The Swine Flu Epidemic

[tniuqs]

I found this ... as I am having some difficulty google " anti viral agents/ cleaning agents' It appears that Google is more interested in Computer Virus Cleaning and Removal.

I am attemping to discover exactly how alcohol kills virus, I found this a small study never the less quite interesting.

http://www.sciencedaily.com/videos/2005/12...d_flu_germs.htm

cheers

[HERBIE1]

From the CDC for EMS/field providers:

http://www.cdc.gov/swineflu/guidance_ems.htm

and a PSA for your further education:

http://www.youtube.com/watch?v=9iJLpe1tZl8

They must be updating their info at the CDC web site- it says the document is currently not available.

As for the PSA- interesting.

Question for you:

What would be your recommendations if a provider comes across several patients on a train or plane, for example, who have flu like symptoms but don't necessarily want treatment or transport? It's a confined space, breathing the same air, and we could have a lot of potential carriers who could wreak havoc on an area. Is a quarantine indicated, or must this come from a CDC or Health Department directive? From what I was told, in this area at least, we do NOT have the authority to do this. It seems to me that we are propagating a potential epidemic if we see clusters of patients like this and simply allow them to go on their way.

I see many legal and ethical problems here. What would you do?

[Brady]

West Nile isn't spread person to person, so despite it being "bad", it is much less likely to effect many people, or spread around the globe.

Thanks I had no idea that I didn't get west nile from a person. must have been those dang misquitoes. And it was a huge thing here.

[ERDoc]

Thanks I had no idea that I didn't get west nile from a person. must have been those dang misquitoes. And it was a huge thing here.

I think p3 was just trying to say that comparing the two, the swine flu is going to spread much quicker. It is person to person contact and, as we have already seen, has spread to different parts of the globe in just a few weeks. Both suck if you get them, but the flu is much more contagious. Coming from NY, we were pretty much ground zero for the WNV outbreak. It took a few summers to reach you guys. At least when it got out that way you already knew what it was. We were still trying to figure it out while taking care of the sick.

Edited April 29, 2009 by ERDoc

[Richard B the EMT]

Read, skim, or ignore the admittedly extensive posting from 5 separate sources, your free choice. I'm not forcing anyone.

I got the information sent to me courtesy New York State Volunteer Ambulance and Rescue Association.

This morning, I was told, without confirmation, The next step is, the US closes our borders. I heard on MSNBC Cuba has closed travel between themselves and Mexico.

Incidentally, I love pork chops, and bacon, but I'm not going to eat any for a couple of days.

I also got this, again courtesy of the NYSVARA:

(Fire Department of New York City)

BUREAU OF OPERATIONS

EMS COMMAND ORDER 2009-077

April 28, 2009

INFECTION CONTROL PERSONAL PROTECTIVE

EQUIPMENT USE

1

1. GENERAL INFORMATION

1.1 In response to the confirmed cases of Type-A influenza ("swine flu") in New York City

and to maximize safety of EMS members, the Department has instituted a new series of

call types indicating a patient with a fever and/or cough (FC Call Type). Members will

be required to wear infection control PPE to limit the transmission of aerosolized

infectious materials.

1.2 In addition, members will be required to wear required infection control PPE when

performing specific medical interventions regardless of call type.

1.3 While this outbreak of swine flu continues, CFR Companies responding to medical

emergencies shall form a medical recon team consisting of the Company officer and 1

CFR trained firefighter. All other firefighters will remain outside the premise until the

medical recon team evaluates the patient.

1.4 This series of call types and the related infection control procedures will be used

routinely even in the absence of a declared pandemic.

2. SCOPE

2.1 This procedure applies to all certified FDNY EMS providers (CFR-D, EMT or

Paramedic) and Voluntary Hospital ambulance personnel who provide prehospital

emergency medical treatment in the New York City 911 system.

3. POLICY

3.1 Infection control PPE (gloves, N-95 respirators, gowns, isolation kits) and red bags shall

be stored in an outside compartment. This PPE shall be used by the vehicle operator

prior to entering the patient compartment or coming in contact with the patient.

3.2 All units shall carry at least 2 pairs of goggles in each oxygen bag.

4. PROCEDURE

4.1 When assigned to any call type with the FC Call Type, all members shall don the following

PPE prior to entering the patient premise (e.g., house, apartment, vehicle, business):

• N-95 respirator mask

• Set of gloves

4.2 If a CFR Company is onscene prior to EMS arrival, members shall switch to the

EMS/Fire IO frequency and contact the medical recon team to determine the patient's

condition and infectious status.

4.2.1 The EMS/Fire Interoperability (IO) frequency is Channel 10 in all FDNY Handie-

Talkies (HT) and FDNY EMS portable radios. Voluntary Hospital portable

radios have the EMS/Fire IO frequency on either Channel 10 or Channel 16.

Radios with a LCD display will show the frequency as EMS/CFR or EMS Tac 2.

4.3 When members are treating a patient, who after examination is confirmed to be an FC call

type (e.g., cough and fever) the patient shall wear a N-95 respirator mask at all times unless

they require oxygen or report that it is too difficult to breathe through the N-95 mask.

