Alameda County EMS Interaction and Transfer of Care Guidance April 6, 2020 General COVID-19, Public Health After surveying the different practices being employed by the receiving facilities, reviewing CDC guidance, consulting with Alameda County Public Health, and in accordance with the pre-hospital care guidance that Alameda County EMS has already distributed, we wanted to share best practices and guidance relating to the interaction and transfer of care between receiving facilities and EMS. Please keep in mind that these are not mandates, however, we are trying to create an opportunity for consistency throughout the system in order to streamline this process as well as minimize confusion and frustration. All healthcare providers should self-monitor for the development of symptoms and it is encouraged that employers assist in these efforts. Take care of yourself, so that you can take care of others. If symptoms develop to take the appropriate actions. Employers should consider touching base with their healthcare providers on a regular basis as well as other measures such as periodic temperature checks. All healthcare providers should wear the appropriate level of personal protective equipment when interacting with patients or each other when risk of exposure to COVID-19 exists. We have a duty to protect our patients and each other to the best of our abilities. Prehospital providers should provide early notification to facilities, especially in cases where COVID-19 is suspected based upon their assessments or patient history. This provides the facility an opportunity to plan for the arrival and make the appropriate room types available if possible. Prehospital providers should limit aerosol-generating procedures as much as clinically possible and should terminate nebulizer treatments prior to entering facilities. Please refer to previously released guidance documents, available at https://ems.acgov.org/covid19, for additional information. Facilities should have a process in place for their staff, wearing the appropriate PPE, to meet incoming ambulances and transfer patient care outside of the facility. This will allow facility staff to triage incoming patients and determine the correct patient movement pathway into the facility while also decreasing the number of people entering the facility which mitigates exposure risk. Facilities should have at least one designated area and receptacle available outside of the facility for their staff and/or prehospital personnel to appropriately remove and dispose of worn PPE as well as accessibility to use a restroom and wash their hands within the facility. This process will centralize the collection of potentially contaminated materials outside the facility and provide access to proper hygiene efforts to reduce possible exposure risk. Everyone’s efforts to work together, collaborate, and leverage best practices in as consistent a manner as possible is greatly appreciated. Healthcare providers are on the front line of this pandemic, and we all need to work together to mitigate exposure, reduce spread, and take care of each other while providing the highest level of care to our patients.