Tag Archives: paramedics

Community paramedics help medically complex homebound avoid hospitalization

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic leader on aging. Her work has appeared in NextAvenue.com, Journal of Active Aging, Cancer Today, Kaiser Health News and other outlets. She is a senior fellow at the Center for Health Policy and Media Engagement at George Washington University and co-produces the HealthCetera podcast.

Photo: Liz Seegert/AHCJBernard Cunniffe, shown with his wife Beverly, was assisted by his city’s Community Paramedics initiative after an accident.

Photo: Liz Seegert/AHCJBernard Cunniffe, shown with his wife Beverly, was assisted by his city’s Community Paramedics initiative after an accident.

When 84-year old Bernard Cunniffe fell in the bathroom one morning, his wife called the paramedics. However, rather than transporting the retired NYPD officer  to the emergency department, the specially-trained responders assessed him for trauma, evaluated his vital signs and settled him into his bed.

Cunniffe, who is homebound because of multiple medical conditions, was uninjured but had low oxygen saturation, the likely cause of the fall. The community paramedics quickly stabilized him in consultation with an on-call physician and avoided a trip to the hospital. The Cunniffes were thrilled with the experience. Continue reading

6-foot rule separates San Diego paramedics, H1N1

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Voice of San Diego’s Randy Dotinga explains exactly how the fear of H1N1 has transformed every step of the health care delivery process in the Southern California city, which has been hit particularly hard by the virus. Dotinga focuses on how paramedics’ routines have changed. “To protect themselves,” Dotinga writes, “paramedics are essentially using the same precautions they would against infectious tuberculosis – something they hardly ever see.”

Dotinga says the changes become evident as soon as the paramedics arrive on the scene. Before H1N1, they’d walk right up to the patient. Not anymore.

Photo by Fetchy via Flickr.

Now, paramedics across the county adhere to a “Six-Foot Rule” when they suspect a patient has a respiratory illness. “If you’re six feet away even without your protective equipment for a short period of time, you’re not likely to get infected,” said Haynes, the county official.

If a patient has possible flu symptoms, the paramedics put on N95 respirators. They began wearing the respirators instead of ordinary masks about a month ago. Paramedics will put on eye shields too. Many paramedics hate to wear them, and forget to put them on.

In this environment of extreme care, not even the ambulances are left to go on as usual. These days, in addition to their regular regimen of extreme sanitation, they visit a nearby fire station a few times a month. There, they are nailed with a super-powered germicidal fog that ensures no microbes, nefarious or otherwise, are going to linger for long.

Does the six-foot rule really work? What about masks?

Maybe. Your view of the effectiveness of social distancing likely depends on where you stand on a particularly contentious issue: airborne vs. droplets. If influenza is spread primarily through droplets (as the CDC says it does here, and here), then it’ll have a tough time spreading beyond three feet unless it’s smeared on a surface. In this case, then, the six-foot rule is an effective way to slow the spread of the virus, as are masks.

If, however, you believe the virus is airborne then it would be able to cross the six-foot gap and you would need, at the very least, an N95 respirator (a mask which filters out at least 95 percent of airborne particles) to protect yourself. In this case, though, it’s important to note that according to some recent research, an N95 won’t offer any more protection than a regular mask.

According to the Institute of Medicine, we haven’t yet heard the final word on influenza transmission and further research is required (PDF). In the meantime, most providers are erring on the side of caution. Check out AHCJ’s primer on controlling pandemic flu for further information.

(Hat tip to AHCJ board member Maryn McKenna for pointing us in the right direction.)