEP
Base Hospital Medical Director
Sam Torbati, MD, FACEP, FAEEM
Co-Chair and Medical Director
Claude Stang RN BSN MA CEN
Executive Director, Emergency Department
1)This is the last week for the overtime raffle. All pickups this week are eligible. Program ends Saturday 3/28/20
2) County Public Health, County EMS and CDC are reevaluating Health Care Provider home isolation times. We will send an update as soon as we have a finalized document from County personnel.
3) Please only use the N95 brand and size you were fitted for. Moldex is our provider unless you were specifically given stock as an individual because of a failed seal test with Moldex brand.
4) Please continue to decon thoroughly after ever call. Please continue to clean your stations thoroughly. Clean high contact points more frequently. Please make sure you are still doing your 30 minute ambulance deep clean.
5) DO NOT COME TO WORK SICK.
6) If you are a trainee, please contact Cristina before coming to HQ to be processed. More details to follow.
7)EMS sent an email to anyone licensed in LA County on how to renew your EMT card this year.
Any questions please contact your divisional field supervisor
Hawthorne M41 310-863-6337
Valley M51 818-968-0373
Carson M61 626-945-0244
Latest PPE Guide from LACoFD
Return to Work Criteria for HCP with Confirmed or Suspected COVID-19
GMR is announcing the following guidelines for the temporary implementation of the Child Care Assistance Program for frontline caregivers and support personnel essential to continuing the operational mission of GMR during the Coronavirus Disease (COVID-19) pandemic.
Click HERE for details
COVID-19 Potential Exposure Reporting Procedure
In an effort to streamline the reporting process for potential or suspected exposure to COVID-19, GMR Medicine and GMR Clinical Informatics have developed an online screening tool.
As some of you may have heard, the LAX hourly rate has been temporarily increased to pay 65 dollars per hour for local operations caregivers that commit to a full time 12 hour shift thanks to a government increase . Anyone selected would be responsible for getting to and from the airport. We are not sure how long the special project at this rate will last. Your current shift would be saved if you are selected for the program. You will most likely be scheduled 4 out of every 5 days and will not get to select the day or shift, that will be at our discretion. We have no additional details so please await us contacting you if you submit an interest. If you were interested in moving to a full time schedule at the airport please email the following information
2)your cell phone
3)your email address
4) your current shift
McCormick will stage 1 block out for every call in Redondo Beach. Make sure the staging location allows us to visualize the address to confirm that Redondo is on scene. If they are not on scene we will await their arrival.
Once Redondo is on scene we will make contact with the Captain or if the engine is not on scene the Medic and ask for direction on how and when to approach the patient.
2020 - Skills Dates
Free for McCormick Employees
2020 - Global CPR BLS Skills
Free for McCormick Employees
1. PPE standards for dealing with suspected/confirmed COVID-19.
If FD is already on scene, FD will be sending a Primary Health Care Provider (HCP) to interview patient and family to necessitate the need for additional PPE’s. If the patient meets the criteria, McCormick crew members should don a N95 mask, goggles/eye protection, gown and gloves. A surgical mask or, if appropriate, a NRB should be placed on the patient to minimize exposure. Once patient care has been transferred to the receiving facility, the crew should doff the PPE’s and place in a red bio-hazard bag and dispose at the hospital in an appropriate container. Immediately wash hands thoroughly with soap and water. If hand washing is not possible, utilize a hand sanitizer followed up with hand washing as soon as possible. Decontaminate all equipment with the Pro-Tech Solution and allow 10 minutes of dry time before going back in service.
If the McCormick crew is first on scene, every attempt should be made by one provider to question the patient/family regarding potential symptoms. Please try to avoid entering any building/structure before asking the following questions. At minimum, keep a six foot buffer between yourself and anyone you’re speaking with.
Questions that should be asked;
“Is anyone at the location, including the patient having any flu like symptoms, runny nose, sore throat or fever?”
“Has anyone at the location, including the patient, been exposed to anyone confirmed to have COVID-19?”
“Has anyone at the location, including the patient, traveled outside of the USA in the past 21 days?
When possible, all patient assessments shall start from a minimum distance of 6 feet away to assess for the possibility of flu like symptoms
NO PATIENT RIDE A LONGS unless a minor, or mandatory caregiver for special needs. All patients should bring their cell phone and charger for family communication. No exceptions. Hospitals will not allow family visitors
2. OSHA Update regarding use of N95’s and annual fit testing:
OSHA is temporarily suspending the annual fit testing of N95 respirators to preserve and prioritize the supply of respirators for use in situations where they are required to be worn. If you use an N95 mask and the patient does not meet the guidelines or PPE’s, please re use the mask unless the integrity of the mask has been compromised
WHEN WOULD AN ANNUAL FIT TEST BE WARRANTED?
