Hospital Screening and Procedures

Effective immediately, the following updates have been made to the pre-hospital screening of COVID-19 for all agencies in the Orange, Seminole, Lake, and Osceola County EMS Systems:

Patients who screen positive for “Strict Respiratory Precautions Alert” include those with any of the following symptoms/risk factors:

• Fever (subjective or confirmed)
• Cough
• Shortness of Breath
• Diarrhea (<14 days duration)
• Close contact with a person with confirmed COVID-19
• Close contact with a person who has been told to self-isolate for possible COVID-19 (not tested or awaiting results)

In order to have a common notification mechanism to all area emergency departments, EMS units will be calling in a “Strict Respiratory Precautions Alert” whenever transporting a patient who meets the above criteria. Please be aware, such notification denotes that EMS personnel will be donning appropriate PPE including N-95 mask, gown, gloves, and eye protection.

In order to facilitate timely transition of care while preventing excessive PPE usage and provider exposures of both pre-hospital and emergency department personnel, this process will now be standardized throughout the region including all agencies within the Orange County EMS System, Seminole County EMS System, Maitland Fire Department, Advent Health EMS, Winter Park Fire Department, Osceola County EMS and Lake County EMS. The following hospital systems have also agreed to the handoff procedure- Orlando Health, Advent Health, Nemours Children’s Hospital, HCA and the VA Medical Center. The procedure is as follows:

• During transport turn the exhaust fan on to full speed.
• EMS provider will call in standard patient report and advise a “Strict Respiratory Precautions Alert”
• Upon arrival at the receiving facility, EMS providers will stay in or near their ambulance until given further direction from receiving facility staff
• Once cleared to enter ED by receiving facility staff, EMS personnel will discontinue all aerosol generating procedures (nebulizers, CPAP) before entering facility
• Once assigned a room, EMS providers will accompany their patient (in full PPE) to the assigned patient room
• Patient hand-off will occur within the assigned patient room
• EMS providers will exit the room taking the most direct route out of the emergency department
• EMS providers will decontaminate their vehicle prior to doffing PPE and performing hand hygiene
• EMS providers may then return for signatures

At this time, “Strict Respiratory Precautions Alert” patients will not be transported to free standing emergency departments.

Additional information and updates will be provided as they arise. Please assure all personnel receive this information and institute this change immediately