VDH/OEMS Authorizes EMS to Transport to Alternate Sites

The Virginia Office of EMS (OEMS) has released a White Paper on “Transportation of Patients to Alternate Sites” to provide agencies with guidance in response to the March 30, 2020 Centers for Medicare and Medicaid Services (CMS) released notification of issuance of temporary regulatory waivers for EMS to have maximum flexibility when responding to the COVID-19 pandemic.  The guidance identifies the manner in which this option is to be employed and places the responsibility on EMS leadership including the OMDs to determine which patients can be adequately treated by these facilities versus being transported elsewhere for more definitive care, as well as for the development of protocols to properly outline that process.

Those protocols should take into account the facilities capabilities, hours of operations as well as  time and distance to other facilities with more definitive care. 

In their rollout of the White Paper, the OEMS Medical Director and the Regulation and Compliance Division Manager emphasized the need for agencies to work with the identified alternate facilities to establish the necessary processes for such protocols to be successful.

PEMS suggests the following things be considered: 

  • Identify the patients that can be appropriately treated at the alternate facility 
  • Identify the triage process 
  • Establish a pre-arrival communications process for the facility
  • Establish a patient reception and handoff process for the facility
  • Establish a waste/PPE/contaminated waste disposal process
  • Establish a unit decon process/in the event decon is needed
  • Establish a medication kit exchange process (involve PEMS) if necessary
  • Establish processes for reporting of positive test results on patients transported by EMS

Also, OEMS told the Regional Council directors to advise their agencies that refusals were only to be used when the EMS agency recommended  a treatment or transport and the patient refused one or both.  Refusals ARE NOT APPROPRIATE AND SHOULD NOT BE USED to document a treat and release by protocol disposition.  If the non-transport decision is provider initiated or initiated by telemedicine consult, it should be documented as such in the PPCR narrative and the disposition should be – Treated and Released by Protocol.

To assist agencies and facilities in the region, the Peninsulas EMS Council Protocol Task Force is currently developing:

1. PEMS COVID-19 Establishing Alternative Destinations Procedure to assist EMS Leadership and OMDs in creating a partnership with alternate sites.

2. PEMS COVID-19 Expanded Services Protocol to guide EMS Providers in determining where to transport patients during the COVID-19 Pandemic

Agencies will be notified when these documents have been finalized.

  Click Here to Download the VDH/OEMS White Paper "Transportation of Patients to Alternate Sites"

An Important Announcement from the Virginia State Health Commissioner

As COVID-19 continues to rapidly evolve, please visit the VDH website for updated epidemiological information and clinical guidance. 

COVID-19 in Virginia 

● As community transmission increases in Virginia, healthcare facilities should consider additional actions to reduce the risk of their employees introducing COVID-19 into their facilities. 

● There is growing evidence of asymptomatic and presymptomatic spread. CDC recently changed the start of the infectious period to 48 hours before symptom onset. 

● For people who must leave their home for essential needs (e.g., grocery shopping and picking up pharmacy medications), CDC recommends that people wear cloth face coverings where other social distancing measures are difficult to maintain, especially in areas of significant community-based transmission. N95 respirators and surgical masks are not recommended in these situations so that they can be reserved for HCP and first responders 

● Mildly ill patients may not need to be tested and can be managed at home. Clinical diagnoses of COVID-19 are reportable; given the volume, reporting through the VDH Online Morbidity Report Portal is preferred. Please continue to call your local health department about suspected outbreaks of COVID-19. 

● For COVID-19 patients, please provide this patient handout about home isolation and encourage them to notify their contacts. 

● A COVID-19 Flag Alert has been added to Virginia’s Emergency Department Care Coordination Program. COVID-19 alerts will automatically become inactive after six weeks. 

● VDH has updated work restriction recommendations to allow asymptomatic healthcare personnel who have had an exposure to a COVID-19 patient to continue to work after options to improve staffing have been exhausted and in consultation with their occupational health program. More information can be found on the VDH COVID-19 Healthcare Personnel Risk Assessment Tool

Testing 

VDH criteria for COVID-19 public health testing at DCLS have been updated to remove requirements for influenza testing. Until testing is widely available, prioritizing testing at private labs for high risk groups should also be considered. 

Personal Protective Equipment (PPE) 

● Virginia continues to experience a critical shortage of PPE. CDC has defined acceptable alternative PPE for caring for patients with confirmed or suspected COVID-19. Additional shipments from the Strategic National Stockpile are not expected in the near future. For questions, individual practices, home health and CHCs/FQHCs should check with their local health districts. Hospitals and nursing homes should contact their regional healthcare coalition. 

Congregate Settings 

● As of April 3, 31 confirmed outbreaks (defined as having two or more COVID-19 cases) have been reported and 12 (39%) are in skilled nursing and assisted living facilities. Answers to frequently asked questions are available on the VDH website and guidance is on the CDC website

● Other congregate settings, such as jails, prisons, and behavioral health residential facilities also face the threat of COVID-19 introduction and spread. To date, two (7%) confirmed outbreaks have been reported in correctional facilities. CDC guidance and resources are available for correctional facilities and detention centers. 

