Resources for First Responders

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Last updated May 5, 2020 at 11:37 am

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PPE Guidance and Information:

For a printable version of this guidance, click here. 

  • This guidance applies to all first responders who anticipate close contact with persons with confirmed or possible COVID-19 in the course of their work.
  • Recommended PPE (Personal Protective Equipment): First Responders who will care for a patient with confirmed or suspected COVID-19 should follow standard and transmission based precautions and use the following recommended PPE:
    • N-95 or higher level respirator 
      • If a respirator is not available, use a facemask​
      • N95 respirators should be used instead of a facemask when performing or present for an aerosol-generating procedure
    • Eye protection (i.e., goggles or disposable face shield that fully covers the front and sides of the face)
      • Personal eyeglasses and contact lenses are NOT considered adequate eye protection
    • A single pair of disposable patient examination gloves
      • Change gloves if they become torn or heavily contaminated
    • Isolation gown
      • If there are shortages, gowns should be prioritized for aerosol-generating procedures, care activities where splashes and sprays are anticipated, and high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of EMS clinicians (e.g., moving patient)
  • N-95 Information:
    • Before anyone can use a N-95 Respirator, they MUST be fit-tested and medically cleared
    • N-95 respirators are tight-fitting respirators that filter out at least 95% of particles in the air
      • When properly fitted and worn N-95 respirators reduce the wearer’s exposure to airborne particles
    • Achieving an adequate seal to the face is essential.
      • Workers must conduct a user seal check each time the respirator is used.
  • For more information:

 

Universal Precautions Recommendations*

*The information has been compiled from CDC and WI Department of Health Services (DHS) Resources. If there was a difference in recommendations, DHS guidance was used.

Universal Precautions Recommendations for 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.

  • Situation: Patient assessment
    • PPE to Use: If Public Safety Answering Point call takers advise patient is suspected of having COVID-19:
      • ​​​N-95 or higher-level respirator or facemask (if a respirator is not available).
      • Eye protection (i.e., goggles or disposable face shield that fully covers the front and sides of the face)
      • A single pair of disposable patient examination gloves
      • Isolation gown
    • Comments:
      • ​​​When the supply chain is restored, fit-tested EMS clinicians should return to use of respirators for patients with known or suspected COVID-19.
      • If there are shortages of gowns, they should be prioritized for aerosol-generating procedures, care activities where splashes and sprays are anticipated, and high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of EMS clinicians (e.g., moving patient onto a stretcher).
      • Change gloves if they become torn or heavily contaminated.
      • If information about potential for COVID-19 has not been provided by the PSAP, EMS clinicians should exercise appropriate precautions when responding to any patient with signs or symptoms of a respiratory infection.
        • Initial assessment should begin from a distance of at least 6 feet from the patient, if possible.
        • Patient contact should be minimized to the extent possible until a facemask is on the patient.
        • If COVID-19 is suspected, all PPE as described should be used.
        • If COVID-19 is not suspected, EMS clinicians should follow standard procedures and use appropriate PPE for evaluating a patient with a potential respiratory infection.
      • During transport, limit the number of providers in the patient compartment to essential personnel to minimize possible exposures.
  • Situation: Precautions for aerosol-generating procedures
    • ​​PPE to Use: 
      • N-95 or higher-level respirator, instead of a facemask, should be worn in addition to the other PPE described above
    • Comments:
      • ​​​If possible, consult with medical control before performing aerosol-generating procedures for specific guidance.
      • EMS clinicians should exercise caution if an aerosol-generating procedure is necessary. Bag valve masks and other ventilator equipment should be equipped with HEPA filtration to filter expired air.
      • EMS organizations should consult their ventilator equipment manufacturer to confirm appropriate filtration capability and the effect of filtration on positive-pressure ventilation.
      • If possible, the rear doors of the transport vehicle should be opened and the HVAC system should be activated during aerosol-generating procedures. This should be done away from pedestrian traffic.

Universal Precautions for Law Enforcement Personnel who anticipate close contact with persons with confirmed or possible COVID-19 in the course of their work.

