Non-Transport During the Covid-19 Pandemic - System Memo # 388 and Form

System Memo 388  EMS Covid-19 updates, including Non-Transports Issued 3/29/20

Patient Agreement for Non-Transport During Covid-19 Pandemic  Posted 3/30/20

Patient Agreement for Non-Transport During Covid-19 Pandemic (Spanish) Posted 3/31/20

I suspect many of you may have similar questions, and it’s important to avoid any misunderstanding so this process is rolled out to all EMS and ECRN personnel as accurately as possible.

The new Covid-19 No Transport form was created because the patient acknowledgement statement is very different for these types of calls than a regular refusal of service.  The nature of patients that are even eligible for this type of no transport determination is limited and different from usual refusals. 

Plus IDPH has now given permission for these types of No Transport determinations.

To ensure that we are doing these calls correctly, a new form was requested and I agree it was needed.

Below is a composite of directions given in the Covid-19 SOP and System memos plus clarification on the NT process:

At this point, assume most elderly in nursing homes and patients complaining of respiratory or GI illness may be ill with or be a possible carrier of Covid-19 virus as the numbers start to climb.

·         Limit # of crew members initially  within 6 feet of person to 1 or 2

·         Take immediate appropriate PPE precautions on crew and patient – even during interview if you are within 6 feet of the person:

·         Assess contact and travel history

·         Assess age and PMH for high risk factors for severe disease (listed in SOP and on form)

·         Physical exam: Assess clinical S&S; take vital signs (including temperature); SpO2, listen to breath sounds on all patients unless they refuses

·         If more severe S&S, see Covid-19 SOP for full exam and treatment requirements

·         If NO risk factors for severe disease  +

·         If asymptomatic or evidence of mild disease and NO S&S of severe disease (listed in SOP and on form) +

·         If home environment supports shelter in place and is safe to leave the person there based on CDC guidelines  =

Patient is a candidate for NO transport – all others get transported

·         Call in all Covid-19 NO TRANSPORTS that meet the current criteria for OLMC in System Policy R6 Refusal of Service.

·         Remember, patients 65 and older are NOT candidates for Covid-19  NT, but minors may be if parent/guardian is well and reliable to observe/care for mildly ill child at home. If any question over the acuity of present illness or safety in home monitoring – they are high risk and need to be called in.

·         Documentation: Complete a full cPCR + the Covid-19 NT form rather than the usual Refusal form.

·         Until the forms can be printed on NRC paper, you’ll likely need to complete two forms on the scene – 1 for pt; 1 for EMS

·         Scan a copy the form into the patient’s electronic EMS record and save the EMS copy for QI reporting purposes.

·         We will do a 100% QI audit of these Covid-19 NT calls based on IDPH requirement- PBPI, we will need your help here!

Hope this helps!  Please let me know if you have any further questions.  Connie