Thank you for all your efforts on the front line of combat against the COVID-19 pandemic. You are an essential part of the public health campaign to protect the health of the people of the Commonwealth. 

M. Norman Oliver, MD, MA - State Health Commissioner

dark blue horiz line290x10

An Important Announcement from the Virginia State Health Commissioner

As COVID-19 continues to rapidly evolve, please visit the VDH website for updated epidemiological information and clinical guidance. 

COVID-19 in Virginia 

● As community transmission increases in Virginia, healthcare facilities should consider additional actions to reduce the risk of their employees introducing COVID-19 into their facilities. 

● There is growing evidence of asymptomatic and presymptomatic spread. CDC recently changed the start of the infectious period to 48 hours before symptom onset. 

● For people who must leave their home for essential needs (e.g., grocery shopping and picking up pharmacy medications), CDC recommends that people wear cloth face coverings where other social distancing measures are difficult to maintain, especially in areas of significant community-based transmission. N95 respirators and surgical masks are not recommended in these situations so that they can be reserved for HCP and first responders 

● Mildly ill patients may not need to be tested and can be managed at home. Clinical diagnoses of COVID-19 are reportable; given the volume, reporting through the VDH Online Morbidity Report Portal is preferred. Please continue to call your local health department about suspected outbreaks of COVID-19. 

● For COVID-19 patients, please provide this patient handout about home isolation and encourage them to notify their contacts. 

● A COVID-19 Flag Alert has been added to Virginia’s Emergency Department Care Coordination Program. COVID-19 alerts will automatically become inactive after six weeks. 

● VDH has updated work restriction recommendations to allow asymptomatic healthcare personnel who have had an exposure to a COVID-19 patient to continue to work after options to improve staffing have been exhausted and in consultation with their occupational health program. More information can be found on the VDH COVID-19 Healthcare Personnel Risk Assessment Tool

Testing 

VDH criteria for COVID-19 public health testing at DCLS have been updated to remove requirements for influenza testing. Until testing is widely available, prioritizing testing at private labs for high risk groups should also be considered. 

Personal Protective Equipment (PPE) 

● Virginia continues to experience a critical shortage of PPE. CDC has defined acceptable alternative PPE for caring for patients with confirmed or suspected COVID-19. Additional shipments from the Strategic National Stockpile are not expected in the near future. For questions, individual practices, home health and CHCs/FQHCs should check with their local health districts. Hospitals and nursing homes should contact their regional healthcare coalition. 

Congregate Settings 

● As of April 3, 31 confirmed outbreaks (defined as having two or more COVID-19 cases) have been reported and 12 (39%) are in skilled nursing and assisted living facilities. Answers to frequently asked questions are available on the VDH website and guidance is on the CDC website

● Other congregate settings, such as jails, prisons, and behavioral health residential facilities also face the threat of COVID-19 introduction and spread. To date, two (7%) confirmed outbreaks have been reported in correctional facilities. CDC guidance and resources are available for correctional facilities and detention centers. 

Thank you for all your efforts on the front line of combat against the COVID-19 pandemic. You are an essential part of the public health campaign to protect the health of the people of the Commonwealth. 

M. Norman Oliver, MD, MA - State Health Commissioner

dark blue horiz line290x10

LOCAL EMS AGENCIES SEEK PPE DONATIONS

9792AC65 FC12 45D9 8B2C 4B017111EC80

Do you have unused Personal Protective Equipment (PPE) to donate to your local EMS agencies?  As you may have seen through state and federal press conferences, there remains a shortage of Personal Protective Equipment (PPE) throughout the nation for Emergency Services and Healthcare Workers in light of the Coronavirus COVID-19 pandemic.

The Penisulas EMS Council, Inc. (PEMS) serves EMS agencies from the Peninsula, the Middle Peninsula, and the Northern Neck.  Those EMS agencies are seeking local donations of N95 face masks, surgical face masks, eye shields, non-latex gloves, disposable gowns, unopened cleaning wipes with bleach and unopened hand sanitizer. In response to this unprecedented national shortage of PPE for Emergency Medical Services personnel and the increased need for PPE for our local EMS agencies, the Peninsulas Emergency Medical Services Council (PEMS) is working to solicit donations of PPE as well as collect any extra, unused PPE from local businesses. PEMS will coordinate the distribution of any donated items to the EMS agencies.

Donations of any quantity of the following are encouraged:

  • Face masks: including N95s, clinical, surgical, or other types
  • Eye/Face shields
  • Non-latex gloves
  • Disposable gowns
  • Unopened Cleaning wipes with bleach
  • Unopened Hand sanitizer

 

Donations should be dropped off ONLY BY APPOINTMENT at the PEMS Council Offices located at 6876 Main Street in Gloucester, VA 23061 (Located right next to the US Post Office)

Individuals, businesses and organizations with PPE to donate should contact the PEMS Council at 804-693-6234 to set up a drop off time

dark blue horiz line290x10

Page 2 of 3

Main Menu

Back To Top