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COVID-19 Pre-Hospital/Emergency Medical Services (EMS) Resources
Topic Collection
July 2, 2020

Topic Collection: COVID-19 Pre-Hospital/Emergency Medical Services (EMS) Resources

This collection provides examples of promising practices, templates and other resources for addressing issues and challenges associated with the COVID-19 pandemic health emergency for two key decisionmakers in Emergency Medical Services (EMS): (1) EMS Administrators and Medical Directors and (2) the 911 System [911 Public Safety Answering Point (PSAP)/Emergency Communications Center (ECC) personnel].

Please refer to CDC’s Coronavirus Disease 2019 webpage for the most up-to-date clinical guidance on COVID19 outbreak management.

If you have COVID-19 promising practices, plans, tools, or templates to share with your peers, please visit the ASPR TRACIE Information Exchange COVID-19 Information Sharing Page (registration required) and place your resources under the relevant topic area. Resources specific to pre-hospital and EMS can be placed under the COVID-19 Pre-Hospital/EMS Resources Topic.

NOTE: inclusion of any reference in this document does not constitute an endorsement, acknowledgment, or suggestion that the reference is the only or best example for that topic. References are included as examples which were provided as suggestions at the time the document was developed.

All guidance posted is accessible to the public, and non-federal resources are noted with an asterisk (*). Linking to a non-federal website does not constitute an endorsement by the U.S. government, or any of its employees, of the information and/or products presented on that site. 

911 System- Caller Screening Resources


Association of Public-Safety Communications Officials-International (APCO). (2020). Recommendations Regarding Caller Interrogation *.
This guidance provides sample language 911 systems can use, in consultation with their local medical authorities, to screen for potentially positive viral illness.
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This guidance applies to all first responders, including law enforcement, fire services, emergency medical services, and emergency management officials, who anticipate close contact with persons with confirmed or possible COVID-19 in the course of their work.
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COVID-19 Healthcare Resilience Task Force. (2020). Redirecting 911 Calls for Information & Low Acuity Medical Complaints.
This document provides guidance and considerations for Public Safety Answering Points (PSAPs)/Emergency Communications Centers (ECC) related to COVID 19. PSAPs/ECCs may need to revise procedures and redirect resources for handling incoming calls for COVID-19 Information and Low Acuity Medical Complaints. These revisions may require administrative, technical and operational protocols, policies and procedures to be modified. This document provides guidance and considerations for these modifications and examples of how a sample of a few individual PSAPs/ECCs have handled/redirected these calls in response to the COVID-19 pandemic.
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NENA: The 9-1-1 Association (NENA). (2020). Coronavirus (COVID-19) Resources.
This list of Coronavirus (COVID-19) resources was compiled by NENA for the 9-1-1 community.
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Clinical Rounds


