This document provides an overview of COVID-19 for EMS providers, including terminology, the origins and spread of the virus, clinical presentation, screening and risk assessment, treatment considerations, infection control protocols, and recommendations for interacting with the public. Key points covered include how the virus is transmitted, projected disease course, limitations of current testing and treatment options, importance of PPE and prenotification, and dispelling common myths. The goal is to equip EMS with up-to-date facts and best practices for responding safely and effectively during the pandemic.
Hello, this presentation is put together to gain general insight about the coronavirus disease (Covid-19) spread across the globe with graphical images, texts and information.
A coronavirus is a kind of common virus that causes an infection in your nose, sinuses, or upper throat. Most coronaviruses aren't dangerous.
In early 2020, after a December 2019 outbreak in China, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus. The outbreak quickly spread around the world.
Corona Virus and Reinfection(Second Time Infection)Apurv Charles
You may think that the one “positive” of testing positive for the COVID-19 causing coronavirus (SARS-CoV2) and surviving would be that you won’t get infected by that virus again.
At least not during this pandemic.
Ah, but is this assumption really true? Will you indeed be immune to the SARS-CoV2 after you’ve recovered from a COVID-19 infection?
Some reports out of Japan and China seem to suggest otherwise.
The February 14 article from Caixin, a Beijing, China-based media group, that was entitled “14% of Recovered Covid-19 Patients in Guangdong Tested Positive Again.” Umm, 14% would seem more like an “ooop” than an “ooops.”
"Remember though, these are news reports and not scientific studies yet. "
Coronaviruses are important human and animal pathogens. At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, in the Hubei Province of China. It is rapidly spreading, resulting in an epidemic throughout china, followed by an increasing number of cases in other countries throughout the world. In February 2020, the WHO designated the disease COVID 19, which stands for corona viruses 2019. The virus that causes COVID 19 is designated severe acute respiratory syndrome coronavirus 2 SARS COV 2 previously, it was referred to as 2019 nCoV. Anushka Bharti | Dr. Gaurav Kumar Sharma | Dr. Kaushal Kishore Chandul "COVID-19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46439.pdf Paper URL : https://www.ijtsrd.com/pharmacy/pharmaceutics/46439/covid19/anushka-bharti
Hello, this presentation is put together to gain general insight about the coronavirus disease (Covid-19) spread across the globe with graphical images, texts and information.
A coronavirus is a kind of common virus that causes an infection in your nose, sinuses, or upper throat. Most coronaviruses aren't dangerous.
In early 2020, after a December 2019 outbreak in China, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus. The outbreak quickly spread around the world.
Corona Virus and Reinfection(Second Time Infection)Apurv Charles
You may think that the one “positive” of testing positive for the COVID-19 causing coronavirus (SARS-CoV2) and surviving would be that you won’t get infected by that virus again.
At least not during this pandemic.
Ah, but is this assumption really true? Will you indeed be immune to the SARS-CoV2 after you’ve recovered from a COVID-19 infection?
Some reports out of Japan and China seem to suggest otherwise.
The February 14 article from Caixin, a Beijing, China-based media group, that was entitled “14% of Recovered Covid-19 Patients in Guangdong Tested Positive Again.” Umm, 14% would seem more like an “ooop” than an “ooops.”
"Remember though, these are news reports and not scientific studies yet. "
Coronaviruses are important human and animal pathogens. At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, in the Hubei Province of China. It is rapidly spreading, resulting in an epidemic throughout china, followed by an increasing number of cases in other countries throughout the world. In February 2020, the WHO designated the disease COVID 19, which stands for corona viruses 2019. The virus that causes COVID 19 is designated severe acute respiratory syndrome coronavirus 2 SARS COV 2 previously, it was referred to as 2019 nCoV. Anushka Bharti | Dr. Gaurav Kumar Sharma | Dr. Kaushal Kishore Chandul "COVID-19" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-6 , October 2021, URL: https://www.ijtsrd.com/papers/ijtsrd46439.pdf Paper URL : https://www.ijtsrd.com/pharmacy/pharmaceutics/46439/covid19/anushka-bharti
Everything we need to know about COVID-19PrincessExtra
These slides is uploaded for information and as a partial requirement of Philippine Women's University in Master of Nursing (MAN); Subject: Nursing Practicum
Everything you need to know about Corona Virus.Tanveer Padder
• This is one of the most comprehensive & fact based resources for Corona virus
• This Presentation covers everything Including the symptoms, diagnosis, testing ,treatment options and prevention of Corona virus.