If the employee/employer observe visual changes in the employee’s physical condition that could affect respirator fit (e.g., facial scarring, dental changes, cosmetic surgery, or obvious changes in body weight).
If your face shape has changed since your last fit test, you may no longer be getting a good facial seal with the respirator and, thus, are not being adequately protected.
Field Crews should inform their on-duty supervisor if the integrity and/or fit of their N95 filtering face piece respirator are compromised.
Exposure to COVID-19 and other illnesses can be greatly reduced if proper prevention takes place. The following measures should be taken:
DO NOT COME TO WORK IF YOU ARE SICK. This includes cough, nasal mucous, fever (100.4 or higher), vomiting or diarrhea.
Wash your hands on a regular basis. Before and after all patient contacts, after cleaning your ambulance, after your morning station decontamination and before you eat.
If you are exposed to a potential COVID-19 patient:
Try to isolate yourself.
At minimum try to maintain the 6 foot barrier between yourself and other people.
Contact the AMR nurse hotline immediately for guidance 855-361-1996.
Practice social distancing. Try to keep a minimum separation of 6 feet between yourself and others and avoid contact such as shaking hands or hugging.
Maintain good health. Get plenty of rest, maintain a moderate exercise program, eat healthy foods, avoid smoking and keep up to date on vaccinations.
HAND HYGIENE. Avoid touching your face and wash your hands frequently with soap and water for at least 20 seconds.
Thoroughly clean workstations daily. This should be done at shift exchange, or ASAP. This includes shared workplaces with a focus on screens, telephones, keyboards, computer mouse, door handles, light switches, restrooms, kitchens, sleep quarters, etc.
Disinfect the front and rear cabs of the ambulance and all durable medical equipment after each patient contact utilizing the Pro-Tech solution. (See GMR Ground Vehicle COVID-19 Decontamination Standards.)
Note: Crews should visually inspect the N95 respirator to determine if the structural and functional integrity of the respirator has been compromised. Over time, components such as the straps, nose bridge, and nose foam material may degrade, which can affect the quality of the fit and seal. If the structural and functional integrity of any part of the respirator is compromised, or has been used on a confirmed or suspected infectious patient, or if a successful user seal check cannot be performed, discard the respirator and use a new one.
4. GMR GROUND VEHICLE COVID-19 DECONTAMINATION STANDARDS
Vehicle will be decontaminated after transfer of care of a confirmed or suspected COVID-19 patient at the receiving facility. Single person decontamination inside the vehicle should be performed to avoid incidental contact in the vehicle.
Employees are engaged in the cleaning and decontamination of GMR ground vehicles (including maintenance staff and Vehicle Service Technicians).
PRO-TECH RTU. If needed, a 1:48 bleach to water solution may be used which is 1/3-cup bleach to 1-gallon water (allowed to dry for 10 minutes).
The Pro-Tech disinfectant and bleach solution are never to be used together.
Disposable rags/disinfecting wipes.
Red Biohazard Bags/Yellow Melt Away Infectious Linen Bags
≥60% Alcohol Based Hand Sanitizer (ABHS)
Gloves (Multiple Pairs for Glove Changes)
Face Shield or Goggles
N95 or greater respirator
Vehicle doors should remain open for a minimum of 10 minutes prior to decontamination allowing sufficient air exchanges to remove airborne virus and throughout decontamination process to provide ventilation during use of decontaminants or bleach solution.
Note if ambulance doors require opening use clean gloves to touch door to avoid potentially contaminated door handles.
Properly don PPE.
Lay two clean sheets at the back of the ambulance. One to be used to place potentially contaminated reusable equipment on and one to be used as a post-decontamination surface. (Place red biohazard bags/yellow infectious linen bags and extra gloves on each sheet).
Place potentially contaminated reusable equipment (monitors, portable oxygen cylinders, etc.) on the decontamination sheet.
Potentially contaminated equipment that requires manufacturer special cleaning instructions may be bagged for later cleaning.
Place linen in yellow infectious linen bags for proper cleaning later.
Remove any contaminated materials from reusable equipment and decontaminate by wiping down all surfaces and placing used rags/wipes in red biohazard bag (leave red bag on decontamination sheet close to accessible edge).
Place decontaminated equipment on post-decontamination sheet for drying.
Absorb/wipe any liquid or solid spills.
