IAFF Preparation and PPE Protection Guidelines

Printable PDF: Interim Guidance for EMS

Recommendations for 911 PSAPs

• Municipalities and local EMS authorities should coordinate with state and local public health, PSAPs and other emergency call centers to determine the need for modified caller queries about COVID-19.
• Development of modified caller queries should be closely coordinated with an EMS medical director and informed by local, state and federal public health authorities, including the city or county health department(s), state health department(s) and the CDC.
• PSAPs or Emergency Medical Dispatch (EMD) centers (as appropriate) should question callers and determine the possibility that this call concerns a person who may have signs or symptoms and risk factors for COVID-19.
• More information: Guidance for Emergency Medical Services Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States

Preparation

COVID-19 Self-Screening Guidelines

• Review your department’s exposure control plan.
• Plan to meet or connect with local and state health departments to discuss policies, procedures and precautions in case COVID-19 becomes widespread.
• Maintain an adequate supply of N-95 and surgical masks and monitor the availability of both masks with your medical supply vendor.
• Routinely check the IAFF website for more information about COVID-19.

Potential Exposure

Risk Assessment for Potential Exposure
Post-Exposure/Quarantine Symptom Monitoring Tracker

• If you treat a patient who shows signs and symptoms addressed below, document potential exposures according to your exposure control plan.
• Potential exposures should also be documented using the National Fire Operations Reporting System (NFORS) Exposure Mobile App. This will assist in collecting national exposure data for all fire fighters and paramedics.
• Notify your infection control officer.
• If you present signs and symptoms, immediately follow up with your healthcare provider and identify your exposure.

Protection

• The CDC recommends N-95 or P100 with eye protection
  • N-95 and higher levels of respiratory protection require fit testing
  • Eye protection should be face shield or goggles
  • Surgical masks with plastic eye lenses are inappropriate PPE
• If possible and tolerated, place a surgical mask on patients to minimize exposure
• Use a clean, non-sterile, long-sleeved, fluid-resistant gown
• Gloves
• Use either single-use, disposable equipment or dedicated equipment to decontaminate. If equipment needs to be shared among patients, clean and disinfect between each patient using ethyl alcohol (70%) or bleach solution (ratio of ¼ cup of bleach in a gallon of water)
• Hand washing
• Minimize patient contact in poorly ventilated areas
• Disinfect the ambulance with bleach solution
  • Routinely clean and disinfect patient-contact areas
• For more information about PPE:
  • CDC Healthcare Supply of PPE
  • Strategies to Optimize the Supply of N95 Masks

Decontaminating Gear and Equipment

• Dispose of disposable respirator, respirator filters, gloves and other disposable equipment/supplies used at the scene as bio-hazardous waste.
• If the turnout gear or station uniform is visibly contaminated by bodily fluid, it should be placed in a biohazard bag at the scene and washed following prescribed laundry procedures. Chlorinated bleach shall not be used with any fire fighter protective clothing. Fire departments should follow the decontamination guidelines in National Fire Protection Association (NFPA) 1851, Standard on Selection, Care, and Maintenance of Structural Fire Fighting Protective Ensembles.
• Non-disposable respirators shall be cleaned and disinfected in accordance with manufacturer’s recommendation.
• For decontamination of non-disposable equipment, follow manufacturer and departmental standard operating procedures.
• Vehicles used to transport persons suspected of having COVID-19 should be cleaned by staff wearing protective equipment, using a bleach solution as a disinfectant cleanser.
• See the EPA’s list of Registered Antimicrobial Products for Use Against Novel Coronavirus SARS-Cov-2, the Cause of COVID-19 as of March 3, 2020.

State and Federal Resources

Congress has passed and the president has signed an $8.3 billion supplemental appropriation to fund the response to coronavirus. There are a variety of resources that will be available to fire departments for personal protective equipment (PPE) and medical supplies, and to meet overtime and backfill needs. Included in this package are:

• $950 million to support states and localities in carrying out a variety of activities related to the response to the virus.
• Approximately $500 million for medical supplies, including PPE.
• $300 million in contingency funding for the procurement of vaccines, therapeutics and diagnostics.

The most important action that state affiliates can take to ensure that these resources are secured to assist our members and their departments is to contact their respective governors to ensure fire and EMS agencies are given priority as resources are distributed.

PPE and medical supplies can also be obtained through the Strategic National Stockpile and state stockpiles. Most states have an infectious disease plan or pandemic plan that outlines distribution of supplies in a public health emergency.

Affiliate leaders should immediately contact your governor and state homeland security director to ensure these plans specify that fire fighters and emergency medical personnel receive priority as supplies are distributed.

Lastly, funding for overtime and backfill needs will be necessary as members are quarantined or isolated due to contact with infected patients. Funds are available for this purpose through the federally funded State Homeland Security Grant Program (SHSP) or the Urban Area Security Initiative (UASI). States and high-risk urban areas must justify proposed expenditures of SHSP or UASI funds in their Investment Justification submissions. Leaders should work with their governors and State Homeland Security directors to reprioritize and reprogram funds via their respective State Administrative Agency.