Office of the Assistant Secretary for Preparedness and Response. (2020). National COVID-19 Clinical Rounds: Emergency Department - Interfacility Transfers (6/4/2020). U.S. Department of Health and Human Services.
This webinar is part of the National COVID-19 Clinical Rounds hosted by ASPR, Project ECHO, NETEC, and other public-private partners. This emergency department session focused on interfacility transfers and featured speakers from Air Methods Corporation and Vidant EastCare.
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Office of the Assistant Secretary for Preparedness and Response. (2020). National COVID-19 Clinical Rounds: EMS (5/11/2020). U.S. Department of Health and Human Services.
This webinar is part of the National COVID-19 Clinical Rounds hosted by ASPR, Project ECHO, NETEC, and other public-private partners. This session focused on emergency medical services from the Memphis Fire Department and Hennepin EMS.
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Office of the Assistant Secretary for Preparedness and Response. (2020). National COVID-19 Clinical Rounds: EMS (5/18/2020). U.S. Department of Health and Human Services.
This webinar is part of the National COVID-19 Clinical Rounds hosted by ASPR, Project ECHO, NETEC, and other public-private partners. This session focused on emergency medical services featured speakers from the State of Alaska Emergency Programs and Pagosa Springs Medical Center.
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Office of the Assistant Secretary for Preparedness and Response. (2020). National COVID-19 Clinical Rounds: EMS - Response to COVID-19 and Protests (6/8/2020). U.S. Department of Health and Human Services.
This webinar is part of the National COVID-19 Clinical Rounds hosted by ASPR, Project ECHO, NETEC, and other public-private partners. This session focused on the EMS response to COVID-19 and protest activity and featured presentations from Hennepin EMS and Seattle and King County EMS.
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Office of the Assistant Secretary for Preparedness and Response. (2020). National COVID-19 Clinical Rounds: EMS Resources (4/10/2020). U.S. Department of Health and Human Services.
This webinar is part of the National COVID-19 Clinical Rounds hosted by ASPR, Project ECHO, NETEC, and other public-private partners. This webinar focused on emergency medical services. Speakers from Seattle and King County EMS and Global Medical Response shared their observations and lessons learned.
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Office of the Assistant Secretary for Preparedness and Response. (2020). National COVID-19 Clinical Rounds: EMS Resources (4/20/2020.). U.S. Department of Health and Human Services.
This webinar is part of the National COVID-19 Clinical Rounds hosted by ASPR, Project ECHO, NETEC, and other public-private partners. Speakers from the Detroit Fire Department/Wayne State University and Emory University School of Medicine shared their observations and lessons learned from the emergency medical services perspective.
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Office of the Assistant Secretary for Preparedness and Response. (2020). National COVID-19 Clinical Rounds: EMS Resources (4/27/2020.). (Added 5/12/2020.) U.S. Department of Health and Human Services.
This webinar is part of the National COVID-19 Clinical Rounds hosted by ASPR, Project ECHO, NETEC, and other public-private partners. This webinar focused on emergency medical services featured presenters from Boston Emergency Medical Services and Wichita/Sedgwick County Kansas Division of Public Safety.
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Office of the Assistant Secretary for Preparedness and Response. (2020). National COVID-19 Clinical Rounds: EMS Resources (5/4/2020.). (Added 5/12/2020.) U.S. Department of Health and Human Services.
This webinar is part of the National COVID-19 Clinical Rounds hosted by ASPR, Project ECHO, NETEC, and other public-private partners. This webinar focused on emergency medical services featured presenters from the Dayton Fire Department and Ohio Department of Public Safety, Division of EMS.
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Office of the Assistant Secretary for Preparedness and Response. (2020). National COVID-19 Clinical Rounds: EMS Resources (6/1/2020). U.S. Department of Health and Human Services.
This webinar is part of the National COVID-19 Clinical Rounds hosted by ASPR, Project ECHO, NETEC, and other public-private partners. This session focused on emergency medical services featured speakers from Grady EMS and New Orleans EMS.
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911 System- Caller Triage & Referral to Non-Emergency Resources


Indiana Department of Homeland Security. (n.d.). PSAP/ECC Triage and Referral: Illinois *. (Accessed 4/23/2020.)
This resource provides recommendations for 911 Public Safety Answering Points (PSAPs) to determine need for modified caller queries about COVID-19.
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Smith, W., Culley, L., Plorde, M., et al. (2000). Emergency Medical Services Telephone Referral Program: An Alternate Approach to Nonurgent 911 Calls *. Prehospital Emergency Care. 5(2): 174-180.
This study examines the effects of transferring nonurgent 911 calls to a telephone consulting nurse.
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911 System- Continuity of Operations Plan (COOP)


