Early in the pandemic, North Metro Fire recognized the high level of risk associated with providing care to patients with respiratory problems. One of the most common means by which to deliver medications to respiratory patients is via a nebulizer. A nebulized mist, however, can easily spread viral particles into the air, creating a significant exposure risk inside an enclosed ambulance and, subsequently, the emergency department.

In order to prevent this problem, North Metro Fire purchased a special type of inhaler to reduce the risk of transmission. Furthermore, for patients requiring more invasive CPAP (continuous positive airway pressure) or intubation (a breathing tube), HEPA filters were used to reduce contaminated air in the ambulance or hospital, thereby reducing exposure risk to providers and patients.

When arriving at a patient’s side, providers immediately performed a COVID-19 patient screening, which included providing the patient with a mask, taking a temperature, and checking oxygen levels in the blood.

Prior to the emergence of COVID-19, fire engine and ambulance crews would combine forces, typically to form a group of five personnel on medical responses. However, based on concerns over the virus’s ability to spread, EMS leadership reevaluated and amended this response model. As a result, on suspected COVID-19 calls, or within high risk facilities such as nursing homes, one or two providers would go in to assess the patient first. If no additional crew members were needed for patient care, the support crew would remain outside and prepare the ambulance to limit unnecessary exposures inside of a home or facility. When additional crew members were needed for patient care, they were called to the bedside to perform their duties. This response strategy ultimately limited exposure and utilized the necessary crew numbers to provide patient care.