Georgia OEMS COVID-19 Guidance for First Responders (EMS, Fire, Law Enforcement)

COVID-19 Resources for EMS

OEMS COVID-19 Guidance Webpage
GA DPH COVID-19 Daily Status Report
CDC Guidance for EMS and 911 PSAP
IAED Emerging Infectious Disease Surveillance Tool
CDC COVID-19 Website
DPH COVID-19 Resources
EMS.GOV COVID-19 Resources
Regional EMS Office Contacts
Risk Assessment for HCP with potential exposure to Pt with COVID-19

Be sure to review Table 1 related to monitoring and work restriction recommendations.
US Fire Administration Coronavirus
When to Call 911
COVID-19 Screening Tool (Apple/CDC)

DPH and the Office of EMS and Trauma will make every effort to keep this site up-to-date. Previously circulated guidance documents from OEMS related to COVID-19 have been replaced by this website.

DPH is working with all of our federal, state and local partners in preparation for and response to this emerging public health threat. As part of that response, DPH is recommending that EMS agencies and 911 Public Safety Answering Points (PSAPs) follow the current guidance from the CDC. 911 centers may also choose to use the latest Emerging Infectious Disease Surveillance Tool published by the International Academies of Emergency Dispatch.

Georgia COVID-19 Suppliers

Many Georgia companies have joined the fight against the COVID-19 pandemic by providing critical health care supplies to those on the front lines of this fight: health care workers, first responders and law enforcement, food service industry employees, logistics workers, and reopening small businesses. Please click HERE to see the list of Georgia suppliers of PPE.

A few CDC updates that you and your partners may find useful (7/15/2020):

First, there is now a “one stop shot for COVID-19 toolkits”
- https://www.cdc.gov/coronavirus/2019-ncov/communication/toolkits/index.html

CDC’s press release on wearing masks
- https://www.cdc.gov/media/releases/2020/p0714-americans-to-wear-masks.html

Guidance for Healthcare Workers about COVID-19 testing
- https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing.html

Key Considerations for Transferring Patients to Relief Healthcare Facilities when Responding to Community Transmission of COVID-19
- https://www.cdc.gov/coronavirus/2019-ncov/hcp/relief-healthcare-facilities.html

Guidance for U.S. Healthcare Facilities about COVID-19 (various guidances reorganized)
- https://www.cdc.gov/coronavirus/2019-ncov/hcp/us-healthcare-facilities.html

Office of EMS and Trauma COVID-19 Update Calls (includes notes for 01/08/2021)
The Georgia Office of EMS and Trauma will be hosting bi-weekly update calls regarding COVID-19 guidance for EMS and the impact on the EMS Educational and Licensing pipeline. Call-in information will be sent to EMS Agency Directors, EMS Agency Medical Directors and EMS Initial Education Programs. Please contact your Regional EMS Director to be added to their contact list to receive the call-in information.

Previous Calls:
Priority COVID-19 Testing for First Responders (EMS, Fire, Law Enforcement) (Updated 4/16/2020)
Healthcare workers, first responders, law enforcement and long-term care facility residents and staff will be prioritized for testing regardless of whether they are or are not symptomatic. To learn more, please review the following documents.
- 4/15/2020 - Press Release - Expanded Testing for COVID-19 In Georgia
- COVID-19 TESTING / Direct Patient Line
COVID-19 NOTIFICATIONS TO 911 PSAPs AND FIRST RESPONDER AGENCIES (Updated 4/14/2020)
It is essential that EMS and other first responders are informed of any potential exposure to patients who test positive for COVID-19. The health and safety of our first responders is extremely important and notifying them in a timely manner of any exposure to COVID-19 allows them to keep themselves, their families, and the general public safe, and helps us to reduce the spread of COVID-19.