• This Presentation will definitely help you to prevent yourself from getting the corona virus.
• This is complete guide and must have resource for everybody.
Here is the you tube Video of this presentation
https://www.youtube.com/watch?v=4ABj7xqMYS4
https://youtu.be/ZogtL23P3Pg
COVID-19 : Introduction,Nomenclature,Incubation Period,Structure,Symptoms,Transmission,Flowchart,Diagnosis,Treatment,Drugs under testing,Prevention,Importance of Social Distancing,Effects in Lungs,Effects in Other organs,Replication,Severity,Stages,Comparison,Facts.
Features, Evaluation and Treatment Coronavirus (COVID-19)
The WHO and other organizations have issued the following general recommendations:
Avoid close contact with subjects suffering from acute respiratory infections.
Wash your hands frequently, especially after contact with infected people or their environment.
Avoid unprotected contact with farm or wild animals.
People with symptoms of acute airway infection should keep their distance, cover coughs or sneezes with disposable tissues or clothes and wash their hands.
Strengthen, in particular, in emergency medicine departments, the application of strict hygiene measures for the prevention and control of infections.
Individuals that are immunocompromised should avoid public gatherings.
Patients and families should receive instruction to:
Avoid close contact with subjects suffering from acute respiratory infections.
Wash their hands frequently, especially after contact with sick people or their environment.
Avoid unprotected contact with farm or wild animals.
People with symptoms of acute airway infection should keep their distance, cover coughs or sneezes with disposable tissues or clothes and wash their hands.
Immunocompromised patients should avoid public exposure and public gatherings. If an immunocompromised individual must be in a closed space with multiple individuals present, such as a meeting in a small room; masks, gloves, and personal hygiene with antiseptic soap should be undertaken by those in close contact with the individual. In addition, prior room cleaning with antiseptic agents should be undertaken and performed before exposure. However, considering the danger involved to these individuals, exposure should be avoided unless a meeting, group event, etc. is a true emergency.
Strict personal hygiene measures are necessary for the prevention and control of this infection.
Corona virus was first identified as a cause of the common cold in 1960. Until 2002, the virus was considered a relatively simple, nonfatal virus.Over the last three decades there have been three attacks of three different coronaviruses, SARS-CoV, MERS CoV and the recent one 2019 novel coronavirus (2019-nCoV).
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases,The World Health Organization has announced that COVID-19 is a pandemic.
Seminar Prepared by :-
Mohammed Musa (M.B.Ch.B)
Azadi Teaching Hospital - Kirkuk
Travel-related infectious diseases on the rise
International travel has an important role in the transmission of emerging and re-emerging infectious diseases across geographical areas.
Since 1980, the world has been threatened by different waves of emerging disease epidemics.
In the twenty-first century, these diseases have become an increasing global concern because of their health and economic impacts in both developed and resource-constrained countries.
It is difficult to stop the occurrence of new pathogens in the future due to the interconnection among humans, animals, and the environment.
As many as 43%–79% of travelers to low- and middle-income countries become ill with a travel-related health problem.
Although most of these illnesses are mild, some travelers become sick enough to seek care from a health care provider.
This presentation showed the impact and the challenges of facing COVID-19 Pandemic and how the world becomes morbid, while the healthcare workforce tries to flatten the "curve".
Everything we need to know about COVID-19PrincessExtra
These slides is uploaded for information and as a partial requirement of Philippine Women's University in Master of Nursing (MAN); Subject: Nursing Practicum
Everything you need to know about Corona Virus.Tanveer Padder
• This is one of the most comprehensive & fact based resources for Corona virus
• This Presentation covers everything Including the symptoms, diagnosis, testing ,treatment options and prevention of Corona virus.
• This Presentation will definitely help you to prevent yourself from getting the corona virus.
• This is complete guide and must have resource for everybody.
