Tag: Personal Protective Equipment (PPE)

Public safety is divided on face mask policy

From EMS1

The use of face masks to stem the spread of COVID-19 has been a divisive topic, from government officials, to public safety entities, and the general public. Messaging from public health agencies has shifted throughout the pandemic, as to the efficacy of different types of face masks in protecting wearers and those they encounter.

Early on, EMS providers faced supply chain issues resulting in mask shortages and re-use and extended use guidelines to stretch their supply of N95s.

Though face mask wearing is still contested and not all states and communities have mandated mask wearing in public, many have, and many retailers and local business have implemented their own requirements.

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Narcissists, Psychopaths, and Masks

From Newsweek on July 22

Two recent studies looked at the relationship between personality traits and reactions to restrictions put in place to slow the spread of the coronavirus COVID-19. Researchers found that people possessing so-called “Dark Triad” traits—narcissism, psychopathy and Machiavellianism—were less likely to comply with restrictions or engage in preventative measures against the pandemic. However, researchers also emphasized the small role personality traits have in the overall response to pandemic restrictions, like face-mask mandates and social-distancing requirements.

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Mercury Public Affairs Update

AAA has teamed up with Mercury Public Affairs to run a robust public affairs campaign to complement our already established lobbying efforts. We are making sure our concerns as frontline EMS responders are heard, by targeting 27 key Senators and Representatives to Congress around the nation.  We are asking them to be the champions we need in Congress and to make sure all of our emergency first responders have the resources they need.

The campaign has been a great success. Major media outlets have picked up our stories, our digital campaign is having higher than industry average conversion rates, and our patch through calls, which have had extremely high percentages of people willing to speak Congressional offices, have been able to provide a steady drumbeat for our issues where it matters.

These  metrics, coupled with the positive feedback we have received from Congressional offices show that notonly do we have the right message, but also that our emergency first responders are being recognized for the work they do during this national health crisis.

It is also helping to build legislative momentum.

We will update you on the campaign as we move forward, but wanted to take some time to share some highlights. 

Media

AAA is running an earned media campaign around issues such as allowing for CMS reimbursement waivers. One of the highlights of this effort has been the following story published in the Wall Street Journal and subsequently featured in the Washington Post Healthcare 202 Newsletter:

Digital Campaign

AAA is running a digital advertising campaign targeted in Congressional districts and states. This campaign will continue with the addition of text messaging in the coming days. Thus far, we have accomplished the following:

Patch Through Calls

AAA ran a 10-day patch through call campaign strategically targeted to Congressional district offices and Senate district offices that complemented the digital campaign:

  • 8,050 calls delivered in total over the last two weeks.
  • This is roughly 15-25 calls per office per day and 200-450 calls per legislator in total.
  • 95% of voters contacted supported AAA’s position. 86% of those supporters were willing to patch-through to their elected official’s office.  These rates are much higher than numbers we are used to seeing for this type of effort.

Gowns | Merrow Forloh Reusable

AAA Professional Standards Committee Chair Bill Mergendahl has offered to coordinate a bulk order of Merrow Forloh reusable gowns.

Although each gown is pricey ($40/pp), they are made of extremely high-quality ripstop material and can be washed 100 times, making them comparable to a $0.40 disposable.  Additionally, they can be sprayed with standard outdoor gear water repellant and be good for another 100 washes.  One size fits all.

These gowns are American made in Fall River, Massachusetts, which avoids a number of the quality assurance problems many member organizations have experienced with imports.

The goal is to pull together a group order of 10,000 pieces for delivery in 3–4 weeks. Pro EMS will coordinate splitting the payments between providers.

Please see the attached brochure, then contact wmerg@proems.com if you would like to participate.