This document details our approach for notifying the public safety community of any potential exposure, and is two-pronged:
1. Prospective – (p1 of the referenced document) - GEMA/HS will have access to a limited data set from DPH of all of the COVID-19 cases in Georgia. The data will include address, Date of Onset, and List Removal Date. This data will be shared by GEMA/HS with the 911 PSAPs so that any first responder being dispatched to an address with a confirmed case during the 21 day period following Date of Onset will be notified of the presence of a confirmed case at that address.
  - NOTE: It is important to understand that most cases of COVID-19 in the community are not known so precautions should be taken to protect all first responders on all calls, regardless of whether the address has been flagged. The list provided will only contain the address of those persons who are known to be positive following a test and cannot be assumed to contain the locations of all persons who are capable of transmitting SARS-CoV-2, the virus causing COVID-19. 911 PSAPs should continue to ask the COVID-19 screening questions for all requested responses.
2. Retrospective (pp 2-4 of the referenced document)
  - Hospital notifications – hospitals/acute care facilities will be asked to notify the Regional EMS Director of any confirmed case at their location. The Regional EMS Director will use that to notify the first responder agencies of a potential exposure.
  - Case list from DPH data – each Regional EMS Director will be given the daily cases reported in SENDSS (the DPH data system where COVID-19 cases are reported). They will then search the EMS Patient Care Report data (GEMSIS Elite) to see if there are any recent patient contacts recorded in the EMS data. If there are, then the Regional EMS Director will notify any of the agencies that may have come into contact with the patient for the 2 weeks prior to the Date of Onset.
We feel that using this two-pronged approach will allow DPH and GEMA/HS to notify first responders in a timely manner, and help us to reduce the spread of COVID-19.
Notices from FBI Regarding Healthcare and Public Health Sector (Updated 4/22/2020)
- Individual(s) Targeting Hospital Staff to Solicit the Sale of COVID-19 Personal Protective Equipment (PPE) with a Fake Certification Letter in an Email
- Indicators of Fraudulent 3M Personal Protective Equipment
Battelle Decontamination System (as of 4/13/2020)
1. Battelle has a regional team to work with healthcare professionals, e.g., hospitals, LTCF, first responders, etc. to help them with the correct storage, packaging, shipping, etc.
  1. Please review the attached Emergency Use Authorization to see which entities are included in the federal contract.
2. The agreement is between the facilities and Battelle. Due to the federal contracted awarded to Battelle, the only cost to the facility is shipping.
3. Under the current FDA EUA, they can only clean N95s. They are testing cleaning other PPE.
  1. The FDA EUA is for N95 respirators. It covers any N95s (healthcare and industrial) that are not cellulose based. Respirators must be certified by NIOSH as an N95. If NIOSH hasn’t certified it, Battelle does not recommend decontamination via their process.
  2. View the EUA here
Steps:

Step 1: Enroll:
- The Facility/system needs to enroll in the decontamination cleaning program. To do so, please click the following link: https://www.battelle.org/inquiry/offerings-and-services/covid-response/
- Once you have submitted your information, you will receive an email providing you with the next steps and documents to review.
Step 2: List of Facilities:
- Read the information and send a list of participating facilities to the contact provided in the email.
- DO NOT fill out the sample agreement. It is only for review.
- You will then provided a contract for your facility/system (4-5 pages in length) and site codes that MUST be written on each mask.
Step 3: Save your masks:
- Please use this guidance for how to label and store masks.
  - Masks should be labeled per the attached guidance and be free of any visual contaminants, e.g., fluids, makeup, or other contaminants.
  - Masks need to be stored and prepared for shipment in the following manner:
    Label per the attached guidance (individuals should label their own masks), to include name and site code
    
    Place masks in biohazard bags (multiple masks in each bag)
    
    Place the biohazard bag in a secondary bag (does not have to be a biohazard bag) and decontaminate it with a sanitizer wipe
    
    Placed bags in a cardboard box for shipping (125-150 masks per box)
    
    Label the box with a biohazard sticker (you must use the sticker)
Step 4: Shipment:
- The facility is responsible for the shipment.
- You may use your preferred Biohazard shippers (the vendor must be able to ship biohazard material). Battelle does have a contract with Cardinal.
Step 5: Cleaning and Return:
- All masks must be free of debris. If they are not, they will be disposed of by the decontamination team.
- Masks are cleaned and returned to the facility according to the site codes on the masks. At this point, they are no longer a biohazard and can be safely shipped.
- The System Team’s goal is to return all masks within 72 hours. However, it may take a bit longer, depending on their workload.
For additional information, Battelle has a “Frequently Asked Questions” page that is updated regularly: https://www.battelle.org/inb/battelle-ccds-for-covid19-satellite-locations/
Requesting PPE Resources (Updated 3/8/2021)