Here is the you tube Video of this presentation
https://www.youtube.com/watch?v=4ABj7xqMYS4
https://youtu.be/ZogtL23P3Pg
COVID-19 : Introduction,Nomenclature,Incubation Period,Structure,Symptoms,Transmission,Flowchart,Diagnosis,Treatment,Drugs under testing,Prevention,Importance of Social Distancing,Effects in Lungs,Effects in Other organs,Replication,Severity,Stages,Comparison,Facts.
Features, Evaluation and Treatment Coronavirus (COVID-19)
The WHO and other organizations have issued the following general recommendations:
Avoid close contact with subjects suffering from acute respiratory infections.
Wash your hands frequently, especially after contact with infected people or their environment.
Avoid unprotected contact with farm or wild animals.
People with symptoms of acute airway infection should keep their distance, cover coughs or sneezes with disposable tissues or clothes and wash their hands.
Strengthen, in particular, in emergency medicine departments, the application of strict hygiene measures for the prevention and control of infections.
Individuals that are immunocompromised should avoid public gatherings.
Patients and families should receive instruction to:
Avoid close contact with subjects suffering from acute respiratory infections.
Wash their hands frequently, especially after contact with sick people or their environment.
Avoid unprotected contact with farm or wild animals.
People with symptoms of acute airway infection should keep their distance, cover coughs or sneezes with disposable tissues or clothes and wash their hands.
Immunocompromised patients should avoid public exposure and public gatherings. If an immunocompromised individual must be in a closed space with multiple individuals present, such as a meeting in a small room; masks, gloves, and personal hygiene with antiseptic soap should be undertaken by those in close contact with the individual. In addition, prior room cleaning with antiseptic agents should be undertaken and performed before exposure. However, considering the danger involved to these individuals, exposure should be avoided unless a meeting, group event, etc. is a true emergency.
Strict personal hygiene measures are necessary for the prevention and control of this infection.
Corona virus was first identified as a cause of the common cold in 1960. Until 2002, the virus was considered a relatively simple, nonfatal virus.Over the last three decades there have been three attacks of three different coronaviruses, SARS-CoV, MERS CoV and the recent one 2019 novel coronavirus (2019-nCoV).
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases,The World Health Organization has announced that COVID-19 is a pandemic.
Seminar Prepared by :-
Mohammed Musa (M.B.Ch.B)
Azadi Teaching Hospital - Kirkuk
Travel-related infectious diseases on the rise
International travel has an important role in the transmission of emerging and re-emerging infectious diseases across geographical areas.
Since 1980, the world has been threatened by different waves of emerging disease epidemics.
In the twenty-first century, these diseases have become an increasing global concern because of their health and economic impacts in both developed and resource-constrained countries.
It is difficult to stop the occurrence of new pathogens in the future due to the interconnection among humans, animals, and the environment.
As many as 43%–79% of travelers to low- and middle-income countries become ill with a travel-related health problem.
Although most of these illnesses are mild, some travelers become sick enough to seek care from a health care provider.
This presentation showed the impact and the challenges of facing COVID-19 Pandemic and how the world becomes morbid, while the healthcare workforce tries to flatten the "curve".
As increasing cases of coronavirus instances are being reported, we at IFS are carefully following the directives issued by way of by using WHO and ICMR and also the reports from the international locations wherein it has ended up an epidemic.
Coronavirus (COVID 19) and Human reproduction Presently, very much less is understood about the impact of COVID-19 on human replicas and its next impact on the ensuing pregnancy.
Covid19 and pregnancy: There are case reports of preterm birth in women with COVID-19 but it is unclear whether the preterm birth was always iatrogenic, or whether some were spontaneous.
