[HFDlist] Fwd: Safe Ventilation Use Reminder

[Ethan Naiman]

   EMS Providers,

Please see attached reminder from OEMS. We have ordered additional  
HEPA in-line filters to serve this purpose. Any questions, please  
reach out.

Ethan

     FROM: Cluett, William (DPH) <william.cluett at state.ma.us>
SENT: Tuesday, August 25, 2020 11:32
SUBJECT: Safe Ventilation Use Reminder

      

    

    

    

    

    

   Dear EMS Colleagues,

    

    

    

   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. 

    

    

    

   The purpose of this email is to remind ambulance services that in  
accordance with the Statewide Treatment Protocols’ emergency protocol  
1.2 Patient at Risk of COVID-19,  
https://www.mass.gov/doc/emergency-release-of-12-patient-at-risk-for-coronavirus-disease-2019-covid-19-updated-april-0/download, 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 IN-LINE HEPA FILTER, whether the patient is intubated or not. This is essential to prevent potential COVID-19 exposure of the EMS and receiving hospital  
personnel. 

    

    

    

   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.

    

    

    

   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). 

    

    

    

   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.

    

    

    

   If you have any questions, please contact Brendan Murphy at  
Brendan.P.Murphy at mass.gov[1].

    

    

    

   The DPH COVID-19 website, which is updated on a daily basis, can be  
accessed at www.mass.gov/2019coronavirus[2].

    

    

    

   Thank you,

    

    

    

   Scott

    

    

    

    

    

   W. SCOTT CLUETT III, NRP

    

   Director

    

   Office of Emergency Medical Services

    

   Bureau of Health Care Safety and Quality

    

   Massachusetts Department of Public Health

    

   67 Forest Street

    

   Marlborough MA 01752

    

   Office - 617-753-8110 – Pls use mobile. Working remotely for COVID19

    

   Mobile - 857-348-3163

    

   scott.cluett at mass.gov

    

   http://www.mass.gov/dph/oems

    

    

    

    

    

    

    

----- End forwarded message -----


Links:
------
[1] mailto:Brendan.P.Murphy at state.ma.us
[2] http://www.mass.gov/2019coronavirus
    Ethan Naiman
   EMS Coordinator
   Holden Fire Department
   1370 Main Street
   Holden, MA 01520
   Office: 508-210-5659
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