Developed by the Healthcare Resilience Task Force Behavioral Health Work Group; and adapted by the Prehospital (911 and Emergency Medical Services [EMS]) Team
This guidance applies to all delivery models including, but not limited to, free-standing, third-service, fire-based, hospital-based, independent volunteer, and related emergency medical service providers.
Day-to-day operations for Emergency Medical Services (EMS) in the prehospital care setting can cause stress and anxiety under normal conditions. During an emerging infectious disease outbreak, such as COVID-19, the number of individuals experiencing distress — and the intensity of that stress and anxiety — may be significantly amplified. This stress and anxiety can contribute to unwanted patient behaviors, increased calls from those who are anxious but not in need of emergency care, and a reluctance to follow guidance from EMS or other health care clinicians, which may ultimately contribute to an increase in mortality and morbidity. This section contains strategies that may be helpful in reducing patient and family stress.
The expected surge of health care utilization brought on by an infectious disease outbreak may make it necessary for EMS to modify their usual care practices. These modifications may be in direct contrast to the expectations that patients and families have about prehospital care and other health care and may therefore make their experience even more distressing. Listed below are steps that EMS clinicians and their medical directors can take to help patients and their families manage this distress more effectively. EMS clinicians are encouraged to adapt recommended actions based on their agency’s individual needs and practical considerations (eg, limited resources and staff) as approved by the medical director.
Patients may be scared for themselves or others and may feel guilty or stigmatized. They may be worried about not only practical issues (eg, who will take care of their dependents or pets, how bills will get paid, whether they will lose their job), but also if they will die from COVID-19.
While in-person visits may not be possible, consider ways that patients can stay in contact with their social support systems (eg, family, friends, or spiritual support system).
The National Child Traumatic Stress Network’s “Parent/Caregiver Guide to Helping Families Cope With the Coronavirus Disease 2019”