NOVEL CORONAVIRUS (2019-NCOV) UPDATE FOR KENTUCKY EMS PROVIDERS - FEBRUARY 7, 2020 - KBEMS
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Novel Coronavirus (2019-nCoV)
Update for Kentucky EMS
Providers
February 7, 2020
Novel Coronavirus (2019-nCoV) Identified • December 31, 2019 – China reports outbreak of respiratory illness • January 9, 2020 – Novel coronavirus first announced by China • January 10, 2020– Genetic sequence posted by China • January 20, 2020 - Person-to-person spread confirmed by China • January 21, 2020 – First case of coronavirus reported in U.S.
Seasonal Coronavirus vs. Novel Coronavirus • Coronaviruses are common throughout the world and typically cause mild to moderate illness. • Some strains of coronavirus are endemic and circulate seasonally in the United States. • The 2019 novel Coronavirus (2019-nCoV) is a member of this family, that includes SARS-CoV and MERS-CoV which can lead to severe illness. • A novel coronavirus is a new respiratory virus that has not been previously identified and was first identified in Wuhan, Hubei Province, China.
Traveler Health Card
Screening Patients presenting to healthcare providers should be assessed for exposures associated with risk of 2019-nCoV infections (e.g., travel to China or close contact with a confirmed case) and for symptoms consistent with 2019-nCoV infection (https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical- criteria.html).
Screening (Continued)
• 1Fever may not be present in some patients, such as those who
are very young, elderly, immunosuppressed, or taking certain fever-
lowering medications. Clinical judgment should be used to guide
testing of patients in such situations.
• 2Close contact is defined as - a) being within approximately 6 feet
(2 meters), or within the room or care area, of a novel coronavirus
case for a prolonged period of time while not wearing recommended
personal protective equipment or PPE (e.g., gowns, gloves, NIOSH-
certified disposable N95 respirator, eye protection); close contact can
include caring for, living with, visiting, or sharing a healthcare waiting
area or room with a novel coronavirus case. – or –
• b) having direct contact with infectious secretions of a novel
coronavirus case (e.g., being coughed on) while not wearing
recommended personal protective equipment.
Screening (Continued) • Ask patient to wear a surgical mask as soon as they are identified • Evaluate patient in private room with door closed, preferably an airborne isolation room (negative pressure) • Obtain a detailed travel history • Notify your infection prevention and control department personnel
Screening (Continued) All healthcare personnel entering the exam area should use: • Standard Precautions • Hand Hygiene, Personal Protective Equipment, Assume infectious, symptomatic or not • Contact Precautions • Gown and Gloves • Airborne Precautions
Screening (Continued) All healthcare personnel entering the exam area should use: • N95 Mask (Fit testing indicated) • Goggles / face shield for aerosol-generating procedures • Hand hygiene should be performed with alcohol-based hand rub and/or soap and water • Use healthcare grade EPA approved disinfectant for disinfection
Specific EMS Management and Transport Considerations 1. If the patient exhibits symptoms of an acute febrile** lower respiratory infection (fever, shortness of breath/difficulty breathing, cough): a. Place a surgical mask on the patient AND b. Obtain a detailed travel history to affected countries within the past 14 days*** or *close contact with someone under investigation for 2019- nCoV 2. If there is a history consistent with concern for potential 2019-coronavirus (2019-nCoV), initiate standard contact and airborne precautions (gloves, gown, N95 respirator) and eye protection (goggles) for EMS clinicians.
Specific EMS Management and Transport Considerations (Continued) 3. Notify the receiving hospital (according to local protocols) of potential infection as soon as possible to allow for emergency department preparation. 4. Use caution with aerosol generating procedures. 5. Properly doff and dispose of PPE according to protocol. 6. Cleaning and disinfection using EPA registered disinfectants with known effectiveness against human coronaviruses. 7. Waste management per policy for medical waste (red bag).
Specific EMS Management and Transport Considerations (Continued) *Close contact is defined as being within about 6 feet, or within the same room or care area, of a patient with confirmed 2019-nCoV without wearing PPE for a prolonged period OR having direct contact with 2019-nCoV patient secretions. **Fever may not be present in all patients; those who are immunocompromised, very young, elderly or taking fever-lowering medications. ***The list of affected countries may change over time and can be confirmed at the CDC site: https://www.cdc.gov/coronavirus/2019-nCoV/. Continue to work with your agency infection control staff and local hospitals, emergency department and public health agencies to coordinate all response activities and notifications.
Reporting Process as determined by the Kentucky Department
for Public Health – February 6, 2020
• If a patient meets the criteria for 2019-nCoV PUI
• Healthcare Provider should directly notify KDPH immediately-KDPH and CDC
will work with the Healthcare Provider to determine if the patient is a PUI
• During Regular business hours (8:00am-4:30pm,M-F): Primary contacts are
Stacy Davidson and Dimple Patel at 502-564-3261
• After hours or on weekends: Call 888-9-REPORT (888-973-7678)
• Do not wait until normal business hours to report a possible case
• Must go through KDPH to consult with CDC and/or submit lab specimensNovel Coronavirus (2019 – nCoV)
Kentucky Department of Public Health Contacts
Division of Epidemiology and Health Planning:
Stacy Davidson or Dimple Pate - 502-564-3261 (After hours: 888-973-7678)
Secure Fax: 502-696-3803
Division of Laboratory Services:
Rachel Zinner or Teresa Fields
502-564-4446
CHFS Communications Office:
Barbara Fox, Beth Fisher or Anya Weber
502-564-6786Novel Coronavirus (2019 – nCoV) Resources The Centers for Disease Control and Prevention (CDC): 2019 –nCoV Situation Overview Interim Guidance for Healthcare Providers Preparedness Checklist for 2019-nCoV Emergency Preparedness and Response 2019 Novel Coronavirus (2019-nCoV) in the U.S. About Human Coronaviruses Frequently Asked Questions and Answers: 2019 Novel Coronavirus NHTSA Office of EMS Novel coronavirus (2019-nCoV) update
Novel Coronavirus (2019 – nCoV) Resources
(Continued):
World Health Organization Infection prevention and control during health
care when novel coronavirus (nCoV) infection is suspected
Association of State and Territorial Health Officials (astho)
Dispatch Emergency of Academies International (IAED)
eScholarship - 2019-nCoV: The Identify-Isolate-Inform (3I) Tool Applied to a
Novel Emerging CoronavirusQuestions
Contact: Robert Andrew, Director of Education
Email: robert.Andrew@kctcs.edu
Phone: 859-256-3577You can also read