  • Situation: General work where physical distance is maintained (in car, using phone, able to talk to general public from greater than six foot distance) 
    • ​PPE to Use:
      • None
    • Comments: 
      • ​​Regular handwashing must occur.
  • Situation: Work with general public where physical distance of six feet cannot be maintained but physical contact is not required (close talking is required) 
    • ​PPE to Use:
      • ​Surgical mask
    • ​​Comments:
      • ​​​Use your PPE sparingly. Keep it with you, but do not use it until you understand the situation. 
      • PPE should be used as a last resort. Avoiding the hazard in general using physical distancing of six feet or more as the first line of defense.
      • Regular handwashing must occur.
  • Situation: Work requiring physical contact with well people 
    • ​PPE to Use: 
      • ​​​Surgical mask, gloves
    • Comments:
      • ​​​Use your PPE sparingly. Keep it with you, but do not use it until you understand the situation. ​
      • PPE should be used as a last resort. Avoiding the hazard in general using physical distancing of six feet or more as the first line of defense.
      • Regular handwashing must occur.
  • Situation: Work requiring physical contact or care of ill people, including people with known or suspected COVID-19​
    • ​​​PPE to Use: 
      • Surgical mask
      • Eye protection (i.e., goggles or disposable face shield that fully covers the front and sides of the face),
      • Gown or single-use coveralls, if possible
    • ​​Comments: 
      • ​N95 mask may also be used, but should be generally reserved as much as possible for health care workers doing aerosolizing procedures.  Please note, using expired N95s or when not fit tested may be considered generally equivalent to the protection of a surgical mask, depending on the exact type of N95 and the level of fit.
      • Surgical masks are an acceptable alternative to N95 respirators until the supply chain is restored; when the supply chain is restored, fit-tested EMS clinicians should return to use of respirators for patients with known or suspected COVID-19.
      • If there are shortages of gowns, they should be prioritized for aerosol-generating procedures, care activities where splashes and sprays are anticipated, and high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of responder.
      • Regular handwashing must occur.
      • Law Enforcement: if unable to wear gown or coveralls, clean and disinfect duty belt and gear prior to reuse using a household cleaning spray or wipe, according to the product label, and follow standard operating procedures for containing and laundering clothes. Avoid shaking the clothes.
  • Click here for Law Enforcement Use and Conservation of Personal Protective Equipment Document from WI DHS.

Universal Precautions Recommendations for EMS Transport of a PUI or a Patient with Confirmed COVID-19 to a Health Care Facility, including interfacility transport

  • Situation: Transport of a patient with an exposure history and signs and symptoms of COVID-19 to a health care facility for evaluation and management
    • PPE to Use:
      • N-95 or higher-level respirator or facemask (if a respirator is not available).
      • Eye protection (i.e., goggles or disposable face shield that fully covers the front and sides of the face)
      • A single pair of disposable patient examination gloves
      • Isolation gown
    • Comments:
      • Notify the receiving health care facility that the patient has an exposure history and signs and symptoms of COVID-19 so that infection control precautions may be taken prior to arrival.
      • Keep the patient separated from other people as much as possible.
      • Family members and other contacts of patients with COVID-19 should not ride in the transport vehicle, if possible. If riding in the transport vehicle, they should wear a facemask.
      • Isolate the driver from the patient compartment and keep pass-through doors and windows tightly shut.
      • Follow routine procedures for a transfer of the patient to the receiving health care facility.
      • When the supply chain is restored, fit-tested EMS clinicians should return to use of respirators for patients with known or suspected COVID-19.
      • If there are shortages of gowns, they should be prioritized for aerosol-generating procedures, care activities where splashes and sprays are anticipated, and high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of EMS clinicians (e.g., moving patient onto a stretcher).
      • Change gloves if they become torn or heavily contaminated.
  • Situation: Vehicle ventilation scenarios
    • ​​PPE to Use: 
      • ​When possible, use vehicles that have isolated driver and patient compartments that can provide separate ventilation to each area.
      • Close the door/window between these compartments before bringing the patient on board.
    • Comments:
      • During transport, vehicle ventilation in both compartments should be on non-recirculated mode to maximize air changes that reduce potentially infectious particles in the vehicle.
      • If the vehicle has a rear exhaust fan, use it to draw air away from the cab, toward the patient-care area, and out the back end of the vehicle.
      • Some vehicles are equipped with a supplemental recirculating ventilation unit that passes air through HEPA filters before returning it to the vehicle. Such a unit can be used to increase the number of air changes per hour (ACH)
      • If a vehicle without an isolated driver compartment and ventilation must be used, open the outside air vents in the driver area and turn on the rear exhaust ventilation fans to the highest setting. This will create a negative pressure gradient in the patient area.
  • Situation: Documentation of patient care
    • PPE to Use: 
      • ​​Documentation of patient care should be done after EMS clinicians have completed transport, removed their PPE, and performed hand hygiene.
    • Comments:
      • Written documentation should match the verbal communication given to the emergency department providers at the time patient care was transferred.
      • EMS documentation should include a listing of EMS clinicians and public safety providers involved in the response and level of contact with the patient (for example, no contact with patient, provided direct patient care). This documentation may need to be shared with local public health authorities.