This workbook provides guidance for coordinating call centers’ response to pandemic influenza and other public health emergencies.
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Federal Communications Commission. (n.d.). Emergency Planning: Public Safety Answering Points. (Accessed 5/6/2020.)
This webpage provides guidelines to help Public Safety Answering Points ensure their continuity of operations and manage the security and operability of their communications systems and networks during emergencies.
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Federal Emergency Management Agency. (n.d.). Continuity of Operations: An Overview of Continuity Planning for Pandemic Influenza. (Accessed 5/6/2020.)
This brochure provides an overview of continuity of operations planning for pandemic influenza.
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Federal Emergency Management Agency. (n.d.). Pandemic Influenza Continuity of Operations Annex Template Instructions. (Accessed 4/23/2020).
This template can help organizations develop their Pandemic Influenza Continuity of Operations Plan and/or Annex.
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National Emergency Number Association. (n.d.). Customizable Influenza COOP Outline *. (Accessed 4/23/2020.)
This outline can help 911 Public Safety Answering Point (PSAP)/Emergency Communications Center (ECC) managers/911 agencies in the preparation of a COVID-19 continuity of operations plan.
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911 System- General Resources


This curated website includes links to resources on preparing/managing pandemic response, sample state and local policies, and related COVID-19 information.
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This guidance applies to all first responders, including law enforcement, fire services, emergency medical services, and emergency management officials, who anticipate close contact with persons with confirmed or possible COVID-19 in the course of their work.
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NENA: The 911 Association. (n.d.). Sample Pandemic Influenza EMS Dispatch Protocol *. (Accessed 5/5/2020.)
This sample pandemic influenza EMS dispatch protocol illustrates how resources can be reallocated during a pandemic.
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NENA: The 911 Association (NENA). (2020). 9-1-1 & COVID-19: A Report on PSAPs During the Pandemic *.
This report summarizes trends in call volume and nature during the COVID-19 pandemic.
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911 System- Managing Expectations


This fact sheet provides guidance for individuals when calling 911 in an emergency.
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Centers for Disease Control and Prevention. (2020). 10 Things You Can do to Manage Your COVID-19 Symptoms at Home.
This fact sheets provides guidance for managing symptoms at home.
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911 System- Telehealth Resources


centers for Disease Control and Prevention. (2020). Phone Advice Line Tool for COVID-19.
This tool includes guidelines for the initial phone script, accompanying decision algorithm, and tailored care advice messages for children (2-17 years) or adults (≥18 years) with possible COVID-19.
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Centers for Medicare & Medicaid Services. (2020). Telehealth Toolkit: Centers for Medicare and Medicaid Services.
This document contains links to reliable sources of information regarding telehealth and telemedicine, including specific documents that will be useful in choosing telemedicine vendors, initiating a telemedicine program, monitoring patients remotely, and developing documentation tools. Information is also included for providers who wish to care for patients through the virtual services that may be temporarily used during the COVID-19 situation.
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This webpage describes how the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered healthcare providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency.
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U.S. Department of Health and Human Services, Office for Civil Rights. (2020). Disclosures to Law Enforcement, Paramedics, Other First Responders and Public Health Authorities.
This notice from the Office for Civil Rights answers questions about how law enforcement, paramedics, other first responders, and other public health authorities can receive information about an individual who has been infected with or exposed to the coronavirus without an individual’s authorization under the HIPAA Privacy Rule.
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EMS Administrators/Medical Directors - Crisis Standards of Care


This document from the Emergency Cardiovascular Care Committee and Get With the Guidelines - Resuscitation Adult and Pediatric Task Forces of the American Heart Association in collaboration with the American Academy of Pediatrics, American Association for Respiratory Care, American College of Emergency Physicians, The Society of Critical Care Anesthesiologists, American Society of Anesthesiologists, American Association of Critical Care Nurses, and National EMS Physicians provides guidelines for treatment of cardiac arrest in patients with suspected or confirmed COVID-19.
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Global Medical Response (GMR). (2020). Guidelines for Covid-19 Preparations and Response *.
This document provides current approaches and practices for all Global Medical Response Operations (air, ground, communications, and direct and indirect field support) in the preparation and response for COVID-19.
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National Highway Traffic Safety Administration (NHTSA) Office of EMS. (2020). EMS Influenza Pandemic Guidelines for Statewide Adoption.
This document provides broad-based pandemic influenza guidelines for consideration by state and local emergency medical services agencies, including the basic planning assumptions underpinnings those recommended guidelines.
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EMS Administrators/Medical Directors - Employer’s Responsibility Regarding Personal Protective Equipment