As per ICMR Guidelines Pregnant women do not appear more likely to contract the infection than the general population. However, pregnancy itself alters the body’s immune system and response to viral infections in general, which can occasionally be related to more severe symptoms and this will be the same for COVID-19. Reported cases of COVID-19 pneumonia in pregnancy are milder and with good recovery.Pregnant women with heart disease are at highest risk (congenital or acquired). In other types of coronavirus infection (SARS, MERS), the risks to the mother appear to increase in particular during the last trimester of pregnancy. There are case reports of preterm birth in women with COVID-19 but it is unclear whether the preterm birth was always iatrogenic, or whether some were spontaneous.The coronavirus epidemic increases the risk of perinatal anxiety and depression, as well as domestic violence. It is critically important that support for women and families is strengthened as far as possible; that women are asked about mental health at every contact. A small study of nine pregnant women in Wuhan, China, with confirmed COVID-19 found no evidence of the virus in their breast milk, cord blood or amniotic fluid. According to WHO, pregnant women
do not appear to be at higher risk of severe disease.
Furthermore, WHO reports that currently there is no known difference between the clinical manifestations of COVID-19 in pregnant and non-pregnant women of reproductive age
ACOG is advising caution based on the impact of other respiratory illnesses (including influenza/ SARS outbreak of 2002–2003), stating that “pregnant women should be considered an at-risk population for COVID-19
The whole world is under the threatens of respiratory disease caused by infections of coronavirus. The latest threat to global health is the ongoing outbreak of the respiratory disease that was recently given the name Coronavirus Disease This article trying to focus on the current outbreak of and explores the epidemiology, causes, clinical manifestation and diagnosis, and prevention and control of the novel coronavirus. The aim of this article to provide valid and reliable information and increasing awareness about the COVID 19. Sameer Pawar | Sayali Budhwant | Ketan Shinde | Ashwini Sable "COVID-19: A Scoping Review" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-3 , April 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30567.pdf Paper Url :https://www.ijtsrd.com/pharmacy/other/30567/covid19-a-scoping-review/sameer-pawar
Health alert: Outbreak of Coronavirus2019-nCov (Fact Sheet #3)AXA Partners
Read the latest recommendations from Dr. Cai Glushak, Chief Medical Officer and Dr. Alan Tan, Asia Region Medical Director.
Situation:
The World Health Organization (WHO) has declared Public Health Emergency of International Concern (PHEIC) now that the 2019 Coronavirus has spread to multiple countries.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
For those battling kidney disease and exploring treatment options, understanding when to consider a kidney transplant is crucial. This guide aims to provide valuable insights into the circumstances under which a kidney transplant at the renowned Hiranandani Hospital may be the most appropriate course of action. By addressing the key indicators and factors involved, we hope to empower patients and their families to make informed decisions about their kidney care journey.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
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Trauma Outpatient Center is a comprehensive facility dedicated to addressing mental health challenges and providing medication-assisted treatment. We offer a diverse range of services aimed at assisting individuals in overcoming addiction, mental health disorders, and related obstacles. Our team consists of seasoned professionals who are both experienced and compassionate, committed to delivering the highest standard of care to our clients. By utilizing evidence-based treatment methods, we strive to help our clients achieve their goals and lead healthier, more fulfilling lives.
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1. COVID–19 : AN APPROACH
FOR EMS
Bryan Johnson NRP, TP-C
2. DISCLAIMER
COVID-19 is a new disease process that we have
little experience managing. This presentation is
based on the latest information available, as well
as best practices from expert consensus. As new
information arises, these facts and guidelines are
subject to change. I will do my best to update
and circulate this as these changes occur. This
presentation does not supersede local or state
policy and is solely informative in nature. Please
keep yourself advised on the latest information
by visiting the following sites:
Centers for Disease Control and Prevention
World Health Organization
EMCRIT by Dr. Scott Weingart
3. TERMINOLOGY
Epidemic Vs. Pandemic
An epidemic is an uncontrolled outbreak of a
serious disease within a defined region. A pandemic sees
worldwide spread of this disease
Quarantine Vs. Isolation
A quarantine restricts movement and contact of a
person with a suspected illness that has not been confirmed.
Isolation is the practice of separating someone with a
confirmed illness from the healthy population.
Person Under Investigation (PUI)
A person under investigation is an individual that
meets screening criteria for a communicable disease. This is
used as a tool to deduce who needs further testing.
Person Under Monitoring (PUM)
This is an individual who has no signs or
symptoms but has known risk for an exposure to a
communicable disease.
Social Distancing
The practice of avoiding congregate settings and
maintaining a distance of approximately six feet from one
another.
