Protected 911: Development, Implementation, and Evaluation of a Prehospital COVID-19 High-Risk Response Team

Justin Mausz, Nicholas A. Jackson, Corey Lapalme, Dan Piquette, Dave Wakely and Sheldon Cheskes
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Justin Mausz: Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada
Nicholas A. Jackson: Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada
Corey Lapalme: Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada
Dan Piquette: Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada
Dave Wakely: Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada
Sheldon Cheskes: Sunnybrook Centre for Prehospital Medicine, 77 Brown’s Line, Suite 100, Toronto, ON M8W 3S2, Canada

IJERPH, 2022, vol. 19, issue 5, 1-15

Abstract: Patients with COVID-19 who require aerosol-generating medical procedures (such as endotracheal intubation) are challenging for paramedic services. Although potentially lifesaving for patients, aerosolizing procedures carry an increased risk of infection for paramedics, owing to the resource limitations and complexities of the pre-hospital setting. In this paper, we describe the development, implementation, and evaluation of a novel pre-hospital COVID-19 High-Risk Response Team (HRRT) in Peel Region in Ontario, Canada. The mandate of the HRRT was to attend calls for patients likely to require aerosolizing procedures, with the twofold goal of mitigating against COVID-19 infections in the service while continuing to provide skilled resuscitative care to patients. Modelled after in-hospital ‘protected code blue’ teams, operationalizing the HRRT required several significant changes to standard paramedic practice, including the use of a three-person crew configuration, dedicated safety officer, call–response checklists, multiple redundant safety procedures, and enhanced personal protective equipment. Less than three weeks after the mandate was given, the HRRT was operational for a 12-week period during the first wave of COVID-19 in Ontario. HRRT members attended ~70% of calls requiring high risk procedures and were associated with improved quality of care indicators. No paramedics in the service contracted COVID-19 during the program.

Keywords: paramedic; COVID-19; patient safety; personal protective equipment; occupational health and safety; quality improvement (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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