The Centers for Disease Control and Prevention and the office of the Assistant Secretary for Preparedness and Response developed outstanding PPE guidelines for EMS agencies to protect providers from Ebola and other infectious diseases. But, while guidelines and algorithms look great on paper, until you actually run it through with your co-response agencies (fire, police, sheriff, hospital and public health), you may not know where the issues might be in actually following the algorithm.
In Fort Worth, Texas, MedStar, Fort Worth Fire, Fort Worth Emergency Management and the other healthcare stakeholders held a simulation in October to actually run an Ebola call. From the initial 9-1-1 call to CDC notification, every step was simulated to identify gaps and fill them. In the photos below, the on-scene supervising safety officer assures baseline vital signs are taken on the personnel who will be donning PPE and moving into the hot zone where the patient is located. The vitals are retaken upon doffing the PPE.
Some of the unanticipated issues identified and resolved through the real-time drill included:
- Assurance of safety staging of first-in units awaiting a specialized strike team and prepped ambulance;
- Time required to respond with an ambulance stripped of all equipment and lined with plastic sheeting for transport;
- Assuring the 9-1-1 call taker remains in regular communications with the caller to reassure them and keep them from walking out to the crew prematurely; and
- The logistics of communicating with medical control and the receiving hospital through a pressurized air purification respirator.