NYT: Disposable N95 Masks Can Be Decontaminated

Disposable N95 Masks Can Be Decontaminated, Researchers Confirm

The National Institutes of Health released research showing N95 masks can be used more than once using certain decontamination methods to prevent infection from the coronavirus, a claim that has been proven from previous research but never specifically for COVID-19. The researchers found that using vaporized hydrogen peroxide or ultraviolet light are preferred methods since masks can still function for at least three rounds of decontamination, while dry heat at 158 degrees Fahrenheit was effective for two rounds of decontamination, but ethyl alcohol was not recommended because it degraded the mask material despite killing the virus. (The New York Times)

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Personal Protective Equipment Supply for Emergency Medical Services (EMS)

Personal Protective Equipment Supply for Emergency Medical Services (EMS)

Document Developed by the Healthcare Resilience Task Force Emergency Medical Services (EMS) Prehospital Team.  Download PDF

Current Situation
Personal Protective Equipment (PPE) supplies, including N-95 respirators and gowns, are in short supply due to the COVID-19 pandemic. These shortages are anticipated to resolve over time as additional sources are identified and manufacturing capacity is expanded. In the interim, Emergency Medical Services (EMS) agencies that are unable to meet their PPE requirements through regular distribution channels are advised to submit requests for PPE supplies through their local and/or state emergency management officials, which are then submitted to Federal Emergency Management
Agency (FEMA) for sourcing and allocation.

Background
Due to the COVID-19 pandemic, health care providers are exhausting PPE supplies faster than
they can be sourced. EMS agencies are part of the critical infrastructure sector and are strongly considered in the decision-making process to allocate supplies.

Actions Taken to Address Supply Issues

  • The Strategic National Stockpile (SNS) has been activated to provide PPE supplies to states for distribution to healthcare agencies. Supplies are being allocated to states on a pro-rata basis for distribution by the state.
  • Initial distributions from the SNS were limited. Additional distributions are ongoing and the
    second and some third distributions from the SNS to states have occurred.
  • FEMA and the U.S. Department of Health and Human Services (HHS) are actively working to source and purchase PPE supplies (including N-95 respirators) from all sources, including international and domestic vendors along with donations from the private sector.
  • FEMA and HHS are also working with industry to increase the manufacturing of PPE supplies.
  • The Food and Drug Administration (FDA) has issued emergency guidance to permit the medical use of all N-95 respirators approved by the National Institute for Occupational Safety and Health (NIOSH), including NIOSH-approved N-95 respirators that are not approved by the FDA for medical use (i.e., those intended for industrial use). A list of N- 95 respirators approved by NIOSH is available here. The FDA’s guidance also permits the use of NIOSH-approved N-95 respirators that have passed their recommended shelf- life and are undamaged.
  • The FDA has also issued emergency guidance to permit the medical use of certain imported,
    non-NIOSH-approved respirators when used in accordance with Centers for Disease Control and
    Prevention (CDC) recommendations on the prevention of exposure to pathogenic biological airborne particulates. A list of non-NIOSH-approved respirators approved for use under this guidance can be found in Table 1 of the FDA guidance.
  • The CDC has issued recommended guidance on the extended use and limited re-use of N- 95 respirators in situations when N-95 respirator supplies are low. Per the CDC guidance, extended use is favored over reuse because it is expected to involve less touching of the respirator and therefore less risk of contact transmission. For areas in crisis see also the CDC guidance on decontamination and reuse of filtering facepiece respirators.

How to Request PPE Supplies

1. Requests for reordering of PPE should be made through the normal request process. Due to shortages, the entire order may not be able to be filled.

2. To request additional PPE supplies from state or federal resources for unmet needs, you must submit requests through your established local emergency management structure. Depending on the state, your request may be processed through the emergency management chain or through the public health chain to state-level emergency management. From the state level, it will be transmitted to FEMA.

3. When submitting a request, please include the following information:
a. Agency
b. Specific material and quantity request
c. Detailed risk/exposure justification for the request
d. Current on-hand requested supplies
e. Burn rate of current supplies – to provide an estimate of time remaining of current supply
f. Other information pertinent to the request
g. Alternatives that are available, if any, and risks associated with pending gaps (For
information regarding PPE alternatives and optimization strategies, click here.)

