COVID-19 EMS Education Update

March 24th, 2020

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EMT Psychomotor Exam Modification

We recognize that there is a continued need to complete courses and test your students. If an EMT class has finished or will finish before June 30th, 2020 we have approved a modification to the EMT psychomotor exam.


Course Coordinators are encouraged to bring EMT students in either individually or in very small groups to complete skills practice and competency verification. We are going to leave it up to the Course Coordinator to create a competency verification. This can be done with redundant practice and testing of individual skills as well as a scenario based test utilizing a mannequin to reduce disease spread. You are welcome to utilize the existing testing modalities, but are not required to set up each skills station and follow the patient guidelines. Once a Course Coordinator feels that an EMT candidate has proven competency you can submit a letter to ems@utah.gov indicating that the candidate has completed the course requirements and verified skills competency.


We strongly encourage that you follow strict hygiene practices when meeting with students. The course location should have enough PPE to accommodate students as well as enough disinfectant to clean all surfaces between students. Candidates should not perform mouth to mouth on mannequins even with new supplies at this time. Any student experiencing symptoms should not test until they are symptom free in accordance with current guidelines.

Conducting EMS Courses

We are continuing to encourage programs to utilize online formats for delivering lectures to students. Where possible we ask that the students be able to interact with the instructor during the delivery. Skills sessions can be done one on one or in small groups to not violate the group gathering restrictions that are currently in place.


Again, we strongly encourage that you follow strict hygiene practices when meeting with students. The course location should have enough PPE to accommodate students as well as disinfectant to clean all surfaces between students. Candidates should not perform mouth to mouth on mannequins even with new supplies at this time. Any student experiencing symptoms should not test until they are symptom free in accordance with current guidelines.

A Word of Caution

We understand this is a difficult time for everyone. We want to commend you for continuing to educate our frontline health care workers. We know that on good days our profession faces staffing demands and this event is certainly creating greater demand. We want to continue to add new workers into the field.


With all the modifications created to keep the workforce moving it is worth mentioning that as agencies hiring new EMS providers with the provisional licenses and the EMT psychomotor exam modifications that you do additional skills verification. The AEMT and Paramedics with provisional licenses will not have completed a psychomotor exam at all, and EMTs will have completed a modified exam.

Pearson Vue Update From NREMT

23 MARCH 2020 – COVID-19 Response Update

National EMS Community,

The National Registry is committed to supporting your vital work in the community by ensuring continued operation of the certification process to ensure a qualified EMS workforce. While circumstances remain dynamic, we will provide updates as information becomes available. Test centers will begin limited reopening for essential healthcare personnel, including EMS providers. Regarding the psychomotor examination, the National Registry will be offering a provisional certification that defers the psychomotor exam until conditions stabilize.

Cognitive Exam Update
Preserving the pipeline of EMS personnel during the pandemic is essential, and vital to public health. Therefore, on Wednesday, March 25, some Pearson VUE Professional Centers (PPCs) across the nation will re-open for the testing of essential healthcare personnel, including EMS providers. Appointments at these centers will be available on a first come, first served basis. More appointments and availability will be available as soon as possible. More information about Pearson VUE’s testing for EMS personnel during the pandemic is available on Pearson VUE’s website (https://home.pearsonvue.com/nremt/essential-services).

In addition to the PPCs, we are working with state and local officials to re-open Pearson VUE Testing Centers (PVTCs) strictly for the testing of essential healthcare personnel, including EMS providers. As a reminder, some PVTCs are currently open and operational. The National Registry is also aggressively pursuing the option of offering cognitive examinations through newly available Remote Proctoring technology, with more information on that in the coming weeks.

Psychomotor Examinations
Conducting psychomotor examinations, while adhering to national Public Health guidelines, is generally not achievable nor recommended. Therefore, last week the National Registry’s Board created a new Provisional Certification.

