Per the Governor’s Executive Order 202.16, issued on April 12, 2020, provides the following directive:
For all essential businesses or entities, any employees who are present in the workplace shall be provided and shall wear face coverings when in direct contact with customers or members of the public. Businesses must provide, at their expense, such face coverings for their employees.
This provision may be enforced by local governments or local law enforcement as if it were an order pursuant to section 12 or 12-b of the Public Health Law. This requirement shall be effective Wednesday, April 15 at 8 p.m.
Given this directive, all essential workers including EMS providers and firefighters are required to wear a face covering when they are in close contact with the public (closer than 6 feet). Face coverings include various types of masks or face shields depending upon the activity.
Due to these changes, and the increasing number of cases in the community it is now advisable for EMS providers providing patient care in close contact to wear a surgical mask and face shield on all calls. To protect the safety of providers while ensuring adequate supplies of PPE the following recommendations for re-use of masks should be followed on all EMS calls during the COVID-19 pandemic:
- Maintain social distancing of greater than 6 feet whenever possible and limit the number of personnel in close contact with the patient and bystanders on all calls
- Providers involved in direct patient care should wear a surgical mask (or N-95 when aerosol generating procedures will be performed) on all calls
- Face shields are the preferred method of eye protection for EMS providers instead of goggles or safety glasses
- A face shield should be worn over the surgical mask or N-95 on all calls to decrease the contamination to the mask. Face shields have been shown decrease contamination on the mask up to 96% for first 5 minutes of exposure and continues to decrease contamination by 81% even after 30 minutes.
- Follow the PPE for EMS & Home Health flowchart for PPE guidance
- Paid providers or those at high volume agencies should use one surgical mask or N-95 for the entire shift
- Volunteer or lower volume agencies should reuse their mask or N-95 for up to 5 uses:
- Only discard surgical mask or N-95:
- Following use during aerosol generating procedures.
- When contaminated with blood, respiratory or nasal secretions, or other bodily fluids from patients.
- When it is soiled, wet, obviously damaged, or becomes hard to breathe through
- After 5 uses
- Only discard surgical mask or N-95:
- When storing face masks or N-95 in between patient encounters:
- Remove gloves, gown & perform hand hygiene. Then don fresh gloves, remove and disinfect face shield. Then remove mask as below. Remove gloves and perform hand hygiene last.
- Clean & disinfect the inside of the face shield (goggles) first, then the outside to avoid any contamination
- Remove masks by the headband or ear loops, using caution not to touch the outside of the mask.
- Masks (and N-95 if able depending on style) should be carefully folded so that the outer surface is held inward and against itself to reduce contact with the outer surface during storage. The folded mask can be stored between uses in a clean sealable paper bag or breathable container.
- Label containers used for storing masks or label the mask itself (e.g., on the straps) between uses with the user’s name to reduce accidental usage of another person’s mask.
- Mark the bag with number of mask uses for easy tracking.
- Cloth or homemade masks:
- Cloth masks should not be used by EMS and healthcare providers performing patient care.
- They may be used on patients for source control
- Firefighters and personnel may wear cloth masks for non-patient care activities (such as hazard calls or CO alarms) when interacting directly with the public
References:
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