Routine PPE

EpiEMS

Forum Deputy Chief
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Is your service mandating respirators (e.g., N95 or better) on all calls? Eye protection?

If so...are you in agreement?

My service mandates N95 & eye pro on all calls - has been this way since March. I am rather pleased by the mandate, but I notice quite a few colleagues sticking with the surgical mask. What’s your policy and/or preference?
 

NPO

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Eye pro should be standard covid or not. It's a cultural change, but IMO needs to be the standard. At the college paramedicine program I teach at we require it.

N95s my agency only requires on calls with high risk procedures like intubation, nebulization, etc. However, we also have an option called a HALO mask which is is significantly more comfortable.
 
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EpiEMS

EpiEMS

Forum Deputy Chief
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Eye pro should be standard covid or not. It's a cultural change, but IMO needs to be the standard. At the college paramedicine program I teach at we require it.
No disagreement there, I'd like eye pro (love the abbreviation, btw) to be normalized, just like (so I'm told) gloves were normalized in the post-HIV/AIDS era.

N95s my agency only requires on calls with high risk procedures like intubation, nebulization, etc. However, we also have an option called a HALO mask which is is significantly more comfortable.
The HALO Mask looks snazzy! Do you have the option to wear an N95 or HALO Mask on all calls?
 

NPO

Forum Deputy Chief
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The HALO Mask looks snazzy! Do you have the option to wear an N95 or HALO Mask on all calls?

Yes. We don't have any N95 shortages and are free to use them whenever, however we are asked to be prudent. We are issued our own personal HALO masks and can use them whenever we want.
 

DesertMedic66

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Ground agency: surgical mask on all calls unless high risk procedure or respiratory/covid complaints, then it’s eye protection/N95/reduce partner exposure to patient.

Flight company: N95 and eye protection on all calls. Bunny suit for COVID rule outs. The N95s we have are very snazzy with integrated comms systems.
 

Jim37F

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N95s on every call. They're only barely starting to back away from "must wear cloth mask in the station at all times" and that'd really only because everyone is vaccinated more or less now (well one guy on our crew never got it, the rest of us did).

Eye Pro on every call. Not just any safety glasses, but goggles that seal around your eyes. We have two types, ones that are basically big swimming goggles, and one that's basically a ski mask lol

We even got half face respirators with N95 filters and a PAPR system for everyone issued (and official policy is they *still* want us to wear a surgical mask with the PAPR.... because I guess we can still be an asymptomatic carrier and give the patient the virus with our non filtered exhaled breaths ID the official reasoning.... yeah since we got them everyone I know has stuck with the regular N95s

We also have "Medical Jackets". These have been in the department since before I joined, and years before COVID was a thing. They're basically rain jackets. The yellow reflective rain jackets (I'm pretty sure that's how they're sold), but here they're out "Med Jackets" to be worn over our t-shirts to Medical calls. It's more so protection from bodily fluids, blood, puke, piss, bile, code browns.... that since it's waterproof any nasty stays on the outside and can be washed away fairly easily afterwards. They do meet DOT requirements for roadside traffic safety regulations, so working in or around streets we don't need to throw on any extra traffic vests if we have that on (which I would have to add the vest to my turnouts for an auto accident call, but can just wear
Before COVID only new guys Luke me wore them regularly on every call (because heaven help the Recruit who isn't toeing the line wearing the full book answer proper PPE...) older guys were hit or miss, but since COVID it has been standard that for almost every Medical call, COVID related or hang nail, we've been wearing gloves, Med Jacket, N95, and goggles to every medical/trauma call as standard.
(Isolation gowns available on top for COVID calls. We have a mix of disposable, and thicker ones that you bag up after the call and then wash afterwards to rewear later after being cleaned)
 

DrParasite

The fire extinguisher is not just for show
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to be honest, we are requiring a face mask on all calls. surgical mask or other cloth types at a minimum, an n95 if it's suspected covid. I've worn glasses for 30+ years, but I'll admit that I don't routinely wear eye protection when I have my contacts in. And I only found one pair of safety glasses that comfortably fit over my eyeglasses. Pre-Covid, I supported wearing n-95 masks when cutting windshields, as well as eye and airyway protection during any intubations.

City Fire has been wearing eye protection on most medical calls for years, especially on cardiac arrests.

I do recall reading a study out of china that said those with eye glasses had a lower chance of getting covid (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2770872)
 

GMCmedic

Forum Deputy Chief
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Surgical masks and eyepro on all calls (visor is suitable eyepro in aircraft).

