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<p>EMS Providers,<br>
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Please see attached reminder from OEMS. We have ordered additional HEPA in-line filters to serve this purpose. Any questions, please reach out.<br>
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Ethan</p>
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<p class="MsoNormal"><b>From:</b> Cluett, William (DPH) <william.cluett@state.ma.us><br>
<b>Sent:</b> Tuesday, August 25, 2020 11:32<br>
<b>Subject:</b> Safe Ventilation Use Reminder</p>
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<p class="MsoNormal"><span style='font-size:12.0pt;font-family:"Times New Roman",serif;color:black'>Dear EMS Colleagues,</span></p>
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<p class="MsoNormal"><span style='font-size:12.0pt;font-family:"Times New Roman",serif;color:black'>The Massachusetts Department of Public Health (DPH) continues to work with state, federal and local partners on the outbreak of novel Coronavirus 2019 (COVID-19), caused by the virus SARS-CoV-2, and we continue to appreciate the essential role you have in responding to this evolving situation. </span></p>
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<p class="MsoNormal"><span style='font-size:12.0pt;font-family:"Times New Roman",serif;color:black'>The purpose of this email is to remind ambulance services that in accordance with the Statewide Treatment Protocols</span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'>’ <span style="color:black">emergency protocol 1.2 Patient at Risk of COVID-19, <a href="https://www.mass.gov/doc/emergency-release-of-12-patient-at-risk-for-coronavirus-disease-2019-covid-19-updated-april-0/download">https://www.mass.gov/doc/emergency-release-of-12-patient-at-risk-for-coronavirus-disease-2019-covid-19-updated-april-0/download</a>, it is critical that EMS take appropriate precautions when treating a patient who needs ventilation. When using a ventilator or bag-valve mask on a patient, EMS is to ensure the ventilation device has an <b>in-line HEPA filter</b>, whether the patient is intubated or not. This is essential to prevent potential COVID-19 exposure of the EMS and receiving hospital personnel. </span></span></p>
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<p class="MsoNormal"><span style='font-size:12.0pt;font-family:"Times New Roman",serif;color:black'>EMS personnel are reminded that Heat and Moisture Exchanger Filters (which may be attached to circuits during IFT) are not High Efficiency Particulate Air (HEPA) filters and are not adequate when used alone.</span></p>
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<p class="MsoNormal"><span style='font-size:12.0pt;font-family:"Times New Roman",serif;color:black'>If in-line HEPA filters are not available, ventilation must be considered an aerosolizing procedure, and the EMS personnel should wear fitted N95 or equivalent respirators. EMS must also notify receiving facilities that an incoming patient is being ventilated without an in-line HEPA filter, so hospital personnel can don appropriate personal protective equipment (PPE). </span></p>
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<p class="MsoNormal"><span style='font-size:12.0pt;font-family:"Times New Roman",serif;color:black'>Continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP) are inherently aerosolizing, and while a HEPA filter on the circuit does not provide sufficient protection to forego N95 or equivalent respirators, EMS personnel should to include an in-line HEPA filter if one is available. In general, it is best to defer CPAP or BiPAP use to the hospital setting where a patient can be in a filtered room, in accordance with emergency protocol 1.2.</span></p>
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<p class="MsoNormal"><span style='font-size:12.0pt;font-family:"Times New Roman",serif;color:black'>If you have any questions, please contact Brendan Murphy at <a href="mailto:Brendan.P.Murphy@state.ma.us">Brendan.P.Murphy@mass.gov</a>.</span></p>
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<p class="MsoNormal"><span style='font-size:12.0pt;font-family:"Times New Roman",serif;color:black'>The DPH COVID-19 website, which is updated on a daily basis, can be accessed at</span> <span style='font-size:12.0pt;font-family:"Times New Roman",serif'><a href="http://www.mass.gov/2019coronavirus">www.mass.gov/2019coronavirus</a><span style="color:black">.</span></span></p>
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<p class="MsoNormal"><span style='font-size:12.0pt;font-family:"Times New Roman",serif;color:black'>Thank you,</span></p>
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<p class="MsoNormal"><span style='font-size:12.0pt;font-family:"Times New Roman",serif;color:black'>Scott</span></p>
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<p class="MsoNormal"><b><span style="color:#1F497D">W. Scott Cluett III, NRP</span></b></p>
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<p class="MsoNormal"><span style="color:#1F497D">Director</span></p>
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<p class="MsoNormal"><span style="color:#1F497D">Office of Emergency Medical Services</span></p>
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<p class="MsoNormal"><span style="color:#1F497D">Bureau of Health Care Safety and Quality</span></p>
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<p class="MsoNormal"><span style="color:#1F497D">Massachusetts Department of Public Health</span></p>
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<p class="MsoNormal"><span style="color:#1F497D">67 Forest Street</span></p>
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<p class="MsoNormal"><span style="color:#1F497D">Marlborough MA 01752</span></p>
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<p class="MsoNormal"><span style="color:#1F497D">Office - 617-753-8110 – Pls use mobile. Working remotely for COVID19</span></p>
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<p class="MsoNormal"><span style="color:#1F497D">Mobile - 857-348-3163</span></p>
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<p class="MsoNormal"><span style="color:#1F497D"><a href="mailto:scott.cluett@mass.gov">scott.cluett@mass.gov</a></span></p>
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<p class="MsoNormal"><span style="color:#1F497D"><a href="http://www.mass.gov/dph/oems"><span style="color:blue">http://www.mass.gov/dph/oems</span></a></span></p>
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----- End forwarded message -----<br></p>
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<div><span style="font-size:12px;">Ethan Naiman</span></div>
<div><span style="font-size:12px;">EMS Coordinator</span></div>
<div><span style="font-size:12px;">Holden Fire Department</span></div>
<div><span style="font-size:12px;">1370 Main Street</span></div>
<div><span style="font-size:12px;">Holden, MA 01520</span></div>
<div><span style="font-size:12px;">Office: 508-210-5659</span></div>
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