Centers for Disease Control and Prevention. (n.d.). Use Personal Protective Equipment (PPE) When Caring for Patients with Confirmed or Suspected COVID-19. (Accessed 4/23/2020.)
This fact sheet from the Centers for Disease Control and Prevention highlights the need for and importance of healthcare personnel training and competency on the donning, doffing, care, maintenance and disposal of personal protective equipment. Access a poster for this resource at https://www.cdc.gov/coronavirus/2019-ncov/downloads/A_FS_HCP_COVID19_PPE_11x17.pdf. An illustration of the correct PPE requirement is available for download at https://www.cdc.gov/coronavirus/2019-ncov/downloads/COVID-19_PPE_illustrations-p.pdf
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Global Medical Resource (GMR). (2020). Blood and Body Fluid Precautions For EMS *.
This checklist from the Global Medical Resource shows the correct level of PPE for select procedures.
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National Institute of Environmental Health Sciences (NIEHS). (2020). Protecting Yourself from COVID-19 in the Workplace.
This training provides health and safety awareness for responders and workers with potential COVID-19 exposure.
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EMS Administrators/Medical Directors - Health Monitoring- Caregiver Well Being (Including Mental Health)


COVID-19 Health Care Resilience Taskforce. (2020). Managing Patient and Family Distress Associated with COVID-19.
These strategies can help healthcare providers in hospitals and alternate care settings ease stress and anxiety experienced by patients during infectious disease outbreaks.
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This document contains general concepts to prepare and take action to help EMS/911 agencies protect the psychological health and wellbeing of workers.
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Global Medical Response (GMR). (2020). Stay Healthy and Safe Poster *.
This printable poster contains basic COVID-19 information useful for EMS professionals.
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EMS Administrators/Medical Directors - Health Monitoring- Sample Employee Occupational Health Surveillance Protocol


Centers for Disease Control and Prevention. (2020). Return to Work Criteria for HCP Suspected or Confirmed COVID-19.
This webpage provides guidance for public health officials tasked with making decisions about return to work for healthcare personnel with confirmed or suspected COVID-19.
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This document provides guidance in preparation for and response to COVID-19 for Global Medical Response Call, Billing, Membership, Communication, Operation and Maintenance Control Centers.
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EMS Administrators/Medical Directors - Organizational Infection Control


Centers for Disease Control and Prevention. (2020). Healthcare Infection Prevention and Control FAQs for COVID-19.
This webpage includes responses to frequently asked questions about preventing transmission of COVID-19 in healthcare settings.
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This checklist can be used for the transport and arrival of patients with confirmed or possible COVID-19.
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Centers for Disease Control and Prevention. (2020). Strategies for Optimizing the Supply of N95 Respirators.
This webpage provides strategies for optimizing the supply of N95 respirators.
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Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH). (2020). NIOSH-Approved N95 Particulate Filtering Facepiece Respirators.
This webpage provides a list of NIOSH-approved N95 respirators, alphabetically by manufacturer.
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National Fire Protection Association. (2020). Infection Control Program Resource for First Responders *.
This infection control resource provides options for modifying the protective levels of personal protective equipment in times of shortages.
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U.S. Food & Drug Administration. (2020). FDA Imported Non-NIOSH Approved Respirator Authorization.
This letter authorizes the use of non-NIOSH-approved personal respiratory protective devices during the COVID-19 outbreak.
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This guidance is intended for healthcare workers, healthcare managers and infection prevention and control teams and includes strategies for use when a COVID-19 infection is suspected.
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EMS Administrators/Medical Directors - Personal Protective Equipment Decontamination