This information will help inform the allocation of state and federal PPE resources. Please understand that your request is important and is being considered seriously in the context of similar requests from your peers. The shortage of PPE will continue to be a challenge during the COVID-19 pandemic. Following the appropriate process for requesting supplies is critical to ensuring that you are able to receive needed PPE supplies. For more information regarding EMS response and infection control during the COVID-19 pandemic, please click here.

JEMS: The Ethics of PPE and EMS in the COVID-19 Era

Read the  full piece at JEMS.

By  Brian J Maguire, Dr.PH, MSA, EMT-PKirsty ShearerJohn McKeown, MAScot Phelps, JD, MPHDaniel R. Gerard, MS, RN, NRPKathleen A. Handal, MDPaul Maniscalco, PhD(c), MPA, MS, EMT/P, LP  and Barbara J. O’Neill, PhD, RN

These are trying times for emergency medical services (EMS) personnel on the front lines of the COVID-19 pandemic. In this article we discuss two critical areas of concern. First, we articulate the ethical challenges EMS personnel face in the absence of having proper personal protective equipment (PPE) and offer some guidance on how to frame their decisions.

Second, we give voice to the urgent need for a national dialogue to address the needs of EMS clinicians and leaders. We present key questions that must be answered to improve the future structure of the profession and the safety of all personnel.

These are times that are putting EMS to the test. These are times that will define the future of EMS.

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Savvik: Genlantis Ozilla Sterilization System

Through Savvik’s partnership with Genlantis, we are able to offer this unique unit that could be vital to your members.  This is not cheap to purchase, but if you look at the cost (and limited availability) of protection equipment this starts to make financial sense.  The base cost of the Ozilla $4,799 plus packing and freight.   The optional NEST unit runs $2,059.  With the size and weight of the shipping unit  (36x33x32) , we will need to quote the total delivered based on units and location.  The quote link is below.

Lead time is 2-3 weeks.

http://go.savvik.com/Ozilla.html

Ozone is the most powerful oxidative agent that occurs naturally. With its extra free radical oxygen molecule, ozone is able to destroy germs, viruses, and microbes that may cause surface or air contaminations. Furthermore, ozone leaves no chemical residue typical of alternative detergent or synthetic cleaners, and if handled properly, by converting ozone back to oxygen molecules, it can be one of the most effective sterilizing tools. Ozone is a powerful and natural purifier, and now with the Ozilla® Ozone Sterilizer, Genlantis has made it safer and easier than ever to use ozone gas for multiple sterilization applications.

The Genlantis Ozilla® Sterilization System is a high quality, compact and purpose-built ozone gas generator measuring 13 x 11 x 5 inches. When used properly, it is able to eliminate airborne and surface contaminants and germs. The Ozilla sterilizer is easy and safe to use and has a novel -scrubbing- technology that removes all ozone gases at the end of each sterilization cycle, by converting ozone gas back to oxygen.  As an added advantage, the Ozilla air sterilizer will leave your room or cabinet odor-free and smelling fresh, clean, and ready for your next usage.

FEMA Advisory | Supply Chain Stabilization

The following information was delivered by FEMA via email on April 9.

Coronavirus (COVID-19) Pandemic Supply Chain Stabilization 

The Supply Chain Task Force continues executing a strategy maximizing the availability of critical protective and lifesaving resources through FEMA for a whole-of-America response. Efforts to date have focused on reducing the medical supply chain capacity gap to both satisfy and relieve demand pressure on medical supply capacity. The task force is applying a four-prong approach of Preservation, Acceleration, Expansion and Allocation to rapidly increase supply today and expand domestic production of critical resources to increase supply long-term.

The preservation line of effort focuses on providing federal guidance to responders and the non-medical sector, such as public service (police, fire, EMT), energy distribution and the food industry on how to preserve supplies when possible, to reduce impact on the medical supply chain.