Epidemiologist
One who is an expert in the branch of medicine
which deals in incidence, distribution and possible control of
a disease.
4. WHAT IS COVID-19?
COVID-19 is the name
of the disease state
that arises due to
infection from the
SARS-CoV-2 virus. This
virus belongs to the
family of
coronaviruses.
Coronaviruses get their
name from their shape
which is crown like
(corona in Latin is
crown). Most other
types of known
coronaviruses cause
nothing more than the
common cold. Other
well-known
coronaviruses that were
particularly deadly were
MERS and SARS.
5. WHERE DID
THIS
DISEASE
ORIGINATE?
Chinese authorities detected an outbreak of
SARS-CoV-2 in December of 2019.
Researchers believe that this virus is zoonotic
in origin and was transmitted to humans via
an intermediary animal. Currently, this animal
intermediary is believed to be a Pangolin. The
initial transmission occurred in a market
located in Wuhan. Wuhan is the capital city of
Hubei Province located in the People’s
Republic of China. Since initial infection, the
virus has spread rapidly through respiratory
droplet transmission. Currently, the outbreak
has been classified as a pandemic.
6. WHAT IS THE CAUSE
FOR CONCERN?
This novel coronavirus is
particularly virulent,
infecting many people in
rapid fashion. In
conjunction, mortality
rates continue to surpass
that of the seasonal flu.
Generally, the seasonal
flu has a mortality rate of
0.1%. This coronavirus is
projected to have a
mortality rate of between
0.5% and 2%. While this is
concerning, even more
alarming is the projected
rates of hospitalization,
which reaches between
10% to 20% of the
infected population. This
will further stress an
already prestressed EMS
and healthcare system,
possibly overwhelming
available resources.
7. PUTTING THE
PANDEMIC IN
PERSPECTIVE
Leading epidemiologists predict
this virus may infect
approximately fifty percent of the
United States’ population. Even
more disconcerting, they predict
there may be close to one million
resulting deaths. In 2018, the flu
killed approximately 37,000
Americans. Even at its worst, the
flu kills approximately 70,000
Americans. This is precisely why
we must stop perpetuating that
this virus is “just like the flu”.
8. WHAT DOES
COVID-19 LOOK
LIKE CLINICALLY?
COVID-19 produces a range
of symptoms which are most
commonly constitutional and
respiratory in nature. A
clinical pearl is that patients
may by hypoxemic without
outward signs of respiratory
distress. Less commonly,
this disease state can
produce gastrointestinal
symptoms. The most
specific and sensitive
symptoms include fever,
cough, myalgias and
shortness of breath. **THE
ABSENCE OF ONE OR MORE
SYMPTOMS DOES NOT
EXCLUDE THE
9. SCREENING
FOR COVID-
19
To the right was the initial
screening tool for suspected
infection. We now know that
this virus is now largely
community acquired and
travel, as well as known
exposure, is not requisite for
high suspicion of this
disease. Known exposure
and travel is still important
to screen for due to it
increasing risk even further.
Also, keep in mind the
previous chart. Some will
present with GI symptoms
and other constitutional and
10. ASSESSING PATIENT RISK OF
MORTALITY
As stated previously overall risk of mortality is markedly higher than
that of the seasonal flu. This risk of mortality disproportionately
effects the following populations and people with the following
diseases:
The elderly - specifically over 60 and risk increases as age increases (4.8% for 60-
69, 9.8% 70-79 and 18% 80+, based off data from China)
Hypertension – possibly people prescribed ACE inhibitors due to virus entering via
ACE-2 channels
Cardiovascular disease
Obesity
Cancer
Pre-existing respiratory conditions – Asthma, COPD, Asbestosis, history of
smoking, etc.
Other typical risk factors such as diabetes, ESRD, immunocompromised patients,
etc.
11. PROJECTED
STAGES OF
ILLNESS
Initial stage consists of viral replication over a a period
of days. This immune response occurs but fails to
contain the virus. During this stage there are relatively
mild symptoms or no symptoms.
The second stage is the process of adaptive immunity.
This leads to falling titers and increased inflammatory
cytokine production resulting in tissue damage. This is
generally when patients begin to deteriorate.