Centers for Disease Control and Prevention. (2020). Decontamination and Reuse of Filtering Facepiece Respirators.
This website provides information about methods used to decontaminate filtering facepiece respirators. While these methods are not approved as a standard of care when personal protective equipment supplies are adequate, they may be considered to ensure continued availability during supply shortages.
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This study on surface decontamination procedure involves the delivery of ultraviolet germicidal irradiation (UVGI) to used N95 filtering facepiece respirators.
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N95DECON. (2020). N95 Decontamination *.
This website contains quantitative studies on N95 filtering facepiece respirator decontamination.
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National Institute for Occupational Safety and Health. (2020). Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings. Centers for Disease Control and Prevention.
This guidance for professionals who manage respiratory protection programs for healthcare facilities provides recommendations on extended use and reuse of N95 filtering facepiece respirators. It also explains the risks associated with extended use and reuse.
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U.S. Food & Drug Administration. (2020). Letter Permitting Medical Use of all NIOSH Approved N95.
This letter from the U.S. Food & Drug Administration authorizes emergency use of (1) all disposable filtering facepiece respirators (FFR) approved by the National Institute for Occupational Safety and Health (NIOSH) in accordance with 42 CFR Part 84, as non-powered air-purifying particulate FFRs, and (2) FFRs that were NIOSH-approved but have since passed the manufacturers’ recommended shelf-life, for use in healthcare settings by healthcare personnel (HCP)2 to prevent wearer exposure to pathogenic biological airborne particulates during FFR shortages resulting from the Coronavirus Disease 2019 (COVID-19).
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EMS Administrators/Medical Directors - Sustainability of Operations Through a Pandemic


This letter from the FEMA Administrator includes specific guidance for emergency managers.
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This document can support first responders’ efforts to provide the best possible service to their team and their community. Information is provided under three main categories: adjusting operations to maintain readiness and response, planning at the local level (a tool is included), and innovative planning and operations concepts. Reference sheets that list action steps are also included.
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EMS Administrators/Medical Directors - Workforce Expansion Resources


This guidance document provides additional flexibility for providers, American Heart Association instructors, and instructor candidates during the COVID-19 pandemic.
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National Registry of Emergency Medical Technicians (NREMT). (2020). NREMT Extends Certification and Waives Distributive Learning Limit *.
The National Registry's Board of Directors approved a motion extending the current recertification deadline from March 31, 2020 to June 30, 2020. Additionally, for registrants due to recertify March 31, 2020 Distributive Education limitations will be removed. This allows all continuing education to be accomplished outside of classrooms.
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State of Maine, Department of Public Safety. (2020). Extension of Maine EMS Service Licenses *.
This notification is specific to Maine emergency medical service (EMS) licenses and states that all EMS services whose license expires in March, April, or May 2020, and are not able to meet all requirements for service re-licensure by their current expiration date deadline, will have their deadlines for re-licensure extended to June 30, 2020.
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EMS Administrators/Medical Directors - Workforce Expansion Strategies


Global Medical Response (GMR). (2020). Guidance on Conducting Classes During COVID-19 *.
This document provides guidance on conducting classes during the COVID-19 pandemic. Access all GMR COVID-19 resources at https://www.globalmedicalresponse.com/coronavirus *
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National Registry of Emergency Medical Technicians (NREMT). (2020). FAQs about Provisional Certification *.
This document provides responses to frequently asked questions about provisional certification.
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Select Resources