The  acceleration  line of effort provides direct results to help meet the demand for personal protective equipment PPE through the industry to allow responders to get supplies they need as fast as possible.

The  expansion  line of effort is charged with generating capacity with both traditional and non-traditional manufacturers, such as adding machinery or by re-tooling assembly lines to produce new products.

The  allocation  of supplies facilitates the distribution of critically needed PPE to “hot spots” for immediate resupply. States report on supplies and can request assistance when they experience a shortage.

The Supply Chain Task Force is working with the major commercial distributors to facilitate the rapid distribution of critical resources in short supply to locations where they are needed most. This partnership enables FEMA and its federal partners to take a whole-of-America approach to combatting COVID-19. The task force is providing distributors with up-to-date information on the locations across the country hardest hit by COVID-19 or in most need of resources now and in the future. The distributors have agreed to focus portions of their distributions on these areas in order to alleviate the suffering of the American people.

A key example of this partnership in action is Project Airbridge. The airbridge was created to reduce the time it takes for U.S. medical supply distributors to receive PPE and other critical supplies into the country for their respective customers. FEMA covers the cost to fly supplies into the U.S. from overseas factories, reducing shipment time from weeks to days.

Overseas flights arrive at operational hub airports for distribution to hotspots and nationwide locations through regular supply chains. Flight arrivals do not mean supplies will be distributed in the operational hub locations.  Per agreements with distributors, 50 percent of supplies on each plane are for customers within the hotspot areas with most critical needs. The remaining 50 percent is fed into distributors’ normal supply chain to their customers in other areas nationwide.  HHS and FEMA determine hotspot areas based on CDC data.

Working together, we can efficiently distribute these vital resources to hospitals, nursing homes, long-term care facilities, pre-hospital medical services, state and local governments, and other facilities critical to caring for the American people during this pandemic.

FEMA_Adv_SCTF_Supply Chain Stabilization.pdf

EMS.gov | PPE Challenges Guidance

The following information was posted to the NHTSA EMS.gov site.

We are all aware of the challenges of obtaining personal protective equipment (PPE) during this pandemic. We hope this information will help address concerns and clarify the replenishment request process.

The current shortage applies to all health care disciplines – the challenges you are experiencing are being felt by your peers. As a nation, we are working very hard to address the challenges through ramped up production and distribution as resources become available. First responders are recognized as a high priority component of the nation’s critical infrastructure. Decisions regarding PPE allocation are based on specific and identified need and are being prioritized based on those needs.

It may be helpful to reinforce to the first responder community the process for submitting your requests for resupply. It is critical that requests are submitted through the proper process:

    • 1. Continue to submit your request for replenishment of PPE through your normal distribution supply chain. While the supply remains limited, filling those orders will be challenging and you may not receive your entire requested order.

 

    • 2. To request supplies from state or federal resources (eg: stockpiles or reserves), you must submit those requests through your established local emergency management structure. Based on that structure in your state, your request may be then processed through the emergency management chain or through the public health chain to state level emergency management. From the state level, it will be transmitted to the federal level. Final decisions for health care material are made by HHS which will then order distribution of the material.
    • 3. When submitting that request, indicate the following:

      • a. Agency
      • b. Specific material and quantity request
      • c. Detailed risk / exposure justification for the request

        • i. Current on-hand requested supplies
        • ii. Burn rate of current supplies
      • iii. Other information pertinent to the request
    • d. Alternatives that are available and risks associated with pending gaps

This information will be critical in helping to determine the reallocation plan. Please understand that your request is important and is being considered seriously in the context of similar requests from your peers. The shortage of PPE will continue to challenge the COVID-19 response. Following the appropriate process for requesting supplies will be critical to your success.

