UNCONTROLLED WHEN PRINTED

The purpose of these COVID-19 Interim Guidelines is to provide short-term advice to manage the risks associated with COVID-19 in the community and to protect patients and St John WA staff from potential exposure whilst maintaining the highest possible standards of clinical care to the community of Western Australia.

FRONT LINE STAFF SAFETY IS OUR PRIMARY CONCERN.

All Clinical Practice Guidelines not addressed in this document remain unchanged and still apply in full. Staff should ensure that they stay up to date with the latest information regarding COVID-19 on Connect.

This update is provided in the setting of very low penetration of COVID disease in Western Australia and zero or close to zero community transmission.

This interim document provides guidance for approach to scenes and patients in order to minimise the risk of unprotected exposure of officers to potential COVID-19.

Sound judgement should apply at all times with consideration to officer exposure, appropriate use of valuable PPE and patient urgency.

En-route:

  • Assess the information on the call-card to formulate a plan and assess risk.
  • When infective respiratory conditions / COVID-19 are considered, discuss this with your crewmate and formulate a plan for patient contact.
  • Discuss alternative options if the primary plan cannot be followed.
  • Anticipate what PPE may be required by the patient and the crew.

At scene:

  • Adopt a cautious approach and assess all risk.
  • Consider whether both officers need to approach; one officer should progress first.
  • Ask if the patient can come to the door if appropriate, or enter only as far as necessary to have the patient in sight.
  • Explain why you are not making close contact immediately.
  • Conduct a ‘front door’ visual assessment and gather pertinent history whilst maintaining a safe distance.
    • Note: Registered Paramedic or most senior clinician to perform front-door assessment.
  • Establish the clinical complaint, urgency, risk of infective respiratory illness and the possible need for high risk procedures that may cause aerosolising of the virus.
  • Communicate with crewmate and agree a plan.

Patient contact, assessment and treatment (assuming there is infective risk):

  • PPE requirements as per guidelines for crew and patient.
  • Only one officer in close contact is advocated.
  • Limit assessments to those necessary to minimise very close contact time (e.g. avoid chest auscultation where it is unlikely to provide any significant benefit, as it requires close proximity to the patient.)
  • Consider urgency and risk vs benefit of oxygen.
  • Consider urgency and risk vs benefit of treatment prior to loading to limit close contact in ambulance.
  • Encourage patient to mobilise and do as much for themselves related to clinical assessment, urgency and their mobility- attempt to limit moving and handling.
  • If administering oral medication (e.g. ondansetron wafer, paracetamol, etc.)
    • Place the medication in the patient’s hand
    • Instruct the patient to self-administer
    • Replace the mask
    • Provide hand sanitiser to the patient

References
References

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