PPE may only be requested for emergency supply, and must be requested through your county EMA.
Information for Licensed EMS Personnel (Updated 3/27/2020)
Licensed EMS Personnel have a responsibility to keep patients safe and are expected to exercise due diligence in following CDC and DPH guidance as well as Local Medical Director protocols to prevent the spread of infectious diseases. DPH Rule 511-9-2-.18 (22) Standards of Conduct for Licensees requires that:
- (22) A licensee shall take no action that would jeopardize the health or safety of a patient, including without limitation the abandonment or mistreatment of a patient.
Any unprotected exposure (e.g., not wearing recommended PPE) should be reported to your occupational health services, a supervisor, or a designated infection control officer for evaluation.Public Safety personnel (EMS, fire, law enforcement) who have been exposed to a patient with suspected or confirmed COVID-19 should notify their chain of command to ensure appropriate follow-up.
- Personnel should be alert for fever or respiratory symptoms (e.g., cough, shortness of breath, sore throat). If symptoms develop, they should self-isolate and notify occupational health services and/or their public health authority to arrange for appropriate evaluation.
National Institute of Environmental Health Sciences COVID-19 Worker Training Program Webpage (info on protecting yourself from COVID-19 in the workplace)
Information for Public Safety Agencies (EMS, Fire, Law Enforcement) (Updated 4/22/2020)
Public Safety Agencies should review or establish processes to:
1. Ensure personnel are aware of the current recommendations and guidelines issued by the CDC and Georgia Department of Public Health. Providing links to the CDC and GDPH Coronavirus web sites is the best method of ensuring access to the most up to date and current information.
2. Coordinate with City or County management to update and or develop systems or process for reporting a possible or real exposure, coordinating with agency/department Medical Director and public health. As well as developing a quarantine/isolation plan.
3. EMS Agencies should work with your medical director to update your Infectious Disease Exposure policy and equipment/vehicle decontamination procedures as appropriate. The latest CDC guidance should be consulted for this.
Questions? Reach out to your Regional EMS Director.

The CDC has created guidance for the Implementation of Mitigation Strategies for Communities with Local COVID-19 Transmission, and that can be accessed here, and the latest guidelines for Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings can be found here.

The CDC has also created Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease (COVID-19), available here.

Links:
Information for EMS Initial Education Programs (Updated 5/1/2020)
EMS Initial Education Programs should be in the process of planning and making decisions on how best to respond to the impact of COVID-19. Since the spread of COVID-19 is continuing, please know that the Georgia Office of EMS and for Paramedic programs, CoAEMSP, supports you as you work through this public health crisis. We will work with our programs to help them navigate issues that impact their students.

All initial education programs (not just Paramedic programs) should consult the CoAEMSP website homepage for the latest COVID-19 guidance related to the completion of initial education programs, as well as the Regional Training Coordinator for your area.

For the latest guidance on what modifications to EMS initial education programs are permitted during the COVID-19 Public Health Emergency, click HERE . This document includes the information shared on the WebEx on Wednesday, 4/15/2020.

Given the current situation that faces Georgia and our country, it is vital that EMS initial education programs continue and prepare the students to enter the workforce as entry-level providers. Please contact your Regional Training Coordinator if you need assistance.

We are also aware of challenges related to testing sites for the National Registry Cognitive exams. For the latest information from the National Registry related to COVID-19, please visit their website here.

Teaching online? You should complete the Distance Education Effectiveness Assessment available HERE.

Links:
- Guidance for interruptions of study related to Coronavirus (COVID-19)
- Pearson Vue NREMT Essential Services Testing
- Pearson Vue COVID-19 (Coronavirus) scheduling and rescheduling
- CoAEMSP - FAQs Document Released Based on April 5, 2020 Statement Regarding COVID-19 (Coronavirus)
- CoAEMSP website (information on COVID-19 for Education Programs)
- NREMT Page on COVID-19
- CoAEMSP Tools Developed to Support Programs During COVID-19
- EMS Education Pipeline is a summary document on the status of the Emergency Medical Services (EMS) education pipeline during a series of recent conference calls with EMS stakeholder organizations.
Pearson VUE Testing Availability Search (Updated 4/23/2020)
Pearson VUE has added an “Anonymous Seat Search” to the Pearson Vue National Registry Page (https://home.pearsonvue.com/nremt). This will allow anyone to search for availability at testing centers without an Authorization To Test (ATT).

From the Pearson Vue National Registry Page:
1. Select Seat availability from the right-side menu; Click Next
2. Select the Examination for which you wish to see availability; Click Next
  1. You’ll have the option to view testing policies; Click Next
3. Enter an address, including the City, State, and Zip Code; Click Search
4. From the list of available centers, you may select a maximum of three, to view their seating availability.
  1. You may select alternative test centers from an option on the screen.
Electronic Patient Care Report (ePCR) Documentation & ICD-10 Codes to Use (Updated 3/24/2020)
- Recent Travel/Travel Locations
  - As a reminder, all EMS personnel are required to document the recent travel question (itExam.070 – “Has the patient traveled outside their community within the last 30 days?”) on ALL patient contacts in their ePCR.
    “Community” is defined by the medical director and need not be limited to just travel outside of the United States.
    