N95 or half face respirator for high risk procedures.
 

Ensihoitaja

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N95 or P100 plus eye pro for every call is the standard. Gowns for aerosol generating procedures. We’ve had mixed compliance, though.

I agree with everyone else about eye pro being a standard, I’ve been wearing it on every call for 15 years now, but I’m very much an outlier.
 

Bullets

Forum Knucklehead
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State DOH requires N95s on all calls. Department requires same, as well as goggles if the patient can not wear a surgical mask.

We also have P100s, which i continue to wear on respiratory and cardiac arrests as well as anything in a SNF. I used to wear eye protection on arrests and intubations before covid, and ill probably just do it on all calls. I also dont know if ill ever stop wearing surgical masks on all calls even if the N95 requirement is lifted
 
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EpiEMS

EpiEMS

Forum Deputy Chief
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Vaccinated and feeling fine? Eye protection.
Any particular rationale for why you wouldn't wear a respirator?

Ground agency: surgical mask on all calls unless high risk procedure or respiratory/covid complaints, then it’s eye protection/N95/reduce partner exposure to patient.

Flight company: N95 and eye protection on all calls. Bunny suit for COVID rule outs. The N95s we have are very snazzy with integrated comms systems.
Interesting to see the distinction - are they in different counties or something like that?

N95s on every call. They're only barely starting to back away from "must wear cloth mask in the station at all times" and that'd really only because everyone is vaccinated more or less now (well one guy on our crew never got it, the rest of us did).
Interesting to hear - we are all (as far as I know) vaccinated in my service but still mandated to wear masks. Regarding the medical jackets...are they something like a BBP resistant approved raincoat ?
We also have P100s, which i continue to wear on respiratory and cardiac arrests as well as anything in a SNF.
I am never going into a SNF without a respirator again!
 

Summit

Critical Crazy
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My recommendations:

Standard Precautions: Surgical mask, Eye-pro, Gloves, Hand Hygiene

AGP PPE: N95/PAPR and gown
* No mushroom valve exhalation ports.
* Extended wear and reprocessing of N95s is no longer acceptable

If *everyone* is vaccinated on a crew and daily symptom screened, then masking en route to call or at station is unnecessary.
* If sick, restrict and test.
* If some are unvaccinated, all mask.
 

Jim37F

Forum Deputy Chief
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Interesting to hear - we are all (as far as I know) vaccinated in my service but still mandated to wear masks. Regarding the medical jackets...are they something like a BBP resistant approved raincoat ?
Yup, liquid and blood borne pathogen protection.

They're basically this:
 

DesertMedic66

Forum Troll
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Any particular rationale for why you wouldn't wear a respirator?


Interesting to see the distinction - are they in different counties or something like that?


Interesting to hear - we are all (as far as I know) vaccinated in my service but still mandated to wear masks. Regarding the medical jackets...are they something like a BBP resistant approved raincoat ?

I am never going into a SNF without a respirator again!
Both are nationwide companies. One is known for being cheap and the other one isn’t. The ground agency is still trying to have us reuse N95s. The flight company does not allow us to reuse them.
 

DrParasite

The fire extinguisher is not just for show
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I just wear a brown paper bag over my head,,,
and we thank you for that. you are no longer scaring the children
 

chriscemt

Forum Lieutenant
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Eye Pro on every call. Not just any safety glasses, but goggles that seal around your eyes. We have two types, ones that are basically big swimming goggles, and one that's basically a ski mask lol

We can use goggles, but the ones issued are awfully uncomfortable and fog up easily, making any isolation moot when I'm having to remove them and rub them clear again repeatedly... Could you provide a link to what you use, both the "basic" as you put it and the ski mask version?

I like the idea of a sealed goggle, or nearly-sealed, as they might not fog easily, and probably provide some actual isolation.
 
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EpiEMS

EpiEMS

Forum Deputy Chief
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E tank

Caution: Paralyzing Agent
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Any particular rationale for why you wouldn't wear a respirator?
To clarify...if there will be airborne goobers and/or blood, I will wear some kind of face protection with eye wear. I haven't worn an N 95/respirator since my vaccination and never have for unknown status for any pathogen. I've no doubt been unknowingly exposed to TB and all kinds of flus. If I'd wear that type of mask after vaccination, it would follow that I ought to wear it long after Covid is gone and I'm not doing that.
 
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