SIPTU representatives have met with National Ambulance Service (NAS) management to discuss the concerns raised by some SIPTU members in the preparation and planning stages of dealing with any outbreak of coronavirus disease (Covid-19) on the island of Ireland.
Nationally, the National Crisis Management team are giving regular updates and information to the group of unions.
The meeting exclusively focused on the NAS frontline staff and discussed the training, information, support and equipment in place for ambulance professionals.
Below is an update from SIPTU representatives on foot of our engagement this morning.
Should members have any concerns or require further information please raise them in the first instance with your manager and contact the union if needed to raise them with the Senior Leadership Team who will discuss this developing situation with your union.
SIPTU representatives asked NAS management to outline what training is being given to staff to prepare them to deal with cases of coronavirus.
- Management confirmed that all frontline staff are trained in infection control.
- In addition to online training and information videos, the National Ambulance Service College is providing training on donning and doffing Personal Protective Equipment (PPE).
- Education officers and instructors are visiting all areas with the kit to train people in their use.
- The education officers will bring SIPTU members through video links and various algorithms to deal with actual or suspected cases of coronavirus, both for patients or themselves. All information will be available through Moodle.
- Any gaps which exist in face to face training will be given priority and people who believe there is a training deficit need to communicate their concerns to their line manager in order to be provided with training as a matter of priority.
Management were asked to confirm that the Personal Protective Equipment required to deal with coronavirus is in place, is appropriate for use and is of a sufficiently high standard to protect staff health and safety.
- Management confirmed that all equipment meets all guidelines and has been sourced for NAS through the HSE National Procurement system.
- Management confirmed that coronavirus, a category B1 disease, can be responded to with the contents of the prepared kits which have been distributed to areas which include an apron, goggles, masks, hand sanitiser.
- Each vehicle will have three kits and crews are asked to check the three kits are there at the start of each shift. Should you use any of the kits during a shift, you need restock your kits again before being sent to any other possible coronavirus case. All vehicles (ICVs, RRVs and Emergency Ambulances) will receive these kits.
- Hundreds of these kits have been distributed in recent days with additional kits being stored centrally to be distributed to areas as stock levels run low.
- Management say they are confident there are no issues with stock levels or sourcing of additional stock now or going forward. The increase in the cost of the contents of the kit will not affect the stocking of same.
- In relation to the specific concern some workers have that Tyvek suits are not being used, management confirmed that waterproof aprons are being issued as they are more suitable as they are droplet-resistant, whereas Tyvek suits are not.
- In line with the European Centre for Disease Prevention and Control requirements, the NAS are issuing staff with FFP3 respirators which conform to EN149 standard. These are in the kits. Patients are issued with a fluid repellent surgical mask in the kit. The masks for patients and staff differ as the surgical mask is required to protect against the exhaling patient, while the FFP3 is to protect the inhaling staff member.
The union side raised an issue with the goggles as they mist after prolonged use.
The union side queried the circumstances in which a crew or sole responder will be sent to a possible coronavirus case.
- Management confirmed no worker will be sent to a possible coronavirus case without first being advised that this is a suspected or confirmed case.
- NEOC will elevate every query re possible coronavirus to Public Health first who will assess if an ambulance needs to be sent.
- Public Health will also liaise with the receiving hospital.
The union cited a couple of examples from recent days where the hospital did not have this information and NAS management are examining the circumstances with Public Health.
SIPTU representatives stressed that the call volume will increase in relation to possible or confirmed cases of coronavirus and it will have an impact on the workload of staff in the NAS.
- Management confirmed they will allocate additional resources including overtime, making officers available to work cases and extra Rapid Response Vehicles (RRVs).
Possible Expansion of work of NAS
The Department of Health is currently considering options to test people in their home for coronavirus, to avoid transporting people unnecessarily in an ambulance to an emergency department unless the patient is acutely unwell and requires going to the hospital.
- For home testing to happen, the Department of Health are considering options, including Paramedics and Advanced Paramedics in the National Ambulance Service testing patients at home.
- This would involve two swabs, throat and nose, and packaging the sample to send away for testing.
- Management will seek expressions of interest from people who would work in RRVs to conduct these tests, should the Department of Health opt for the NAS to perform this service.
- Training would be provided to those interested.
- Nobody will be compelled to perform this training or to do the swabbing, though they would be required to transport a patient in an ambulance vehicle who had or was suspected of having coronavirus.
- In the case of home testing, the patient would remain in their home following the test unless based on the environmental assessment of the practitioner they required transportation to hospital.
This situation is evolving and while management have plans for further escalations should the time come, at this point the training, information and equipment outlined above is deemed acceptable to keep staff safe.
Management commit to appraise SIPTU representatives of all developments and to meet regularly to address members concerns.