Clinical conundrums produced due to patients being
relatively well for many days and then acutely
deteriorating.
Important to consider initial symptoms do not predict
future clinical course.
12. PROJECTED DISEASE COURSE
INCUBATION PERIOD IS A
MEDIAN OF 4 DAYS POST
EXPOSURE, HOWEVER,
CAN RANGE FROM 1 TO
14 DAYS.
SHORTNESS OF BREATH
WILL APPEAR AT A
MEDIAN OF 6 DAYS POST
EXPOSURE.
INITIAL HOSPITAL VISIT
AND ADMISSION AT A
MEDIAN OF 8 DAYS POST
EXPOSURE.
INTUBATION AT A
MEDIAN OF 8 -10 DAYS
POST EXPOSURE.
TRANSMISSION OF VIRUS
MAY OCCUR UP TO 14
DAYS POST RESOLUTION
OF SYMPTOMS.
13. WHAT IS THE
TREATMENT?
There is no specific treatment for COVID-19.
Experimental treatments using anti-viral therapy
are being trialed in hospital settings. No data is
currently available regarding the efficacy of
these treatments.
Treatment of these patients is largely supportive
but also focused on treating underlying
pathology exacerbated by this virus, as well as
the complications from this virus.
Please use treatments judiciously as most are
not without consequence. This is not to say
withhold treatment but understand what the
sequelae are. For example, steroid use increases
viral shedding and may increase risk
transmission, risk of further deterioration and
length of ability to transmit virus. Understand
that oxygen therapy is not without risk. Nasal
cannula, non-rebreather, nebulizer, CPAP and
BVM adjuncts can result in aerosolization of
airway secretions increasing risk for
transmission. Also, be especially cautious when
using suction. This list is not exhaustive and
please use good clinical judgement and common
sense when treating PUI and PUM patients.
**FLUID RESTRICTED RESUSCITATION IS
RECOMMENDED AS LARGE QUANTITIES OF
CRYSTALLOIDS HAS SHOWS INCREASED
MORTALITY**
14. SARS-COV-2
FACTS
Amount of people infected with virus is
grossly underreported due to factors such
as lack of testing and broad spectrum of
clinical presentation.
Clinical spectrum can range from
asymptomatic to death resulting from
infection.
Elderly and persons with comorbidities are
overrepresented in mortality rates.
Appears that younger population,
specifically under 10 years old, have some
sort of immunity to virus. This is possibly
due to infection from other coronavirus
types. Children remain a vector.
Complications from virus are largely
pneumonia and ARDS. Possible
phenomenon of “cytokine storm”.
Polymerase chain reaction (PCR) testing is
presumed to be approximately 75%
sensitive and 100% specific in symptomatic
patients.
Reported large false positive rate, up to
50%, in PCR testing of asymptomatic
patients.
Public health strategy has moved from
15. SARS-COV-2 FACTS
The vast majority of infected, patients >80%,
do not require hospitalization.
Of those who are hospitalized,
approximately 10-20% were admitted to the
ICU.
Of those approximately 3-10% require
intubation.
Of hospitalized patients approximately
2– 5% die.
All studies show that with proper PPE, the risk
of transmission to healthcare workers is
extremely low. To be clear, zero cases have
been reported in most studies.
16. HOW IS THIS
VIRUS
TRANSMITTED?
Primary human transmission is from
person to person via large droplet.
This risk is typically regarded as
being within six feet of the patient.
Airborne transmission is
controversial and there is no
evidence that this is possible under
normal circumstances. Special
consideration should be taken when
performing procedures that can
produce aerosols. Contact
transmission has also been
demonstrated via “fomite to face”
route. The virus, in droplets from
infected patients, are speculated to
survive up to ONE WEEK on surfaces
and could potentially last longer.
Typically a person touches a
contaminated surface and then
proceeds to bring that hand in
17. HOW DO WE
PROTECT
OURSELVES?