    Choices for the travel question include: “No,” “Yes,” “Unknown,” “Unresponsive,” “Refused.”
  - If the answer to the travel question is “Yes,” then the medic is required to answer the following additional questions:
    itExam.072 - Beginning Travel Date
    
    itExam.071 - Ending Travel Date
    
    itExam.074 - Travel Locations (Document all places and locations the patient has traveled in the last 30 days)
- Narrative
  - Include the term “COVID-19” in the narrative (eNarrative.01) for any patient that has a confirmed positive COVID-19 test, has an exposure to a confirmed patient, or is a suspected case or patient under investigation.
- Personal Protective Equipment Used
  - EMS Personnel should record what Personal Protective Equipment (PPE) was used on each Patient by each Crew Member by recording the appropriate choice in eOther.03 - Personal Protective Equipment Used. This is a multi-select field, so EMS crew members should record any and all PPE that they use related to the Patient.
- Potential Exposures
  - If EMS Personnel have a potential exposure during patient care, then this should be documented properly on the electronic patient care report.
    eOther.05 - Suspected EMS Work Related Exposure, Injury, or Death (Choices are "Yes" or "No")
    
    eOther.06 - The Type of Work-Related Injury, Death or Suspected Exposure (this is a multi-select field)
- Primary (eSituation.11) and Secondary Impression (eSituation.12)
  - The following COVID-19 ICD-10 codes are recommended as of 3/17/2020 for documentation related to COVID-19 - all of these codes have been made active in GEMSIS Elite, and all other software vendors and agencies should make sure that these are available as well:
    Impression: COVID-19 – Confirmed by testing
    ICD-10 Code: B97.29
    
    Description: Prior to EMS interaction, the patient has confirmed COVID-19. Examples include interfacility transports, transport from clinic or skilled nursing where diagnosis is known, etc.
    
    Impression: COVID-19 – Exposure to confirmed patient
    ICD-10 Code: Z20.828
    
    Description: Patient has contact with a patient confirmed by testing. Examples include household members, residents of healthcare facilities with confirmed case, etc.
    
    Impression: COVID-19 – Suspected -- No Known Exposure
    ICD-10 Code: Z20.9
    
    Description: This is for all other concerns. Examples include positive travel history, exposure to suspected/PUI but not confirmed cases, etc.
    