CDC: PPE Guidance and Burn Rate Calculator

U.S. Centers for Disease Control |  April 7, 2020

U.S. Strategies to Optimize the Supply of PPE and Equipment

Personal protective equipment (PPE) is used every day by healthcare personnel (HCP) to protect themselves, patients, and others when providing care. PPE helps protect HCP from potentially infectious patients and materials, toxic medications, and other potentially dangerous substances used in healthcare delivery.

PPE shortages are currently posing a tremendous challenge to the US healthcare system because of the COVID-19 pandemic. Healthcare facilities are having difficulty accessing the needed PPE and are having to identify alternative ways to provide patient care.

CDC’s optimization strategies for PPE offer options for use when PPE supplies are stressed, running low, or absent. Contingency strategies can help stretch PPE supplies when shortages are anticipated, for example, if facilities have sufficient supplies now but are likely to run out soon. Crisis strategies can be considered during severe PPE shortages and should be used with the contingency options to help stretch available supplies for the most critical needs. As PPE availability returns to normal, healthcare facilities should promptly resume standard practices.

PPE Burn Rate Calculator

The Personal Protective Equipment (PPE) Burn Rate Calculator is a spreadsheet-based model that will help healthcare facilities plan and optimize the use of PPE for response to coronavirus disease 2019 (COVID-19). Non-healthcare facilities such as correctional facilities may also find this tool useful.

To use the calculator, enter the number of full boxes of each type of PPE in stock (gowns, gloves, surgical masks, respirators, and face shields, for example) and the total number of patients at your facility. The tool will calculate the average consumption rate, also referred to as a “burn rate,” for each type of PPE entered in the spreadsheet. This information can then be used to estimate how long the remaining supply of PPE will last, based on the average consumption rate. Using the calculator can help facilities make order projections for future needs.

 

 

US News: AAA, NAEMT, IAFC Urge PPE for First Responders

DOL: Guidance for Respiratory Protection During N95 Shortage

U.S. Department of Labor  |  April 3, 2020

U.S. Department of Labor Issues Guidance for Respiratory Protection During N95 Shortage Due to COVID-19 Pandemic

WASHINGTON, DC – The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has issued interim enforcement guidance to help combat supply shortages of disposable N95 filtering face piece respirators (N95 FFRs). The action marks the department’s latest step to ensure the availability of respirators and follows President Donald J. Trump’s Memorandum on Making General Use Respirators Available.

Due to the impact on workplace conditions caused by limited supplies of N95 FFRs, employers should reassess their engineering controls, work practices and administrative controls to identify any changes they can make to decrease the need for N95 respirators.

If respiratory protection must be used, employers may consider use of alternative classes of respirators that provide equal or greater protection compared to an N95 FFR, such as National Institute for Occupational Safety and Health (NIOSH)-approved, non-disposable, elastomeric respirators or powered, air-purifying respirators. 

When these alternatives are not available, or where their use creates additional safety or health hazards, employers may consider the extended use or reuse of N95 FFRs, or use of N95 FFRs that were approved but have since passed the manufacturer’s recommended shelf life, under specified conditions.

This interim guidance will take effect immediately and remain in effect until further notice. This guidance is intended to be time-limited to the current public health crisis. Visit OSHA’s Coronavirus webpage regularly for updates.

For further information about COVID-19, please visit the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA’s role is to help ensure these conditions for America’s working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit www.osha.gov.

The mission of the Department of Labor is to foster, promote and develop the welfare of the wage earners, job seekers and retirees of the United States; improve working conditions; advance opportunities for profitable employment; and assure work-related benefits and rights.

###

Media Contacts:

Emily Weeks, 202-693-4676, weeks.emily.c@dol.gov

Release Number:  20-572-NAT

EMS Granted Access to the Amazon COVID-19 Store!

