EMS and Covid-19 in Italy

    • EMS and Covid-19 in Italy

      Hi everybody, I know that everybody are discussing about this topic, I'd just want to know which instruction have the the whole EMS around the world.
      I personally work and in live in Italy, nearby the red area where there is a big focus of Covid-19 in Europe.
      The local healt autorities, ECDC and minister of healt have given some advice to avoid the contact, 10 town are under isolation, school, universities, sport activities, events are all suspended until the 1st of May (but the time con be extended if needed)

      They recommend the health workers to use of FFP3 mask,suit, gloves and eye glasses if you have to deal with someone who has flu symptoms . <X

      Which advise does the EMS autories have given in your area?
    • Same here. Basically, all of Germany adheres to the recommondations of the Robert-Koch-Institut, which is our CDC. It recommends FFP3 masks for the EMS staff, full body suit, eye glasses and - of cource - gloves. Plus a mask for the patient.

      In the case of our district, we use the same saftey measures, as with the SARS epidemy of 2003. This equals the above. An emergency physician is to be called to the scene. The local health department then has to decide, which hospital will take the patient. The saftey suites, masks, ect. have to stay at the destination hospital. Desinfection of the ambulance we use Dismozon pure (4%), which is an oxygen-active surface disinfectant.
    • It sounds interesting, actually we are applying the same measures here, even in the town under isolation.

      The Regional Agency for Medical Emergencies (AREU) in Lombardy has given all the istructions about when is needed or the FFP3 and so on.

      They recommend the use in the following cases:
      -Flu
      -Dyspnea
      -Pneumonia
      -Unknown unconscious patient

      The transport now dipends where the call comes from, ìn the red area (isolation area) they are taken to lodi hospital ora codogno hospital (who are in the red area) whereas out of red area, are taken to hospitals who has an infectious diseases department.

      There are 23 patien in ICU, 99 in patients infectious diseases department and 91 under isolation at thier own houses. There are 223 cases reported for more than 4000 check

      The post was edited 1 time, last by gabryzano ().

    • gabryzano wrote:

      They recommend the use in the following cases:
      -Flu
      -Dyspnea
      -Pneumonia
      -Unknown unconscious patient
      Is that a general recommondation or just now because of Covit-19?
      I'm curious, because we have a long list of which precautions to take at which illness/infection. But there are only few recommondations for symtpons. Basically - so far - we only should use masks, overalls, ect. when a patient has high fever (40+). Usually we go to a patient without any saftey precautions (except for gloves of course). Further precautionary measures are only taken if the patient shows symptoms or if we have a certain diagnosis. This may change of course, if there should be a greater number of Covit infections in the country/region.
    • TheOssi wrote:

      Is that a general recommondation or just now because of Covit-19?
      Are new general recommondation s due to Covid-19 emergency, all emergency crew has to follow thoose rules, if you don't, you and your colleguage have to stop and get isolatetd.



      Before whe had to use them as the same of your "..when a patient has high fever (40+). Usually we go to a patient without any saftey precautions (except for gloves of course). Further precautionary measures are only taken if the patient shows symptoms or if we have a certain diagnosis .. "



      Obviusly the calls to 112 are very high now and thoose are special recommondation s due to the emergency situation, the region and the healt minstery have created new phone number to call if you think you can gat the Covid-19,

      15000 - Ministery of healt, for information about Covid-19

      800.89.45.45 - Lombary Hotline, for thoose who has symptoms like flu

      112- just for real emergency situation such as high fever, pneumonia or short breathing

      We are using many many FFP3 and so on, and disinfectants, whe are running out because everyone is going to buy them.
    • That's a problem in some pharmacies around here, as well. Face masks are sold out here and there. We're actually told at the moment, not to "overuse" our FFP3s, because they may lack in the future due to possible supply shortages. Funny thing is, that our chief physician says "most people only have the flue", which - in my opinion - is a damn good reason for using a mask, but... well... who am I?
    • TheOssi wrote:

      Funny thing is, that our chief physician says "most people only have the flue", which - in my opinion - is a damn good reason for using a mask, but... well... who am I?
      I think so, because until you do the test, you are not 100% sure that is not Covid-19, in 80% of the cases the symtoms are like flu, so actually, the best solution, in my opinion, is to overvalue the risk.

      Everything here in Italy started in the same way, a person with flu has come to the hospial, and now whe have 229 cases and 6 deaths.
    • gabryzano wrote:

      if you don't, you and your colleguage have to stop and get isolatetd.
      A question about that: what does mean "isolated"? Would you be quarantained in a hospital or sent home to your (hopefully) healthy family (hopefully not infecting them), orderd not come out within the next 14 days?
      I had that topic today with my wife-to-be, who happens to be EMS, as well. Fact is, we wouldn't want to go home an risk infecting our daughter or each other.

      Of course it's all a matter of resources. When the first case was confirmed in Bavaria earlier this year, he was rushed to and isolated in a hospital. The second and the third, also, but the fourth (not the exact numbers) and fifth and so on were sent home. All went well, but it's kind of bullsh*t, sending an infected home to his (until then) uninfected family.