Universal Precautions Recommendations for Public Safety Answering Points (PSAP) Regarding COVID-19

  • Situation: Modified caller queries should be closely coordinated with an EMS medical director and informed by local public health authorities, including the city or county health department(s).
    • ​PPE to Use:
      • ​​​None needed for remote PSAP or emergency medical dispatch centers
    • Comments:
      • The query process should never take precedence over pre-arrival instructions to the caller when immediate lifesaving interventions (e.g., CPR or the Heimlich maneuver) are needed. Patients in the United States who show signs and symptoms of COVID-19 should be evaluated and transported as a Person under Investigation (PUI).
      • Information on a possible PUI should be communicated immediately to EMS clinicians before arrival on scene in order to allow use of appropriate personal protective equipment (PPE). PSAPs should use medical dispatch procedures that are coordinated with their EMS medical director and with the local public health department.

Universal Precautions for Public Health Personnel Evaluating Persons (with Symptoms)  Under Investigation (PUI) for COVID-19

  • Situation: Interview the PUI by telephone, text monitoring system, or video conference.
    • ​​PPE to Use: 
      • ​None needed
    • ​​Comments: 
      • Temperature monitoring could be reported by phone or shown to a provider via video conferencing.
      • Regular handwashing must occur
  • Situation: If necessary, interview a PUI in their home or other residential setting
    • ​PPE to Use: 
      • Gown
      • Gloves
      • Eye protection (for example, goggles, a disposable face shield that covers the front and sides of the face)
      • Respiratory protection that is at least as protective as a NIOSH-approved N95 or higher level respirator or facemask (if a respirator is not available)
    • Comments:
      • Hand hygiene should be performed before putting on PPE using alcohol-based hand sanitizer that contains 60 to 95% alcohol.
      • PPE should ideally be put on outside of the home prior to entry into the home.
      • If unable to put on all PPE outside of the home, it is still preferred that face protection (that is to say, respirator and eye protection) be put on before entering the home. Once the entry area is clear, enter the home and put on a gown and gloves.
      • PPE should ideally be removed outside of the home. If unable to remove all PPE outside of the home, it is still preferred that face protection (that is to say, respirator and eye protection) be removed after exiting the home.
      • Once outside the home, perform hand hygiene with alcohol-based hand sanitizer that contains 60 to 95% alcohol, remove face protection.

Universal Precautions for Public Health Personnel Evaluating Asymptomatic Close Contact of Confirmed Cases

  • Situation: Interview the asymptomatic close contact by telephone, text monitoring system, or video conference.
    • ​​PPE to Use:
      • ​​None needed
    • ​​Comments: 
      • Temperature monitoring could be reported by phone or shown to a provider via video conferencing.
      • Regular handwashing must occur
  • Situation: If necessary, interview the asymptomatic close contact in person.
    • PPE to Use:
      • Facemask
      • Eye protection and gloves (if asymptomatic close contact is not able to take their own temperature)
    • Comments:
      • Stay at least 6 feet away from the asymptomatic close contact and ask them if they have had fevers or respiratory symptoms.
      • If the interview and assessment is occurring in the home environment, the public health personnel should not enter the home until these questions have been asked and the asymptomatic close contact has been determined to be fever-free by temperature measurement.
      • If person is unable to take their own temperature, the public health personnel should perform hand hygiene with alcohol-based hand sanitizer that contains 60 to 95% alcohol, put on a facemask, eye protection and gloves, and proceed with checking the contact’s temperature.
      • Once outside the home, perform hand hygiene with alcohol-based hand sanitizer that contains 60 to 95% alcohol, remove face protection.
  • Click here for CDC Interim Guidance for Public Health Personnel for more information on evaluating Persons (with symptoms) Under Investigation (PUI) for COVID-19 and asymptomatic close contacts of confirmed cases.

 

Resources for First Responders and Law Enforcement:  

Supporting Documents

PDF icon PPE Guidance for First Responders April 6, 2020 (96 KB)