Clean and decontaminate all potentially contaminated surfaces inside ambulance patient treatment area and driver/passenger compartment. Special attention should be given to high contact areas such as control panels, floors, walls, cabinet facings, seats, cot, mounts, door handles as well as main oxygen cylinder with recommended decontaminant and dispose of in red biohazard bag.
Place red biohazard bag at edge of decontamination sheet.
Properly doff and leave PPE on decontamination sheet.
Use alcohol-based hand sanitizer.
Don clean pair of gloves from post decontamination sheet.
Place used red biohazard bags in new ones from the post-decontamination sheet.
Fold up the decontamination sheet with PPE inside and place the contents in red biohazard bags.
Doff and dispose of gloves in red biohazard bag.
After surfaces dry, place equipment back in vehicle.
Dispose of post-decontamination sheet in yellow infectious linen bags for proper cleaning later.
Wash hands thoroughly or use Alcohol based hand sanitizer
Dispose of used red biohazard bags according to local procedures for regular medical waste.
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads (maintenance staff and Vehicle Service Technicians should utilize the protective equipment and procedures discussed in this document).
5. Effective immediately, all ambulances going to Providence Saint Joseph Medical Center are to drop off and pick up in the front of the hospital due to pop up tents and screening for Covid-19 taking place in the ambulance bay.
6. Long Beach Memorial Visitor Limitation
For adult patients:
NO visitors are allowed in the Emergency Department for general visitation.
If a visitor/family member is needed for crisis control/history/interpretation, or the patient is altered or dependent , ONE (same person) who must be a minimum of 16 years of age AND remain in the room for the duration of the patient’s stay may come in with the patient.
ALL VISITORS MUST BE MASKED
End of life patients – 2 visitors
For pediatric patients:
Minors under the age of 18 may have one parent who must remain in the room for the duration of the visit
End of life patients – 2 visitors
ALL VISITORS MUST BE MASKED
For labor and delivery patients:
1 labor support person (must be same person throughout stay). No siblings.
ALL VISITORS MUST BE MASKED
Today's update from GMR
Linked to video (Takes a bit longer to load)
Today's update is a link to information produced specifically for McCormick Employees.
to be updated!
A.Torrance memorial is implementing a new process while they deal with Covid-19.
Inbound patient procedures:
1. Crews should should call Torrance when coming in with a BLS run 310-325-2223
2. At arrival the patient should not be brought in the ambulance entrance until a crew member checks in with the assigned nurse (they will be sitting at the entrance) and confirms chief complaint and evaluates if the patient is showing any symptoms related to Covid-19.
3. After checking in the nurse will direct whether the crew needs to enter through the main entrance where they have isolation or if they can enter through the regular entrance.
They are requesting we verify basic questions like recent fever, cough, shortness of breath, travel and potential exposures.
We have produced a qr code that has been placed at all stations that allows you to scan and get the most recent updates from us. It should reduce the emails you receive. It is important you check it daily when arriving on shift.
A) Please make sure you are doing a deep clean of your unit at shift change. We are allotting 30 minutes daily. If you get disrupted because of emergency traffic please handle at the next earliest interval.
B) Make sure you read the information regarding the new cleaning products. Luke sent it out yesterday. These are the 2 exclusive options until further notice
C) When switching out your house oxygen tank, please remember to place a cap on top of the used one and make sure the tank is chained back up with the rest of the empty house tanks
D) When you need to use the bio hazard disposal containers at one of our approved stations, please remember you gain access with your L3 key to the padlock
E) Make sure you are checking your temperature and looking for symptoms identified on the self check list at your stations. Do this every morning and every night. If you have a ride along or trainee have them check themselves too. Ride alongs must have their own ppe and proof it has been fit tested.
If the reading is above 100.4°F, please obtain your body temperature again to confirm the reading.
If the second reading is found to be above 100.4°F, please keep a distance of 6 feet from other people and contact the Nurse Navigator Line at 855-607-1418.
If at any point prior to, during, and/or after your shift you begin to experience a cough or shortness of breath, please notify your Supervisor and contact the Nurse Navigator Line at 855-607-1418 for additional assistance.
If you have taken any over the counter medications for symptoms including fever and/or cough, please be sure to relay the information to the Nurse Navigator Line representative.
F) Do not come to work sick. If you are sick, call off. Not just because of this new virus, because its important to keep others healthy.
G) Lastly. Please wash your hands frequently for at least 20 seconds. Please clean your stations and units. Clean high touch common areas more frequently.
Thanks. We look forward to the QR code era!
Michael Jones, EMT, SPO
310-946-0345 (Office & Fax)