    Impression: COVID-19 – Concern for disease, ruled out
    ICD-10 Code: Z03.818
    
    Description: Encounter for observation for suspected exposure but is ruled out after evaluation
- Other EMS or Public Safety Agencies at Scene (eScene.02) Other EMS or Public Safety Agency ID Number (eScene.03), and Type of Other Service at Scene (eScene.04)
  - It is important for EMS Agencies, especially transport EMS agencies, to record all other EMS or Public Safety Agencies that are present on scene. This information may used by the hospital and medical epidemiologists to notify all responding agencies of potential or confirmed COVID-19 cases.
Stress Management and Mental Health during COVID-19 (Updated 4/14/2020)
Webinars and Other Training Related to COVID-19 (4/22/2020)
- NHTSA Office of EMS webinar on COVID-19
- COVID-19 EMS Patient Management: Myth vs. Reality
  - Webinar (Recording will be posted soon)
  - PowerPoint
- Coronavirus Disease 2019 (COVID-19) Update and Infection Prevention and Control Recommendations
- National Institute of Environmental Health Sciences COVID-19 Worker Training Program Webpage (info on protecting yourself from COVID-19 in the workplace)
- Crisis Standards of Care and COVID-19: What EMS Needs to Know - March 26, 2020
- Addressing Your Questions About COVID-19
- OpenWHO Offers Free Online Courses for Responders
- CDC COVID-19 Training for Healthcare Professionals
- Medical and Public Health Considerations of COVID-19
- American Public Health Association/National Academy of Medicine COVID-19 Webinars
- Coronavirus Disease 2019 (COVID-19) News and Resources from the National Academies of Sciences, Engineering, and Medicine (includes recorded webinars)
- NAEMSP COVID-19 Resources, including protocols (includes recorded webinars)
- ACEP COVID-19
- NETEC, the National Emerging Special Pathogen Training and Education Center - COVID-19
- COVID-19 Clinical Rounds Peer-to-Peer Virtual Communities of Practice are a collaborative effort between ASPR, the National Emerging Special Pathogen Training and Education Center (NETEC), and Project ECHO. These interactive virtual learning sessions aim to create a peer-to-peer learning network where clinicians from the U.S. and abroad who have more experience treating patients with COVID-19 share their challenges and successes; a generous amount of time for participant Q & A is also provided. Three webinar topics are covered every week:
  - EMS: Patient Care and Operations (Mondays, 12:00-1:00 PM ET)
  - Critical Care: Lifesaving Treatment and Clinical Operations (Tuesdays, 12:00-1:00 PM ET)
  - Emergency Department: Patient Care and Clinical Operations (Thursdays, 12:00-1:00 PM ET)
  - Access previous webinars and sign up today to receive information on upcoming webinars!
CDC and Other Links Relevant to EMS Agencies and Personnel (Updated 5/6/2020)
Clinical
- CDC Clinical Guidance for Management of Patients with Confirmed COVID-19
- CPR & Resuscitation
- COVID-19 Content: An AHA Compendium
- Resources for Hospitals and Healthcare Professionals Preparing for Patients with Suspected or Confirmed COVID-19
- DoD COVID-19 Practice Management Guide - Clinical Management of COVID-19
- NAEMSP COVID-19 Resources, including protocols
- Surviving Sepsis Campaign COVID-19 Guidelines
- COVID-19 Clinical Rounds Peer-to-Peer Virtual Communities of Practice are a collaborative effort between ASPR, the National Emerging Special Pathogen Training and Education Center (NETEC), and Project ECHO. These interactive virtual learning sessions aim to create a peer-to-peer learning network where clinicians from the U.S. and abroad who have more experience treating patients with COVID-19 share their challenges and successes; a generous amount of time for participant Q & A is also provided. Three webinar topics are covered every week:
  - EMS: Patient Care and Operations (Mondays, 12:00-1:00 PM ET)
  - Critical Care: Lifesaving Treatment and Clinical Operations (Tuesdays, 12:00-1:00 PM ET)
  - Emergency Department: Patient Care and Clinical Operations (Thursdays, 12:00-1:00 PM ET)
  - Access previous webinars and sign up today to receive information on upcoming webinars!
- COVID-19 - 10 Steps to Help Patients While Staying Safe (Resuscitation Academy)
- Ten Clinical Tips on COVID-19 for Healthcare Providers Involved in Patient Care
- COVID-19 Treatment Guidelines (NIH)
- CDC Symptoms of Coronavirus
- Management of Acute Myocardial Infarction During the COVID-19 Pandemic (JACC)
- Information for Pediatric Health Providers
- Association of American Medical Colleges (AAMC): Coronavirus (COVID19) Clinical Guidance Repository
Crisis Standards of Care
Planning and Mitigation
Guidance (other)
Funding
Research
Behavioral Health
MISC
CDC and Other Links Relevant to Fire Agencies and Personnel (Updated 5/6/2020)
CDC and Other Links Relevant to Law Enforcement Agencies and Personnel (Updated 5/1/2020)
Resources for 911 Dispatch Centers (Updated 4/30/2020)
Personal Protective Equipment (PPE) and Infection Control Links and Information (Update 5/6/2020)
PPE
- CDC guidance about N95 reuse and decontamination
- PPE COVID-19 resources page from Emory with printable donning/doffing guide and conservation measures
- Strategies for Optimizing the Supply of PPE
- Strategies for Optimizing the Supply of N95 Respirators
- Healthcare Supply of PPE
- PPE Burn Rate Calculator
- Coronavirus (COVID-19) Pandemic: Personal Protective Equipment Preservation Best Practices
- CDC guidance for Decontamination and Reuse of Filtering Facepiece Respirators
  - This updated guidance now includes information about Battelle decontamination (see section above on this webpage about how you can make use of the Batelle decontamination system)
- Personal Protective Equipment Supply for Emergency Medical Services (EMS)
Infection Control
Fraudulent PPE Warnings
- FBI Warns of Advance Fee and BEC Schemes Related to Procurement of PPE and Other Supplies During COVID-19 Pandemic
- Counterfeit Respirators / Misrepresentation of NIOSH-Approval
Legal Issues Related to COVID-19 (Updated 4/30/2020)
COVID-19 Resource Pages from other Agencies/Organizations (Updated 5/6/2020)

About DPH