If you live in the U.S., chances are you or someone you know have had the flu. The CDC classifies this year’s seasonal flu as an epidemic and reports that 47 states experienced widespread flu activity this past week.
Some states, including New York, have declared states of health emergency, thereby allowing certain measures such as pharmacists giving flu shots to children as young as 6 months (this is a break from state law). Boston’s mayor declared a health emergency after health officials confirmed 700 cases of flu there, 10 times the number of cases from last year. All of this translates into overwhelmed healthcare systems and should serve as a wake-up call to EMS providers. We are on the front lines of our systems and see patents in their homes; thus we have unique concerns regarding flu. In the past, declarations of public health emergencies—such as those seen during the H1N1 pandemic and Hurricane Sandy—have seen the potential for EMS providers to be pressed into different-than-normal roles as vaccinators, transporting patients to alternative care sites and assisting with Strategic National Stockpile assets.
The flu is spread through droplets that are aerosolized when coughed or sneezed by an infected person. These droplets are spread through airborne contact or settle onto surfaces via gravity and spread via personal contact. This means your ambulance and equipment are great places for flu to spread from an infected patient to you, your partner, other patients, the next shift, etc. The CDC estimates the flu virus can remain viable on external surfaces, exposed to the environment, for anywhere from 2–8 hours.
It’s evident that this year’s flu is not to be taken lightly. As EMS providers, some of our best weapons are solid infection-control procedures and prevention. So here are the top five things you need to do this flu season:
1) Get your annual flu shot. Once vaccinated, EMS provides are less likely to get sick, less likely to spread the flu among their patients and less likely to bring the virus home to their families. The CDC has made it clear that vaccinations offer the best protection against the flu.
2) Wash your hands. Or, if you (or your partner) can’t, have a bottle of hand sanitizer on your belt and use it liberally.
3) Wear your PPE. Also have your patients wear theirs: Ask patients exhibiting symptoms of influenza-like illness to wear masks. EMS providers should wear gloves as well as surgical masks when treating these patients. Also keep surfaces clean; as the flu virus can be killed on your hands with soap and water or alcohol-based hand sanitizer, it can be killed on surfaces with commonly available disinfectants and regular cleaning. This means thorough decontamination of stretcher straps, ceiling handrails, door handles, driver’s compartment surfaces, portable and fixed O2 tanks, stair chairs, jump kits, computers and clipboards.
4) Be prepared. If you’re the person in charge of supplies, ensure you have adequate inventories of N95 masks, simple surgical masks, alcohol-based hand sanitizer and ambulance decontamination spray. If you are a provider, make sure you have these items on the truck when you go on shift.
5) Call in sick. Yes, I said it: If you are showing any signs or feeling any symptoms of flu, do not go to work. I know this is intuitive, yet there are some who will go to work while sick and risk infecting others. Play it safe and stay home.
The only positive element of this year’s flu season is that, as of right now, some states (specifically those in the South and Southeast) are actually seeing decreases in flu activity. There and elsewhere, however, EMS providers and agencies must be vigilant to protect themselves as well as their patients.
Raphael M. Barishansky, MPH, is director of EMS for the Connecticut Department of Public Health. A frequent contributor to and editorial advisory board member for EMS World, he can be reached at firstname.lastname@example.org.