Provisional Certifications will be automatically assigned to any candidate that (1) completes an educational program at the EMR, EMT, AEMT or Paramedic level and (2) successfully passes the National Registry's cognitive examination. The requirement for completing the psychomotor examination is suspended for the duration of the national emergency or until psychomotor examinations can be safely reinstated in the United States.

National Registry Continues Operations with Remote Work
On Sunday afternoon, the State of Ohio issued a Stay at Home Order effective 11:59 p.m. on March 23, 2020, until 11:59 p.m. on April 6, 2020. This order (like many other state orders across the nation) identifies certain organizations, businesses, and operational functions as essential, and therefore are exempt. Although the National Registry of EMTs is designated an essential organization – and a vital component of maintaining the national EMS system – last week we implemented extraordinary measures to shift 90% of our staff to remote work.

As a result, the National Registry is operational and we will continue fulfilling our duty and responsibilities to the National EMS System, while also maintaining our commitment to employee safety and our shared responsibility to ‘flatten the curve’. Our workforce is leveraging technology to complete work from home and will continue to do so. Staff working in our office are following the CDC’s recommendations and guidance provided by our local authorities.

Continued Monitoring We will continue to monitor the evolving situation and will make adjustments as needed to support the pandemic response efforts, while also ensuring the long-term sustainability and viability of the Nation’s Emergency Medical Services system.

To all those truly on the front lines of this response, THANK YOU. Please stay safe and healthy.

Pearson VUE Centers Opening for Essential EMS Testing

Preserving the pipeline of EMS personnel during the pandemic is essential, and vital to public health. Therefore, on Wednesday, March 25, some Pearson VUE Professional Centers (PPCs) across the nation will re-open for the testing of essential healthcare personnel, including EMS providers. Appointments at these centers will be available on a first come, first served basis. More appointments and availability will be available as soon as possible. More information about Pearson VUE's testing for EMS personnel during the pandemic is available on Pearson VUE's website.

Information for Candidates
Candidates with an Authorization to Test (ATT) and candidates that had an examination canceled are encouraged to log into the Pearson VUE site to reschedule your examination. (https://home.pearsonvue.com/nremt) These centers are strictly for the testing of essential healthcare personnel, including EMS providers.

What if I can't find a test center near me?
If you are not able to locate a Pearson VUE testing center today, we encourage to check back in a few days. Conditions vary greatly across the United States and the testing network availability is expected to change daily. We are working with state and local officials to re-open testing centers across the United States, while adhering to public health guidance on social distancing and Stay at Home Orders.

Provisional Licenses

The bureau will begin to issue provisional licenses to candidates who have received a provisional certification from NREMT. These licenses will be granted for a period of two years and will be listed in our system as "provisional" instead of "active" for fully licensed providers.


These providers can begin working immediately at their provisional license level. We strongly recommend that an agency does not put two provisional providers together at this time.


For a provisional license to be issued the candidate will have to have an application on file with us, a provisional certification from NREMT, and completed the DACS background check.

Utah Dispatch/EMS Pandemic Coronavirus Plan and PPE Recommendations

By Peter Taillac, MD

I’d like to summarize here recent recommendations from DOH/BEMSP regarding potential altered response standards and PPE for EMS in Utah. Our recommendations are based primarily on current CDC guidance and discussions with many of you on our phone meetings, as well as the Utah Crisis Standards of Care document and Pandemic Influenza Plan (https://www.utahhospitals.org/resources). Our over-arching goal is safe and effective care to the public while simultaneously maintaining the safety and health of our Dispatch and EMS workforce. This requires some balancing acts and compromises. It is hoped that these recommendations will provide this balance. All recommendations made here should be tailored to the needs and realities of each agency’s staffing and volume demands.

Dispatch/EMS Pandemic Coronavirus Plan

Attached you’ll find the updated Dispatch/EMS Pandemic Coronavirus Plan. It is divided into “green, yellow, orange, and red statuses, depending on call volume and workforce status. Statewide, we are at currently at “yellow” status. However, individual agencies may be at “orange” or “red” depending on your individual staffing and call volumes. You may determine your own status based on the workforce and volume challenges your agency is experiencing.


