The EMS Super–Human Response
By CHELLE CORDERO, Correspondent | July 01, 2020 | NEW YORK
Story No. 052920110
COVID-19 has kept our EMS system on its toes for months. Our EMTs and Paramedics (and hospital healthcare) have maintained excessively long hours, treated an almost non-stop line of patients, and many have seen more death than ever before (with the possible exception of military medics in combat zones). Our EMS responders have been superheroes determined to defeat the “Kryptonite” known as the Coronavirus. And sadly, some of the brave responders have fallen victim to this scourge. Being faced with so many POTENTIAL Coronavirus patients has forever changed EMS response — for one thing, it has instilled the terribly poignant knowledge that even our superheroes are vulnerable.
The fear of COVID-19 has also complicated the typical call for help. Ambulance crews and hospital ERs are seeing more patients in advance stages when it comes to ailments from strokes, heart attacks, appendicitis and other medical emergencies. More and more patients, even non-COVID, have tried to wait out other symptoms, treat themselves at home, and otherwise deny the need to go to the hospital. No one wanted to be in the hospital which is seen as breeding grounds for a virus which we are only just learning about… its traits, symptoms, which organs it affects, and so much more. And with the higher incidence of stroke in younger adults caused by blood thickening due to the Coronavirus, Paramedics and EMTs have had to treat not just one chief complaint, but two or even more. Overall medical personnel have noticed far less patients presenting with inflamed appendixes, infected gall bladders and bowel obstructions, and more ominously, chest pains and stroke symptoms in both the ambulances and emergency rooms. Patients experiencing medical emergencies who tried to “wait it out” never realized the seriousness of the situation and when they finally did call 911 (or were driven to the hospital) they often had severe complications from the delay.
The NYS Viral Pandemic Triage Protocol (20-06 Pandemic Triage) begins with directions to conduct an initial screening of the patient from no less than six feet away to ascertain if the patient has signs or symptoms of an Influenza-type illness. Based on findings, if the answer is no, providers are to use standard PPE and treat according to ALS/BLS guidelines. If the patient does exhibit any s/s of flu-like illness, providers need to don N-95 or surgical masks, gloves, gowns and eye protection before conducting a close patient assessment of vital signs, patient history and underlying medical conditions. Depending on the findings, the provider needs to make a decision if the patient meets the criteria for transport to the hospital or for treatment-in-place. If the patient argues about not being transported to the hospital then the provider needs to contact medical control for direction. It’s certainly a big change from simply transporting on (almost) every call and a huge responsibility for our providers to make these decisions.
Especially with the country opening up and relaxing its aggressive mitigation practices, the knowledge that each patient can be POTENTIALLY carrying a deadly virus is nearly paralyzing; our EMS personnel will still answer those 911 calls hoping that patient families will not be saying goodbye at the door and hoping that the patients didn’t try to ignore their symptoms out of fear. And heaven forbid our country experience a “second wave”, our responders are tired, so many supplies have been depleted, and so many potential patients, with or without the virus, are still scared of going to the hospital.
This article is a direct street report from our correspondent and has not been edited by the 1st Responder newsroom.