Patients that report difficulty breathing through the N-95 mask shall be given oxygen by

non-rebreather.

4.4 Regardless of call type, members performing or assisting with intubation, suctioning

and/or nebulized medication administration shall don the following PPE:

• N-95 respirator mask

• Set of gloves

• Goggles

4.5 When a member may be splashed by the bodily fluids (e.g., vomit, diarrhea, spurting

blood) the members shall don the following PPE:

• N-95 respirator mask

• Set of gloves

• Goggles

• Gown

4.5 EMS bunker-style PPE may be used instead of a gown for splash protection.

4.6 Members who are not actively involved in patient care shall remain at least 4 feet away

from the patient when nebulized medication administration is being performed.

Members who are more than 4 ft from the patient being intubated or receiving nebulized

medication are not required to wear goggles. Members shall don the appropriate PPE

based on the care being provided when required to be close to patient for any reason

(e.g., moving the patient).

4.7 PPE shall be removed according to the following procedures:

4.7.1 Remove the set of gloves.

4.7.2 Wash hands with soap and water, if available. Alcohol-based hand gels can be

used when soap and water is not available.

4.7.3 Remove the N-95 respirator mask.

4.7.4 All used PPE shall be disposed of in proper infectious waste containers (e.g., red

bag, hospital infectious waste container).

4.7.5 After disposing of the infectious waste, members shall re-wash hands with soap

and water if available or an alcohol-based gel.

5. TRANSPORT PROCEDURES AND VEHICLE CLEANING MEASURES

5.1 The window/door between driver and patient compartments (if present) should be closed

during patient transport.

5.2 Exhaust fans in the patient compartment shall be turned on at the highest setting. HVAC

fans for both the driver's and patient compartments shall be turned on at the highest

setting.

5.3 The vehicle operator shall remove their PPE prior to entering the driver's compartment,

and dispose of the used PPE in a red bag stored in an outside compartment of the vehicle.

Prior to reestablishing patient/equipment contact they should don another set of PPE from

the additional PPE are stored in an outside compartment.

5.4 Following delivery of the patient to a hospital, the patient compartment and all equipment

that are contaminated with patient secretions (e.g., stairchair, stretcher, oxygen bag) must

be disinfected with properly diluted bleach and water solution before the ambulance is

returned to service.

5.4.1 Members shall don complete PPE prior to disinfecting the ambulance and

equipment.

5.4.2 Dispose of red bag waste from the outside compartment.

5.4.3 All hard surfaces of the patient compartment shall be disinfected by wiping.

5.4.4 Equipment shall be disinfected according to the FDNY Infection Control Program

Equipment Disposal/Decontamination guidelines.

6. CLEANING OF PERSONAL PROTECTIVE EQUIPMENT

6.1 Non-disposable PPE and work duty uniforms that have become spotted or lightly soiled

with blood, blood products, or other body fluids shall be decontaminated at the station.

6.2 When an EMS member's work/duty uniform or bunker-style PPE becomes contaminated

with large amounts of body fluids or other potentially infectious material, the member shall:

6.2.1 Ensure that their contaminated uniform items (shirts, pants, jacket, and tie) are

labeled with an indelible ink pen with the member's name.

6.2.2 Place contaminated work duty uniforms in a double sealed clear plastic bag with a

biohazard label attached to the inner bag. The bag shall be marked with the

member's name, assigned battalion and type of contaminant (e.g., blood, vomit).

6.2.3 Complete an EMS Command Uniform Cleaning Receipt indicating that uniform

articles have been submitted for laundering.

6.2.4 Deposit uniform articles in a light traffic area (remote location) as directed by the

Station Officer.

6.3 EMS Station Officers shall ensure that contaminated clothing is processed for cleaning as

follows:

6.3.1 Ensure that the member completes the Uniform Cleaning Receipt accurately,

paying particular attention to ascertain that uniform articles have been labeled as

indicated above.

6.3.2 Contact the Special Operations Command (SOC) for collection of the

contaminated uniforms. SOC will fax a SOC Equipment Decontamination Report

(SOC Decon 3) for the equipment. Uniform items shall be listed in the

"Misc/Remarks" column. This form shall be filled out completely and faxed back

to SOC. The copy of the form and the Uniform Cleaning Receipt is placed in the

outer of two clear bags facing out for Decon personnel to view prior to opening.

6.3.3 Ensure that pick up of contaminated laundry and return of clean laundry are

accurately documented in the Station Logbook for inventory control reasons.

