Coronavirus: How Health Care Workers Can Protect Themselves

IN A NUTSHELL:

• Know how to wear and remove personal protective equipment
• Transmission thought to occur via respiratory droplets among close contacts
• EMS drivers should take extra precautions to isolate themselves during transport

Researchers are still learning about the newly emerged COVID-19, also known as the Coronavirus Disease 2019, including how easily it spreads. Based on what is currently known about COVID-19 and what is known about other coronaviruses, transmission is thought to occur mostly from person-to-person via respiratory droplets among close contacts.

Health care workers are on the front lines of caring for patients with confirmed cases or possible infections with COVID-19. Due to being in close contact with patients, their job gives them an increased risk of exposure to this virus.

Close contact is defined as:

• Being within approximately 6 feet of a patient with COVID-19 for an extended amount of time
• Having direct contact with infectious secretions from a patient with COVID-19

It is important to note that general face mask use is not recommended by the Centers for Disease Control and Prevention (CDC).

How to protect yourself while caring for patients:

There are steps health care workers can take to minimize their chance of being exposed to COVID-19 when caring for confirmed or possible patients. The CDC has infection prevention and control guidelines for health care workers, including the use of recommended personal protective equipment.

The CDC defines personal protective equipment (PPE) as a main source of protection for emergency and recovery workers which is necessary to provide protection from physical, chemical and biological hazards.

Recommended PPE:

• A single pair of disposable patient examination gloves. (Change gloves if they become torn or heavily contaminated)
• Disposable isolation gown,
• Respiratory protection
• Eye protection (goggles or disposable face shield that fully covers the front and sides of the face)

The CDC has specific protocol for how to put on PPE:

When it comes time to remove PPE, the CDC reminds health care workers that the front of the gown, sleeves, and outside of the gloves are considered to be contaminated. Extra precaution should be taken to ensure none of your bare skin touches the contaminated material.

All PPE should be removed before exiting the patient’s room, except if you are wearing a respirator.

To remove the gown:

1. Grasp the gown in the front and pull away fro your body so that the ties break. Make sure to only touch the outside of the gown with your gloved hands.
2. When removing the gown, roll or fold the garment inside-out and into a bundle.
3. As you are removing the gown, peel off your gloves at the same time, only touching the inside of the gloves and inside of your gown with your bare hands.
4. Place the gown and gloves into a waste container.

After all of the PPE has been removed, it is important to wash your hands for a minimum of 20 seconds or use an alcohol-based hand sanitizer.

Tips For First Responders:

• EMS workers should notify the receiving health care facility that the patient has an exposure history and signs and symptoms suggestive of COVID-19
• Keep the patient separated from other people
• Family members and other contacts should not ride in the transport vehicle
• Isolate the ambulance driver from the patient compartment
• Keep pass-through doors and windows tightly shut
• When possible, use vehicles that have isolated driver and patient compartments that can provide separate ventilation to each area.
• Close the door/window between these compartments before bringing the patient on board.
• During transport, vehicle ventilation in both compartments should be on non-recirculated mode to maximize air changes that reduce potentially infectious particles in the vehicle.
• If the vehicle has a rear exhaust fan, use it to draw air away from the cab, toward the patient-care area, and out the back end of the vehicle.

Information from the Centers for Disease Control and Prevention.