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Cortland County Fire and Emergency Management EMS Bureau www.cortlandcountyfire.com April 27, 2009 Urgent Swine Flu Notice to All County EMS Agencies An outbreak of influenza in Mexico has been linked to cases of flu in the United States and Canada by the World Health Organization. There have been confirmed cases in New York City. The U.S. Department of Health and Human declared a public health emergency this afternoon. The following outlines key strategies for EMS agencies (including Fire Department first responders) to implement for protection of their members and to be public health partners in managing patient care. There are a number of steps EMS agencies should take to identify potential victims, protect their members, provide excellent patient care and participate in the public health process. The Fire and Emergency Management Office will continue to monitor state and national discussions until the event is concluded. Identified trends, new information, and best practices will be disseminated through the County EMS email list server and the Cortland County FEMO website (www.cortlandcountyfire.com). Individual agencies are asked to share their experiences, policies, procedures and other relevant information by contacting the County EMS Deputy Coordinator, Doug Van Etten ([EMAIL REDACTED]). Agency Chiefs and Administrators: Notify all members and staff of the emerging problem. Review and update local plans using the CDC EMS Pandemic Preparedness Checklist Monitor emails and the FEMO web site. Monitor news reports and government resources, such as: o the Centers for Disease Control (www.cdc.gov) o www.pandemicflu.gov o o www.cdc.gov/flu/swine/recommendations.htm o www.cdc.gov/swineflu/investigation.htm o the Public Health Agency of Canada (www.publichealth.gc.ca) For a minute to minute update and summary of the swine flu investigation, visit the CDC at www.cdc.gov/swineflu/whatsnew.htm?s_cid=tw_epr_68. (continued on page two) ---PAGE BREAK--- Direct Care EMS Providers: Request additional information from EMS Dispatch when sent to respiratory, sick person and fever related calls if limited initial dispatch information is provided. Perform initial interview of all patients from at least 2 meters (6.5 feet) away to determine if personal protective equipment precautions are necessary. Place a mask on all patients with suspected influenza before approach. Use a surgical mask or non-rebreather mask (when oxygen is required). Avoid droplet producing procedures whenever possible including nebulizers, bag- valve-mask, suctioning or intubation. If bag-valve-masks are needed, use BVMs with HEPA filters whenever possible. Recommended PPE for taking care of ill/potentially infected patients includes: gloves and N95 or better respirators. PPE should be donned and doffed according to published guidelines to prevent cross contamination, including faceshield/eye and gown protection when splash or airborne contamination is possible. Alert receiving hospital personnel of the possibility of an infectious patient as soon as possible and hold suspected infectious patients in the ambulance until their destination in the hospital is known, rather than immediately moving them into the emergency department. Perform a thorough cleaning of the stretcher and all equipment that has come in contact with or been within 2 meters (6.5 feet) with an approved disinfectant, upon completion of the call following CDC interim guidelines for cleaning EMS transport vehicles (www.pandemicflu.gov/plan/healthcare/cleaning_ems.html). Note that the most severe flu cases so far have been mostly adults from ages 25 to 45, but patients of all ages have been infected, so the same precautions should be used for all patients. We will communicate additional information as it becomes available.