Thank you to the thousands of EMS and fire professionals who joined our social media campaign to encourage Amazon Business to admit mobile healthcare providers into their new COVID-19 Store. In response to the collective voices of our profession, Amazon has updated their policy! Effective April 6, EMS and Fire will begin to be onboarded into the limited-access marketplace. To participate:

  1. Ensure your agency has established an Amazon Business account. 
  2. Request access to the COVID-19 Store. When you complete the form, select “OTHER” as organization type until/unless EMS becomes available as an option. When entering your company name, please make it clear that you are an ambulance service or fire department (no abbreviations).
  3. Wait patiently for up to 10 days to receive confirmation of access as each enrollment request is individually reviewed by Amazon staff.
  4. If you have questions, experience excessive delay, or need assistance, please contact Amazon support.

The store is a new venture, and the virtual shelves are in the process of being stocked. However, Amazon has assured us that they have tens of millions of units of PPE and supplies on rush order. We encourage you to set up your agency account and check back frequently for new item availability. 

We hope that access to the COVID-19 supplies and Amazon’s legendary logistics and delivery expertise will assist ambulance services in meeting the needs of their communities during this challenging and stressful time.

WaPo: SNS Nearly Depleted

By Nick Miroff, Washington Post |  April 1, 2020 at 10:00 p.m. EDT

The government’s emergency stockpile of respirator masks, gloves and other medical supplies is running low and is nearly exhausted due to the coronavirus outbreak, leaving the Trump administration and the states to compete for personal protective equipment in a freewheeling global marketplace rife with profiteering and price-gouging, according to Department of Homeland Security officials involved in the frantic acquisition effort.

Read the full article►

NHTSA | PPE Challenges: Important Information for the First Responder Community

From NHTSA’s Office of EMS on March 25 via email.

PPE Challenges: Important Information for the First Responder Community

We are all aware of the challenges of obtaining personal protective equipment (PPE) during this pandemic. We hope this information will help address concerns and clarify the replenishment request process.

The current shortage applies to all health care disciplines – the challenges you are experiencing are being felt by your peers. As a nation, we are working very hard to address the challenges through ramped up production and distribution as resources become available. First Responders are recognized as a high priority component of the nation’s critical infrastructure. Decisions regarding PPE allocation are based on specific and identified need and are being prioritized based on those needs.

It may be helpful to reinforce to the first responder community the process for submitting your requests for resupply. It is critical that requests are submitted through the proper process.

Process:

  1. Continue to submit your request for replenishment of PPE through your normal distribution supply chain. While the supply remains limited, filling those orders will be challenging and you may not receive your entire requested order.
  2. To request supplies from state or federal resources (eg: stockpiles or reserves), you must submit those requests through your established local emergency management structure. Based on that structure in your state, your request may be then processed through the emergency management chain or through the public health chain to state level emergency management. From the state level, it will be transmitted to the federal level. Final decisions for health care material are made by HHS which will then order distribution of the material.
  3. When submitting that request, indicate the following:
    Agency
    Specific material and quantity request
    Detailed risk / exposure justification for the request
    Current on-hand requested supplies
    Burn rate of current supplies
    Other information pertinent to the request
    Alternatives that are available and risks associated with pending gaps

This information will be critical in helping to determine the reallocation plan. Please understand that your request is important and is being considered seriously in the context of similar requests from your peers. The shortage of PPE will continue to challenge the COVID-19 response. Following the appropriate process for requesting supplies will be critical to your success.

Thank you,

Jon R. Krohmer, MD, FACEP, FAEMS
Director, Office of EMS

CDC Conference Call: Optimization Strategies for Healthcare Personal Protective Equipment (PPE)

Crisis Standards of Care and COVID-19: What EMS Needs to Know
Webinar from EMS Focus
Wed, Mar 25, 2020, 2:00 PM EDT

Presenters from the Center for Disease Control will provide a COVID-19 update and discuss strategies for healthcare facilities to optimize personal protective equipment (PPE) supplies such as eye protection, isolation gowns, facemasks, and N95 respirators.

Webinar Link:
Click Here

Dial In:
US: +1 669 254 5252
or +1 646 828 7666

More Information