American Heart Association. (2020). Coronavirus (COVID-19) Resources for CPR Training and Resuscitation. (Added 6/4/2020.)
This page includes several resources including guidance on basic and advanced life support, infographics, resuscitation algorithms, training courses, and podcasts.
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ASPR TRACIE. (2017). EMS Infectious Disease Playbook. U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response.
This playbook synthesizes multiple sources of information in a single planning document addressing the full spectrum of infectious agents to create a concise reference resource for emergency medical services (EMS) agencies developing their service policies. The information can be incorporated into agency standard operating procedures and reviewed by the EMS medical director.
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  • Bridget Kanawati Thank you for your interest in this resource. Unfortunately, funding restrictions preclude our being able to provide printed versions of our resources so all of our products, including this one, are only available electronically. ASPR TRACIE Team
    3/26/2020 2:12:41 PM
  • Frances Thorpe I agree with Tracy, is there a way to order this publication in hard copy format? The information contained in this publication highlights agency infection control policies and is a great resource to have in the department library.
    3/26/2020 12:21:36 PM
  • Tracy Miller Is there any way to order a printed and bound version?
    8/9/2018 5:16:09 PM
Baxter, C. and Stull, J. (2020). Balancing the Risk - Strategies for Respiratory Protection During a Pandemic. The Interagency Board for Emergency Preparedness and Response.
This document describes a phased approach to risk management for first responders based on the availability of respiratory personal protective equipment during the COVID-19 pandemic.
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This policy is an example of procedures implemented under a COVID-19 emergency declaration to allow EMS to transport patients to a location other than an acute care hospital.
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Centers for Disease Control and Prevention. (2017). Framework for Expanding EMS System Capacity During Medical Surge.
This framework can help community planners better understand the role of emergency medical services in medical surge planning and crisis standard of care adaptations, which falls under four strategies: Tiered Dispatch; Modified Treatment and Transport Strategies; Coordinated Transport to Alternate Destinations; and Support for Rapid Implementation of Patient Interventions.
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This guidance applies to all first responders, including law enforcement, fire services, emergency medical services, and emergency management officials, who anticipate close contact with persons with confirmed or possible COVID-19 in the course of their work.
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This document provides an overview of general considerations, potential strategies, and existing resources that emergency medical services (EMS) agencies may use to inform changes to their operations and standards of care to preserve and effectively allocate EMS during the COVID-19 pandemic.
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COVID-19 Healthcare Resilience Task Force. (2020). Guidance for First Responder Interactions with Suspected/Confirmed COVID-19 Patients. (Added 5/12/2020.)
This document provides information to assist first responders in decision-making related to interactions with suspected or confirmed COVID-19 patients.
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This document from the Emergency Cardiovascular Care Committee and Get With the Guidelines - Resuscitation Adult and Pediatric Task Forces of the American Heart Association in collaboration with the American Academy of Pediatrics, American Association for Respiratory Care, American College of Emergency Physicians, The Society of Critical Care Anesthesiologists, American Society of Anesthesiologists, American Association of Critical Care Nurses, and National EMS Physicians provides guidelines for treatment of cardiac arrest in patients with suspected or confirmed COVID-19.
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Hanfling, D., Hick, J., and Stroud, C. (2013). Crisis Standards of Care: A Toolkit for Indicators and Triggers. (Free registration required.) Institute of Medicine: National Academies Press.
This toolkit contains key concepts, guidance, and practical resources to help individuals across the emergency response system develop plans for crisis standards of care. Chapter 7 includes sample indicators, triggers, and sample tactics for use in the transition from conventional surge to contingency surge to crisis surge, and a return from crisis response to conventional response (detailed specifically for emergency medical services using slow-onset and no-notice scenarios).
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Hanfling, D., Hick, J., and Stroud, C. (2013). Crisis Standards of Care: A Toolkit for Indicators and Triggers – Table 7.1. (Free registration required.) Institute of Medicine, Washington, DC: National Academies Press.
Table 7.1 provides specific indicators, triggers, and tactics for EMS to use along the continuum of care during the COVID-19 pandemic.
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International Academies of Emergency Dispatch. (2020). Emerging Infectious Disease Surveillance Tool (2019-Novel Coronavirus).