Prescreening is being performed by
dispatchers based off predetermined
questioning. Ideally, dispatch will notify you
of a potential exposure risk prior to reaching
your destination. PPE should be donned prior
to entering a destination or encountering a
potentially infected person. Prescreening
may fail to identify a hazard. If identified
during clinical exam or other scene
information, retreat will be made in order to
don proper PPE. During routine patient
contact, current recommendations include
donning eye protection, a surgical mask,
gloves and a disposable gown. If performing
an intervention or procedure that carries a
risk of aerosolization of airway secretions
(nebulizer treatments, CPAP, intubation, any
oxygen therapy), an N95 respirator is
recommended. Some guidelines are
recommended covering of hair and shoes,
however, is not universally accepted at this
time. Paramount to keeping yourself from
contamination is proper doffing of PPE after
potential exposure. The latest infection
control guidelines can be found here.
18. INFECTION
CONTROL
Mitigating your risk can be accomplished by
simple procedures:
All potentially contaminated
equipment and surfaces must be thoroughly
cleaned. Thankfully, this virus is killed rapidly
with standard cleaning and disinfecting
procedures.
Basic hand hygiene is of paramount
importance.
Attempt to avoid touching your face
(nearly impossible).
Being vigilant in laundering any
clothing after possible or known exposure.
Donning appropriate PPE.
Doffing PPE effectively and at the
appropriate time.
20. HOW DO WE PROTECT
OUR FAMILIES AND
FRIENDS?
Unfortunately, our exposure
to this disease puts our
friends, family, patients and
anyone we encounter at risk.
We can mitigate this risk by:
Proper hand washing
techniques and frequency.
Ensuring proper PPE is
utilized at work.
Removing work clothing at
work / showering at work (if
possible).
Removing work clothing in
initial household entry area
and showering upon
entering your home.
Disinfecting equipment and
worn items such as watches,
stethoscopes, keys, etc.
21. DISPELLING MYTHS
A vaccination will be soon available.
Even optimistic projections predict a vaccine will be
available and approved in approximately one year.
Conservative estimated see a commercially available vaccine in
18 – 24 months.
Antibiotics are an effective treatment.
This disease is viral in nature, so antibiotics are not
effective. Antibiotics will only improve outcomes if a patient is
suspected to have a coinfection.
Herbal and other remedies are effective treatments.
There is no current literature supporting this claim.
Pets can be a vector of transmission.
No current literature supports this claim.
22. DISPELLING MYTHS
The elderly are only affected by this disease.
While they are disproportionately represented in
mortality rates, young and healthy people can become severely ill
and even die from infection. Furthermore, all persons have a duty
to take precautions as to lessen their ability to infect the at-risk
populations.
This virus will die as warmer months approach.
There is no current evidence to support this.
Furthermore, other epidemics occurred primarily during the
warmer months. While it is true that flu season ends during
warmer weather, we do not know if this will translate to this virus.
Packages from high risk countries should not be handled.
All evidence shows no risk and no cases of infection
from handling packages sent from countries with known novel
coronavirus outbreaks.
Routine facemask usage will lower my risk of catching this virus.
No current evidence supports this claim. On the
contrary, these masks may serve as a surface for the virus to live
and, if not removed properly, infect a person through mucous
membrane contact.
23. WHAT DO WE TELL THE
PUBLIC?
EMS is often the first healthcare
provider patients and families
contact. Due to us being public
figures, people seek guidance from
us regarding situations such as this.
Avoid mass gatherings and practice
social distancing.
Be diligent in basic hygiene.
Masks are not recommended for
general use and do not decrease
infection risk of population.
Mass purchasing of medical supplies
decreases availability for those who
need them.
”Panic purchasing” has widespread
effect.
Utilize hospital only if severe
symptoms occur, medical advice
should initially be sought by
telephone.
Self isolation / quarantine with OTC
medication therapy is best practice
for those with mild, moderate
symptoms.
PCR testing will not occur in most
people, especially those who are
asymptomatic.
Most importantly, ensure the public
that EMS is always prepared and
capable to answer their call.
24. QUESTIONS,
CONCERNS,
COMMENTS
This topic is extremely important to me,
as it should be to you. I am a street
paramedic just as most of you are. If
there are any questions, comments or
concerns please do not hesitate to
reach out to me. If you have any
suggestions, best practices or other
information I would love to hear from
you.
Contact information:
Cell - 516-425-2715
Email - BJohnson6272@gmail.com