[HFDlist] PPE requirement for 32 Mayo/MOLST/L&D/Other Reminders

[Ethan Naiman]

  Good Morning,

To elaborate on the Chief's email, the advisory from MA DPH regarding  
PPE includes all long term facilities. This should include all group  
homes or similar facilities. PPE for calls in these facilities should  
include the use of N95/Gloves/Gown/Eye Protection for the provider and  
Surgical Mask for the patient. Our response guidelines will be updated  
to reflect these recommendations. 

Attached is an emergency update from DPH to STP 7.3 regarding the  
verification of DNR/MOLST forms. This update allows for patients and  
patient guardians to provide verbal consent to Physicians to enact a  
DNR/MOLST form when regular means of obtaining a signature is  
impossible. An official DNR/MOLST form  with documentation of verbal  
consent must still be presented. This emergency update is valid only  
during the declared state of emergency. 

Also attached is emergency waiver from DPH for L&D patients, who  
during the state of emergency, may at the discretion of the receiving  
hospital be transported directly to a Labor and Delivery unit without  
the need to be evaluated in the ED first. 

I anticipate some emergency changes to the cessation/withholding of  
resuscitation protocols in the coming days. I will keep you abreast to  
these changes as I receive them. For now, please continue to use  
due-diligence when responding to cardiac arrests, providing a detailed  
primary assessment to determine the need to begin resuscitative  
efforts, and to minimize the risk of exposure spread by using the  
current cessation of resuscitation protocol (termination with med  
control after 20 minutes of efforts for Asystole/PEA). 

Lastly, please remember the importance of removing soiled PPE from all  
scenes and disposing of it properly. Please encourage other responding  
agencies to do the same. 

I appreciate everyone's continued dedication and ability to adapt to a  
very fluid situation. I am always available by phone if you have  
questions or concerns during a call -- please dont hesitate to reach  
out.

Stay safe,
Ethan

Quoting Russ Hall <rhall at holdenma.gov>:

> All:
>
> Attached is an update from MA DPH regarding PPE when entering  
> nursing homes.  Per their guidelines, EMS providers should assume  
> that any patient called for is a positive COVID-19 case.  All  
> members should be donning full PPE protection prior to entering the  
> facility.
>
> Thanks:
>
> Russ
>
> --
> Russ Hall
> Fire Chief/EMD
> Holden Fire Dept.
> 1370 Main Street
> Holden, MA 01520508-210-5650
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