What infection control protocols should New Jersey (NJ) paramedics (Emergency Medical Technicians (EMTs)) follow when working inside a hospital during the Coronavirus Disease 2019 (COVID-19) pandemic?

From the Guidelines

New Jersey paramedics working inside hospitals during the COVID-19 pandemic should follow a strict infection control protocol, prioritizing the use of personal protective equipment (PPE) as outlined in the most recent guidelines, including donning a proper disposable respirator N95 or FFP2 standard, as recommended by the European Heart Journal in 2020 1. When working inside a hospital, NJ paramedics should adhere to a comprehensive infection control protocol that includes wearing appropriate PPE, such as N95 respirators or higher-level respirators, eye protection (goggles or face shields), gloves, and isolation gowns when caring for suspected or confirmed COVID-19 patients.

• Key components of the protocol include:
  • Donning PPE in a specific sequence, as outlined in the European Heart Journal study 1, which includes:
    1. Removing personal items
    2. Putting on a lead apron
    3. Putting on a first disposable gown
    4. Gathering necessary PPE and checking for integrity
    5. Performing hand hygiene with soap and/or hand gel/rub
    6. Putting on a proper disposable respirator N95 or FFP2 standard
    7. Putting on hair cover
    8. Putting on shoe covers
    9. Putting on goggles and/or face shield
    10. Performing hand hygiene again
    11. Putting on the first pair of gloves
    12. Putting on a gown (sterile or not)
    13. Putting on a second pair of gloves (over cuff)
  • Practicing physical distancing when possible
  • Participating in daily symptom screening before shifts
  • Being familiar with the hospital's specific protocols for donning and doffing PPE, designated areas for COVID-19 patients, and decontamination procedures for equipment
  • Staying home when sick and getting vaccinated against COVID-19 These measures are crucial because healthcare workers, including paramedics, face high exposure risk, and proper infection control prevents transmission to vulnerable patients, colleagues, and the community.

From the Research

Infection Control Protocols for NJ Paramedics

When working inside a hospital during the COVID-19 pandemic, New Jersey (NJ) paramedics should follow specific infection control protocols to minimize the risk of transmission. These protocols include:

• Wearing personal protective equipment (PPE) such as N95 respirators, gloves, gowns, and face shields 2, 3
• Ensuring proper fit and use of PPE, including regular fit testing for N95 masks 4, 3
• Following proper donning and doffing procedures for PPE 5
• Practicing good hand hygiene, including frequent hand washing and use of hand sanitizer 4, 5
• Avoiding close contact with patients and other healthcare workers whenever possible 6

Protective Measures

The use of protective measures such as gloves, gowns, and face masks has been shown to be strongly protective against infection 6. NJ paramedics should:

• Use gloves and gowns when interacting with patients or handling potentially contaminated materials 6, 5
• Wear face masks, including N95 respirators, when interacting with patients or working in areas where aerosol-generating procedures are being performed 2, 3
• Use face shields or other eye protection when working in areas where splashes or sprays may occur 2

Strategies for Rational Use of PPE

To conserve PPE supplies, NJ paramedics should:

• Follow guidelines for the rational use of PPE, including prioritizing use for high-risk procedures and patients 5
• Use PPE only when necessary, and avoid unnecessary use or waste 5
• Consider strategies for extending the life of PPE, such as extended use, reuse, and decontamination of used masks 3