UPDATES REGARDING COVID-19 PROCESSES

ER INTAKE

The following information relates to the transport of COVID-19 patients and the appropriate processes for intake at the ED’s. It is the goal that appropriate patients will be cared for at their local health departments, or at home.  Many measures have been put into place across the region to assist with this.

Please work with your respective dispatch centers to ensure the screening questions suggested by the CDC are being asked.

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At the meeting of the Southwest Virginia Medical Direction Committee, the issue of incidents between EMS provider and hospital staff related to Hospital Diversion was discussed.  Local facilities have also expressed the desire to ensure positive working relationships with EMS agencies.  The Council has developed a quick reporting tool to help us address issues as they arise.  Upon submission, council staff will begin working to address and resolve these issues.  Likewise, we are working to implement a debriefing process to work through such incidents expeditiously to ensure good collaboration.  The form can be addressed by clicking this link or from the Quick Menu at www.southwest.vaems.org.

On March 10, 2020, the Centers for Disease Control (CDC) provided updated guidance for EMS agencies and Public Safety Answering Points (PSAPs) for COVID-19 in the United States. Major changes are outlined below, but please refer to the complete guidance document to assist with COVID-19 planning activities.

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Dear EMS Providers,

Today, the Southwest Virginia EMS Council received multiple communications from members of the EMS community regarding hospital diversion declarations in our region.  While hospital diversions are intended to address temporary periods when a hospital’s resources are overwhelmed, we know that the incidence of diversion has increased and creates a strain on the EMS system.  Such declarations also create hostility between prehospital and hospital employees.

We want to affirm regional EMS policies regarding hospital diversion and direct EMS agencies and providers to adhere to provisions of the regional Ambulance Diversion Policy.  When adjacent facilities declare diversion, it is permissible for EMS agencies to disregard those declarations, especially when increased travel time places communities and citizens at risk.  If you encounter issues, direct those to our office.  We will not tolerate aggressive or rude treatment of EMS providers following this policy and will deal swiftly with these incidents.

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The Southwest Virginia EMS Council has been made aware of upcoming changes to Trauma activation criteria that will likely impact our region's EMS agencies.  As such, we want to ensure that EMS agencies and providers are aware of these changes.

Effective August 1st, Ballad Health will implement a standardized set of trauma activation criteria for the three Ballad Health trauma centers (Johnson City Medical Center, Holston Valley Medical Center and Bristol Regional Medical Center). One set of standardized activation criteria will allow trauma centers and EMS partners to have common terminology and activation standards, for both the adult and pediatric patient population.

These standards were adapted from the American College of Surgeons, Committee on Trauma, Resources for Optimal Care of the Injured Patient trauma activation criteria document. In addition, these standards were approved by the Ballad Health Trauma Medical Directors, and further vetted through a pilot group of regional EMS Directors.

Please find attached the document containing our standardized activation criteria. As you review these criteria please note:

· We are providing these for your knowledge of our internal terminology, and standardization, for trauma activations, not for additional decision making by our pre-hospital partners, as your processes will not change.
· When our EMS partners radio report on their trauma patients they can request a “trauma alert” and our Communications Center will activate the appropriate internal activation.

Contact Anita Perry, Corporate Director of Trauma Services and EMS Liaison, by phone or email to schedule any needed training sessions with your agencies or for any questions you have concerning these criteria.