This three-page protocol is a screening tool for possible cases of COVID-19. Questions cover symptoms, travel history, and patient contact history. It does not require a specific order or number of questions to ask. Geographically, areas of recent travel concern can change daily. The specifics of when to use this tool and the extent of questioning within this tool must remain user-defined. Scroll down to the “Download the EIDS Tool to Screen for Coronavirus” section to select the current version of the tool.
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Los Angeles County Department of Public Health. (2020). Guidance for Monitoring EMS Personnel.
This guidance provides recommendations to EMS agencies and employees on self-monitoring for symptoms, agency screening, testing, quarantine, isolation, and return to work.
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Massachusetts Department of Public Health. (2020). Emergency Measures Relating to EMS Due to COVID-19 Outbreak.
This memo is an example of statewide emergency measures to protect EMS personnel and first responders during the COVID-19 response. It updates statewide treatment protocols, allows ambulance transport to designated alternate sites on hospital grounds, clarifies the unprotected exposure protocol, updates the PSAP response, provides considerations for ambulance services, outlines post-transport cleaning, and addresses scene management, initial assessment, transport, treatment, and PPE for patients with a risk of COVID-19 infection.
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Michigan Department of Health and Human Services. (2020). Michigan EMS Coronavirus Disease (COVID-19) Response.
This web page includes numerous materials to guide the pre-hospital response to COVID-19. Included are guidance on COVID-19 screening, links to emergency protocols, and quick sheets on topics including infection control, pre-shift screening, respiratory protection, and screening.
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Minnesota Emergency Medical Services Regulatory Board. (2020). Emergency Suspension of Ambulance Service Requirement. (Updated 6/22/2020.)
This document is an example of suspended pre-hospital staffing, equipment, and response requirements under a state disaster declaration for COVID-19.
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Minnesota Metro Region EMS System. (2020). COVID-19 Response Matrix.
This table summarizes conventional, contingency, and crisis strategies for EMS systems related to dispatch, staffing, personal protective equipment, and supplies as well as decisions about which responders to send, patient destination, and lefts.
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Minnesota Metro Region EMS System. (2020). Crisis Contingency Strategies.
This flow chart depicts real-time and shift adaptations to allow EMS systems to transition among conventional, contingency, and crisis strategies while responding to the COVID-19 pandemic.
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Minnesota Metro Region EMS System. (2020). Pandemic Response Matrix.
This document outlines the standing orders that EMS directors may implement during crisis conditions to provide the best pre-hospital care to the most people. It outlines the following options for 22 different scenarios: transport by EMS, transport by law enforcement, referral to use alternate transportation to a medical facility, referral to a clinic or other medical facility, and provision of home care information.
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National Highway Traffic Safety Administration, Office of EMS. (2020). Crisis Standards of Care and COVID-19: What EMS Needs to Know.
This webinar provides an overview of why crisis standards of care (CSC) planning is critical in the pre-hospital setting, implications for leaders who implement CSC in their communities, and an example of one state's preparedness for emergency medical services surge.
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NHTSA’s Office of EMS. (2020). EMS Coronavirus/COVID-19 Resources.
The NHTSA Office of EMS maintains this list of federal guidance and resources as well as sample policies and protocols from state and local agencies around the country.
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This document details personal protective equipment (PPE) considerations for first responders to protect against inhalation, ocular, and dermal exposures to SARS-CoV-2; donning, use, and doffing considerations; cleaning, sanitizing, and disinfecting considerations; decontamination and disinfection procedures and considerations for vehicles, apparatus, and fire stations; and waste management considerations.
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United States Fire Administration (USFA). (2020). COVID-19 Resources for Fire and EMS.
This website includes select COVID-19 resources and guidance on funding, planning and response, infection control, and behavioral health.
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This document provides links to current CDC guidance applicable to EMS providers and systems. It provides general considerations followed by action steps under the following categories: assessment criteria, patient transport, PPE, safe work practices, documentation, post-transport management of the contaminated vehicle, and follow-up of EMS personnel.
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Agencies and Organizations


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National Association of Emergency Medical Technicians. Coronavirus (COVID-19).
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National Association of EMS Physicians. COVID-19 Resources.
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National Association of State EMS Officials. COVID-19 Resources.
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National Highway Traffic Safety Administration, Office of EMS. Coronavirus/COVID-19 Resources.
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