6.3.4 Advise members that cleaned uniform articles are available for their pick-up.

7. FEVER / COUGH (FC) CALL TYPES

7.1

Current Call Type Fever Cough Call Type

ARREST ARREFC

CHOKE CHOKFC

ANAPH ANAPFC

STATEP STATFC

UNC UNCFC

ASTHMB ASTHFC

DIFFBR DIFFFC

CVAC CVACFC

ALTMEN ALTMFC

CARD CARDFC

INBLED INBLFC

CVA CVAFC

DRUG DRUGFC

RESPIR RESPFC

SICPED PEDFC

ABDPN ABDPFC

MEDRXN MEDRFC

SEIZR SEIZFC

SICK SICKFC

8. RELATED PROCEDURES

8.1 EMS Operating Guide Procedure 109-08, Protocol for the Use of the EMS/Fire

Interoperability Frequency

8.2 EMS Operating Guide Procedure 125-04, Infection Control Program

BY ORDER OF THE CHIEF OF EMS COMMAND

I also got this from the Department of Homeland Security.

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Emergency Management and Response

Information Sharing and Analysis Center

(EMR-ISAC)

CIP Bulletin 3-09 April 29, 2009

NOTE: This Bulletin provides members of the Emergency Services Sector with information concerning the protection of their critical infrastructures. For further information, contact the Emergency Management and Response- Information Sharing and Analysis Center (EMR-ISAC) at (301) 447-1325 or by e-mail at emr-isac@dhs.gov.

Media Advisory

Contact: USFA Press Office, 301-447-1853

FOR IMMEDIATE RELEASE

A MESSAGE FROM THE UNITED STATES ACTING ASSISTANT ADMINISTRATOR REGARDING THE H1N1 FLU

Washington DC- In an effort to send a common message the USFA is working with Department of Homeland Security Office of Health Leadership and other Federal partners (FICEMS) to issue an EMS, Medical First Responder and 9-1-1 specific guidance document to the Nation's first responders. This is a dynamic process and we will provide additional information as soon as we receive the appropriate agency(s) approval. In addition to the CDC link

http://www.cdc.gov/swineflu/ take a look at www.EMS.gov for Pandemic Influenza specific information:

"We are currently monitoring the H1N1 Flu information as it comes forward from the CDC and DHS medical experts. As a part of FEMA and DHS, the USFA is seeking to ensure our nation's firefighters and their families are provided the information they need to stay safe," said Acting Assistant Administrator Glenn A. Gaines. "We know as firefighters and EMTs called to emergency medical responses and other emergencies across the nation, there is always the concern for secondary exposures to fellow firefighters and families as firefighters return to their homes. As conditions change, we will work closely with you to ensure firefighters and EMTs have the most current information."

The U.S. Department of Transportation's EMS Pandemic Influenza Guidelines for Statewide Adoption and Preparing for Pandemic Influenza: Recommendations for Protocol Development and 9-1-1 Personnel and Public Safety Answering Points (PSAPs) are available online at www.ems.gov (Click on Pandemic News). State and local EMS agencies should review these documents for additional useful information.

For the most current information regarding the outbreak of H1N1 Flu, visit: http://www.cdc.gov/SwineFlu/.

DISCLAIMER of ENDORSEMENT

The U.S. Fire Administration/EMR-ISAC does not endorse the organizations sponsoring linked web sites, and does not endorse the views they express or the products/services they offer.

FAIR USE NOTICE

This Bulletin may contain copyrighted material that was not specifically authorized by the copyright owner. EMR-ISAC personnel believe this constitutes "fair use" of copyrighted material as provided for in section 107 of the U.S. Copyright Law. If you wish to use copyrighted material contained within this document for your own purposes that go beyond "fair use," you must obtain permission from the copyright owner.

Reporting Notice

DHS and the FBI encourage recipients of this document to report information concerning suspicious or criminal activity to DHS and/or the FBI. The DHS National Operation Center (NOC) can be reached by telephone at 202-282-9685 or by e-mail at NOC.Fusion@dhs.gov.

The FBI regional phone numbers can be found online at www.fbi.gov/contact/fo/fo.htm.

For information affecting the private sector and critical infrastructure, contact the National Infrastructure Coordinating Center (NICC), a sub-element of the NOC. The NICC can be reached by telephone at 202-282-9201 or by e-mail at NICC@dhs.gov.

When available, each report submitted should include the date, time, location, type of activity, number of people and type of equipment used for the activity, the name of the submitting company or organization, and a designated point of contact.

[stcommodore]

more importantly why do your memos end with "ems command" and mine "by orders of the fire commisioner"

[p3medic]

Thanks I had no idea that I didn't get west nile from a person. must have been those dang misquitoes. And it was a huge thing here.

"Huge" is a relative term. Millions of people have died from influenza, I don't think West Nile even comes close. Just saying. We have it here too, along with EEE, mosquito's suck, but DEET works. Influenza is a far bigger public health threat.

[Just Plain Ruff]

The WHO has just today increased the pandemic level from 4 to 5 which is pretty big.

The other thing that the WHO is saying is that it's not to the level of closing borders.

Just please wash your hands, brush your teeth(to those out there with bad breath) and keep your uniform separate from your families clothes when you wash.

If you feel ill like the flu don't go to work. Stay home and keep away from the family.

I'm extra vigilant based on our pregnancy.

[FireMedic65]

http://doihaveswineflu.org/

nuff said

[tskstorm]

http://doihaveswineflu.org/

nuff said

ahahahahahaaa