EMTs stand ready during challenging health crisis
Stonington — Emergency medical technicians and drivers from the Stonington Volunteer Ambulance Corps are used to arriving at calls wearing gloves and carrying equipment bags.
Since the outbreak of the COVID-19 pandemic, however, patients can expect to be greeted by a single EMT wearing a surgical mask who will ask a series of screening questions for the coronavirus — even if the call is for an unrelated problem, such as a broken wrist. The EMT also will ask the patient and anyone else in the home to don a surgical mask.
And if the patient is suspected to be infected with the coronavirus, the EMT will enter the home wearing full personal protective equipment, or PPE, including gloves, a mask, face shield and a gown. Sending in just one EMT saves PPE for future calls. They also may ask the patient to come outside, if possible.
“It can be frustrating for the patients and people may be a little nervous when they see us. But we're doing it just out of precaution to protect both them and us,” ambulance corps President Theresa Hersh said. “We may be meeting you with a mask but we’re still the same smiling face under the mask that’s here to serve you.”
Maria Wilson, president of the Region 4 Eastern EMS Council, which comprises emergency medical organizations such as ambulance companies across the eastern part of the state, said members are not just trying to obtain replacement PPE but exchanging ideas about how to improve protocols when it comes to dealing with the virus.
“We’ve been doing a real good job of sharing information. We’re exchanging ideas about ‘what’s working for you?’ and what’s not,” she said, adding those discussions are taking place using virtual meeting platforms such as Zoom.
For example, Hersh said, Mystic River Ambulance suggested keeping a replacement PPE kit on the front seat for the driver to easily change into before entering a hospital emergency room.
“We’re communicating better now than ever before because we’re all in this together,” Hersh added. “We’re all first responders. We’re doing this as a team. We all have a lot of good ideas and we’re sharing them. That’s why we’ll beat this.”
Finding PPE: almost a full-time job
For those not familiar with PPEs, they are not a one-time purchase. Each kit has to be disposed of after a single use and much of the time two kits have to be used for each first responder if they respond to a call and then transport the patient to the hospital. This means an ambulance company can quickly eat through its supply. Having just one EMT go into a house or business to assess the situation is one way to save PPE.
Wilson, who is also a member of Mystic River Ambulance Corps, said that while it's common for police officers and firefighters to routinely respond to medical calls, she said there are efforts now to limit the number of first responders going to a call to EMTs to prevent any unnecessary exposure. Doing this also saves PPE. If police and firefighters are needed, she said, they can be called.
Hersh said that in the past it was easy to call a medical supply company and restock the ambulance corps’ PPE supply. But with skyrocketing demand and hospitals and doctors taking precedence for the vital gear, Hersh said she is spending endless hours on the internet talking to companies she has never used before, asking if they have items in stock and how long it will take to ship them. In addition, she said prices have risen.
Both she and Wilson said the state Office of Emergency Services is doing the best it can to obtain the equipment and distribute it.
“We’re facing the same challenges all health care providers are having. Getting the right equipment for our first responders," said Wilson, who says she is checking websites two hours a day looking for equipment and then telling ambulance companies where they can find it.
Hersh said she expects to see an increase in cases over the next several weeks as the virus spreads through the region, which means a greater demand for PPE. As of Thursday, Stonington had 14 confirmed cases of COVID-19 and two related deaths.
“We have to be ready if our call volume peaks all of a sudden,” she said. “And if this is drawn out into June and July, we’ll need more PPE.”
Hersh said after each call, ambulance members have to properly dispose of their PPE, and then disinfect the entire ambulance, from the equipment on board to the steering wheel and radio microphone.
“Everything has to be cleaned before we can go back in service,” she said.
She said members wash their uniforms before they go home. A disinfectant mist also is being used in the ambulances and their headquarters.
Buying coffee for workers
Hersh said a few of her volunteers have stepped back from responding to calls during the pandemic because they are caring for elderly parents or have young children at home and do not want to spread the virus.
“If there was a vaccine or an effective treatment available, there would be a lot less concern,” she said.
She said the community has been supportive of the ambulance company, making donations. One person sent a check to supply coffee for the members.
Wilson said another challenge for ambulance companies is providing ongoing training for its members, something typically done hands-on and in person. She said they are now making more use of video to deliver the latest training that first responders need. Hersh has been making her own videos for members.
Wilson also said Hartford Healthcare and Yale New Haven Hospital, which operate the Backus, Lawrence + Memorial and Westerly hospitals, have done a good job getting out a unified message to ambulance companies about proper care.
Hersh, who is well known in town because she is also a police officer and holds supervisory positions with both the Quiambaug and Stonington Borough fire departments, also is trying to send the right message to residents.
For example, when she goes shopping at Big Y, she said she wears a mask.
“We want to set an example about the right thing to do. We don’t want to give the impression this is not a big deal,” she said.
The financial impact
Wilson said the virus is hurting ambulance companies from a financial perspective.
That’s because they rely in large part on income from billing insurance carriers for patients’ trips to the hospital. Meanwhile, expenses are increasing, as they have to buy more PPE at a higher price.
With people driving less, there are fewer car crashes, and people have been calling primary care doctors and using telemedicine, as well. This means less chance for the virus to spread but also fewer calls to transport patients. Hersh said she also expects payments from Medicare and Medicaid to be delayed.
“What’s great is the 911 system is not being used as much, which is what we want,” Wilson said. "The call volume is down, which is good but our income is down. We’re worried about the long-term impact of that.”
Despite the financial concerns, Wilson said EMTs and ambulance companies have a simple message for residents of eastern Connecticut: “We are ready. We are prepared. We’re here for our communities.”