      The post was edited 1 time, last by TheOssi ().

    • TheOssi wrote:

      A question about that: what does mean "isolated"? Would you be quarantained in a hospital or sent home to your (hopefully) healthy family (hopefully not infecting them), orderd not come out within the next 14 days?
      Well, actually dipends where you are (in or out of red area) and by your symtoms.

      For residents in red area (10 towns who are isolated as quaranteen) :

      - If you just have flue symtoms you are isolated at home for 14 days (you and your room mates/family) as quaranteen.

      - If you have short breathing or pneumonia, call 112 and than be trasported to an hospital with infectious diseases department. or ICU (dipends by the clinical conditions)

      For residents out of Red area :

      - If you just have flue symtoms, call 1500 or 800.89.45.45 (just for Lombary ) and immediatly get isolated at home, a local health agency doctor will come to your house and see your clinical conditions, if he thinks that you may have Covid-19, an ambulance will come and take you to a infectious diseases department in quaranteen

      - If you have short breathing or pneumonia, call 112 and than be trasported to an hospital (is not needed the infectious diseases department). The hospital will take the patient under quaranteen until they do the test, if the test is positive for Covid-19, you will be transported to infectious diseases department.

      -If patient is in ICU, he will stay at the hospital, the medical team will contact the center for disease control (Sacco hospital for desease control in north italy, and than Spallanzani Hospital in rome who is the national institute for desease control )and try to find uot his history to find out the possibly infected peolple (such as his family or friends), they will stay in quaranteen at their home inult they have any sign of flue


      For Health operators who are working in Lombardy and Veneto, now they are considered as red area residents.

      The other country healt operators, they are considerated as normal residents out of the red area
    • TheOssi wrote:

      fifth and so on were sent home
      I've red the WHO instructions about that.
      They if the patien is symptomless, he must stay at home in quaranteen, because the Covid-19 is infectious just when you got symptoms (so said the WHO and CDC).
      If have any symptoms, you will be taken in quaranteen under isolation (in hospital ora prepared areas such as apposite military barracks wh are ready but not still used).
    • They reccomend something but they don't provide ambulance personnel of appropriate PPE and I think is not acceptable. After ambulances are dispatched to suspected or confirmed cases should go case by case to hospitals to pick up them (and a doctor): that's the procedure in my region. They say it's because there isn't yet a sufficient number for everyone.

      Today the Chief of the National Department for Civil Protection in Rome says that they'll acquire and then distribute an appropriate number of protective equipment from italian industries. In fact now all manufacturers of PPE in Italy must supply first orders from italian government

      We now have 322 cases, 11 deaths, 1 recovered.
      240 in Lombardy
      45 in Veneto
      26 in Emilia Romagna
      3 in Piedmont
      3 in Sicily
      3 in Latium (1 recovered and 2 coming from China)
      2 in Tuscany (1 coming from Singapore)
      1 in Liguria
      1 in Sud Tyrol

      All cases come from "clusters" in South Lombardy and Veneto. Clusters are maybe connected but is not yet confirmed. The Superior Institute of Health didn't yet identified the "Zero patient" who bought the virus in the country. Doctors and nurses have performed over 8000 swabs across the country. All dead people were > 60 y of age and they already suffer by many pathologies.

      There is an unnecessary sense of panic in many people and social media, fake news and political exploitations are not helping about that:
      A recent study states that in over 80% of the cases sign and syntomps are mild, in 15% are serious and in 5% are critical.

      The post was edited 7 times, last by marcolone95 ().

    • gabryzano wrote:

      I've red the WHO instructions about that.
      They if the patien is symptomless, he must stay at home in quaranteen,
      because the Covid-19 is infectious just when you got symptoms (so said
      the WHO and CDC).
      Do you have a link for that? Cuz as far a I know the virus is so contagious, because one is intefctious BEFORE having symptoms.
    • I’ve found out some WHO Line guide in english

      who.int/docs/default-source/co…=bc7da517_6&download=true

      apps.who.int/iris/rest/bitstreams/1269109/retrieve


      TheOssi wrote:


      gabryzano wrote:

      I've red the WHO instructions about that.
      They if the patien is symptomless, he must stay at home in quaranteen,
      because the Covid-19 is infectious just when you got symptoms (so said
      the WHO and CDC).
      Do you have a link for that? Cuz as far a I know the virus is so contagious, because one is intefctious BEFORE having symptoms.
    • Thanks, but that doesn't include anything about when a patient starts to be infectious.

      The Frankfurt am Main university hospital in cooperation with the virological institute of the university of Marburg (and the Health Protection Authority of Frankfurt) checked 126 people the Bundeswehr evacuated from Wuhan earlier in february and found two positive tested persons without any symptoms.

      Source: The New England Journal of Medicine
    • Maybe the don't know. This publication is just a week old. And it doesn't really change anything. There's just a 1.7 to 2.6% (one of the 115 symptom free patients refused testing) that someone, who was in Wuhan, the "epi-center", is infectious without symptoms. This isn't really much and the tesz group is quite small. So I guess the risk is much smaller in reality.

      The post was edited 1 time, last by TheOssi ().