At the “yellow” status, you are authorized to begin to decrease responses to minor calls (omega and alpha, for example) and simply provide referrals to the callers to community resources or follow-up calls, delayed responses, etc. The details of how you choose to alter your responses are up to your individual agencies and dispatch centers. Please communicate regularly.


As you progress to “orange” or “red” status, your responses and ambulance/response staffing may further change. Guy Dansie is preparing a statewide waiver allowing altered staffing levels on response vehicles for “orange” and “red” status. If you have questions or immediate needs, please contact Guy (gdansie@utah.gov). I’ve attached a brief explanation regarding the MPDS protocols/cards from Greg Scott which are cited in the document (thanks, Greg!). For further questions regarding MPDS, please email Greg at Priority Dispatch (greg.scott@emergencydispatch.org).

I’ve also attached an altered standards protocol from Salt Lake City Fire Department, with the permission of Dr. Scott Youngquist, their Medical Director (thanks, Scott!). It is consistent with the recommendations of the DOH/BEMSP. He has given us permission to share it widely as a practical example of “yellow” status and beyond for EMS. Feel free to adapt it for your agency as you see fit.

Finally, there are multiple CDC links below that may be of assistance as you plan your agency's responses. I’ll be sending out some separate emails regarding workforce preservation recommendations, EMS provider testing, and other issues over the next few days. Please email or call me with questions or suggestions. Thank you all so much for your dedication and bravery in the face of this public threat.

PPE

Since community transmission has been well documented now and many patients are essentially asymptomatic, our new recommendation is that EMS providers wear a simple mask (surgical mask) on EVERY call, along with gloves and eye protection. On calls that have a respiratory complaint, an N95 mask and gown should be worn along with eye protection and gloves.

Based on CDC guidance for extending PPE supplies (link below), we are recommending that providers wear the same mask all day long (24 hrs) unless it becomes grossly contaminated or it is used for an aerosol generating procedure such as intubation, CPAP, or albuterol nebulizer treatment. Every effort should be made to avoid these procedures (see below). This 24 hr use goes for the surgical mask as well as the N 95. If N95s are not available, a surgical mask should be worn instead for patients with respiratory complaints.


Utah EMS Pandemic Coronavirus Plan

SLC Fire 2019 Covid19 EMS non-transport Protocol

https://www.cdc.gov/coronavirus/2019-ncov/downloads/10Things.pdf - This can be left with patients at home

https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-home-care.html - Guidance for home care

https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/care-for-someone.html - Info for people caring for someone at home

https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html - CDC Guidance for Workforce Preservation and Quarantine https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html - Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure

How long does the virus live outside of body: https://www.nejm.org/doi/full/10.1056/NEJMc2004973?query=featured_home Information on durability of virus. 3 days outside the body

CDC Guidance for PPE Use Extension and Re-use https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html




Thank you for everything you do for our communities, Please communicate your questions, concerns, and suggestions to me.




Here For You

As with the theme of this email we are doing all we can to keep the workforce progressing and working. That said, we are here for you. Please do not hesitate to reach out to a member of our team if you need any help during this time.


EMS Education

Mark Herrera

EMS Education Specialist

markherrera@utah.gov

801-232-9138


Dan Camp

EMS Education Specialist

dcamp@utah.gov

801-273-6673


Brett Cross

Program Director

bcross@utah.gov

801-879-2912


Provider Licensing


ems@utah.gov

801-273-6666


Jan Miltenberger

Licensing Specialist

jmiltenberger@utah.gov

801-273-6625


Amy Melton

Licensing Specialist

amelton@utah.gov

801-273-6645


Janene Parry

Licensing Specialist

jcparry@utah.gov

801-273-6624


Guy Dansie

Program Director

gdansie@utah.gov

801-560-1544