Revised Ebola Guidance Addresses PPE for EMS Practitioners

In a continued effort to ensure that Interim Guidance for EMS Systems and 911 PSAPs for Management of Patients with Known or Suspected Ebola Virus Disease in the United States" guidance is kept up-to-date, substantial revisions regarding personal protective equipment were recently released based on lessons learned from treatment of Ebola patients in the United States.

The guidance currently states that the likelihood of contracting Ebola in the United States is small unless a person has direct contact with blood or body fluids of an infected patient. With that in mind, the most significant change in the guidance document suggests reducing direct contact and now clarifies the recommended minimum personal protective equipment (PPE) on two different levels for EMS personnel and first responders when treating a patient with Ebola-like symptoms.

The Dec. 2, 2014 revision to the guidance, updated by the Centers for Disease Control and Prevention (CDC) in coordination with NHTSA's Office of EMS (OEMS) and the Federal Interagency Committee on EMS (FICEMS), recommends that practitioners:

  • Perform initial screening from at least three feet away from the patient
  • Wear a surgical facemask, impermeable gown and double gloves if patient is not showing signs of bleeding, vomiting or diarrhea
  • Wear double gloves, gown, leg covers and a full-face shield if patient is bleeding, vomiting or has diarrhea

An accompanying algorithm released on January 2, 2015 graphically illustrates the recommendations in the guidance.

In November, the Office of EMS worked with the CDC and the FICEMS preparedness committee to conduct a conference call with national EMS and 911 organizations to discuss concerns and challenges they were facing when treating suspected Ebola patients.

"The guidance was shared with EMS and 911 national organizations who then provided comments that were closely reviewed by the CDC," said Gam Wijetunge, NRP, a program specialist with the Office of EMS. "The comments were crucial to enhancing the document itself and provided an additional level of expertise."

"This kind of collaboration and community input is imperative to ensure the guidance is most useful to EMS practitioners and 911 centers across the nation."

FICEMS also developed a memo regarding the guidance during its Dec. 4 meeting that was shared publicly. The memo discussed feedback from the community and recommended actions for the FICEMS member agencies to focus on in the near and long-term future.

Next steps, priorities and initiatives determined during the meeting included:

  • Focusing on emerging infectious diseases
  • Providing additional Ebola-related guidance and educational materials for facility guidance and pediatric patients
  • Focusing on basic infection control to improve response to day-to-day incidents

The Office of EMS will continue to work with the CDC and FICEMS to develop additional guidance as needed. Review the updated EMS and 911 Guidance document here.