Many EMS personnel and healthcare providers have had to carry the brunt of the COVID-19 pandemic’s effects over the past two years. According to a national survey, nearly 27% of the EMS workforce has had to quarantine at some point during the pandemic, and on average, respondents said over 18% of their practitioners have contracted COVID-19. They’ve endured all this while working on the frontlines to keep people safe and mitigate the spread of the virus.
It’s become clear, though, that the virus isn’t going to disappear anytime soon — rather than returning to normal, our world is still adjusting to a new normal. This year will bring new challenges for the EMS workforce, as well as some continued obstacles to be mindful of when treating patients with COVID-19.
Unique Challenges for EMS Workers
Like previous years, EMS personnel are having to continually expose themselves to the virus every time they enter the home of a patient. This is hard to avoid since there are often different standards of cleanliness in homes than in sterile hospital settings, where staff are expected to maintain strict public health guidelines, both for their patients and themselves, and sanitize things after each use.
Exposing themselves to inconsistent cleanliness standards is not the only challenge EMS providers face when on the job, though — obstacles like delayed ambulance trips to and from the hospital, longer wait times during hospital transfers and low hospital staffing due to employees calling off sick or testing positive for COVID are all factors that impact EMS teams daily. Issues of low federal reimbursement rates and salary constraints have come to the forefront even more during these COVID-related staffing shortages. According to a 2021 survey done by the American Ambulance Association, the turnover among paramedics and EMTs ranges from 20-30% annually, resulting in a 100% turnover rate every four years.
Although there’s a high demand for care in all emergency departments right now, hospitals are operating with slower turnaround because of low staffing. In many cases, emergency departments have had to declare entire units “out of service” when too many employees have gotten sick or tested positive for the virus. These developments continue to add stress to systems that are already operating in mandatory overtime mode. EMS teams have also struggled to maintain training programs for new recruits, an issue that will likely continue for some teams in 2022.
Airway Management and Suctioning for Patients with COVID-19
There are several unique considerations EMS providers should continue to be aware of when treating patients with COVID-19, such as utilizing the right airway device, securing the airway and maintaining clean and reliable equipment. When choosing an airway device, it’s important to know that endotracheal intubation and extubation can increase the risk of infection transmission due to proximity to airway secretions, particularly when a patient coughs. Therefore, the use of high-level personal protective equipment is necessary during all airway management scenarios.
The primary goal for airway management when treating a COVID-19 patient should be to secure the airway rapidly, ideally upon the first attempt, and to reduce or eliminate the aerosolization of respiratory secretions, like blood and vomitus.
Below is a list of some of the most important considerations providers should focus on when clearing the airway of a COVID-19 patient:
- Create an airway management plan with backup contingencies, including an intubation checklist and the enactment of COVID-19 intubation simulations
- Use double gloves during intubation and remove outer gloves immediately after a laryngoscopy
- Use disposable airway equipment when possible
- Use a closed suction system as necessary for tracheal suction, or for oral suction, prior to intubating
- Minimize the number of people in the operating room during intubation; usually limit to one intubator and one other assistant skilled in airway management
EMS teams must continue to adapt to the changing landscape of the pandemic, as vaccine protocols and public health guidelines shift in response to new discoveries related to the virus. It’s essential that your team is equipped with the right suction devices so they’re able to tend to patients’ needs at all times. Read SSCOR’s Ultimate Guide to Purchasing a Portable Emergency Suction Device to learn more about must-have devices to keep in your emergency preparedness kit during the COVID-19 pandemic.