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EMS Infectious Disease Playbook: Combatting Infectious Disease Threats with Knowledge and Best Practices

Author: Jennifer Nieratko, ASPR TRACIE Team; John Hick, MD, Emergency Physician and Deputy Chief EMS Medical Director, Hennepin County Medical Center & HHS; and Richard Hunt, MD, Senior Medical Advisor, National Healthcare Preparedness Programs, HHS/ASPR Office of Emergency Management
Published Date: 6/26/2017 10:58:00 AM
Category: Public Health Preparedness; Innovations;

Emergency medical services (EMS) providers face a wide variety of risks on an almost daily basis, ranging from physically dangerous scenes and combative patients or bystanders to inattentive drivers to the negative behavioral health effects of exposure to traumatic incidents. While EMS personnel cannot predict which hazard they may face on any given day, the entire EMS community – medical directors who establish policies and procedures, dispatchers who direct personnel to patients, and responders at a scene – has a stake in staying up-to-date on innovations in the field and related training.

ASPR Technical Resources, Assistance Center, and Information Exchange (TRACIE) developed the EMS Infectious Disease Playbook to address occupational exposure to a potentially infectious patient. What information should call takers relay to responders before they arrive on scene? How should responders react if they unexpectedly encounter a patient they suspect has an infectious disease? Where can medical directors find information to incorporate in standard operating procedures? The EMS Infectious Disease Playbook helps answer all these questions.

ASPR TRACIE incorporated existing official guidance and best practice information into this one-stop resource that can guide the transport of patients known or suspected of having an infectious disease. The Playbook begins with a dispatch and responder actions section outlining general principles and considerations. This section also features two algorithms to support decision-making: a dispatch screening algorithm and an on-scene assessment algorithm.

While the Playbook emphasizes standard precautions as the basis for all patient encounters, it describes accompanying transmission-based precautions dispatchers and responders should consider based on identified patient signs and symptoms, medical history, and relevant travel and exposure history. The Playbook contains sections for the following types of precautions:

  • Standard
  • Contact
  • Droplet
  • Airborne
  • Special Respiratory
  • Ebola Virus Disease/Viral Hemorrhagic Fever

Each precautions section of the Playbook lists example diseases; the goal of the precaution; related dispatch actions; considerations for arriving EMS, patient care, and transport; type and proper use of personal protective equipment; instructions for ambulance decontamination; and links to original source documents for users seeking additional information.

The final section of the Playbook provides links to additional resources and special considerations on topics such as hand hygiene, pandemic influenza, pediatric issues, aeromedical transport, and occupational health and exposure. The final section is an annotated bibliography of all of the resources cited throughout the document and an index of abbreviations.

The Playbook’s design is user-friendly and includes distinct color-coded sections, consistent icons that distinguish sub-sections, and interactive links that enable users to access information of interest quickly and navigate around the document easily. Whether users seek a quick reference on a specific topic, want an overview of precautions for infectious disease, or look for a starting point for in-depth information, the EMS Infectious Disease Playbook meets their needs.

ASPR recognizes the important role the EMS community plays in our nation’s healthcare system every day and the challenges that many face in staying up-to-date on the vast amount of ever-changing information about infectious disease threats. By compiling need-to-know information in an easy to use format, this resource lessens the effort needed to maintain awareness of resources and knowledge to protect the personnel who provide care in our communities.

Visit ASPR TRACIE to download the EMS Infectious Disease Playbook and access the slides and recording of a June 22 webinar in which the authors describe this new resource.


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