March 7, 2022 – The first comprehensive nationwide assessment of emergency medical services (EMS) guidance issued in response to the COVID-19 pandemic reveals that while there was great variability in the development and dissemination of protocols to protect frontline emergency responders and their patients, most states and territories surveyed provided some level of direction.
Still, nearly 2 out of every 5 states or territories did not make their guidelines accessible online, according to a survey led by a University of Pittsburgh School of Medicine physician-scientist and published this week in the Journal of the American College of Emergency Physicians Open. It details successes and gaps in EMS guidance that can be used to help U.S. state and territory EMS offices in preparing for future infectious diseases emergencies.
States and territories without specific guidance provided less comprehensive information to frontline EMS agencies, including lack of recommendations for how to perform cardiac arrest resuscitation and when to stop, as well as care of special populations, such as children, despite these topics receiving significant media attention.
In the first phase of their study, the team examined publicly available documents in 50 states, the District of Columbia and five territories to learn about the development of COVID-19 guidance and protocols for EMS clinical management and operations. They found that while the majority had easily accessible EMS protocols posted online, a sizeable minority – 37% — did not.
In the second phase, the study team interviewed state EMS officials using a standardized survey tool. They were asked to verify whether their state had mandatory EMS protocols or recommended guidance, and whether the pandemic prompted their state or territory to issue COVID-19 specific guidance or make changes to clinical or operational protocols. Among the officials interviewed, 64% said their state or territory issued either formal protocol changes or specific guidance for the pandemic.
Interestingly, the research team points out the presence of existing EMS protocols or recommended guidelines was not associated with increased likelihood of states issuing COVID-19-specific guidance. To plan for future waves of COVID-19 and other pandemics, the research team says that additional work should correlate state- and territory-level guidance with COVID-19 clinical and operational outcomes. This would inform whether guidance was effective in impacting EMS response and service to communities during public health emergencies.