2020 Covid-19 Regional Questionnaire

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The Regional Medical Directors are asking that you take a moment to fill out the following form. In this ever changing time, we, your medical directors, want to ensure that all guideline updates, PPE policies, and general health of our EMS providers are being met. This short survey allows us the opportunity to get feedback directly from you, the front line provider. Thank you for your time, and as always, please be safe and thank you for the professional patient care you all continue to provide during these uncertain times.

Agency *

Are you currently wearing Coronavirus appropriate PPE with EVERY patient interaction?

YES

Clear selection

Which combination of PPE are you wearing as you respond to alarms?

normal PPE (as before the Coronovirus outbreak)

non-N95 mask (paper or cloth)

N95 mask and traditional eye protection

N95 mask and Covid-19 specific eye protection (goggles, shield, etc)

N95 mask, traditional eye pro, and gown (some sort of disposable body protection)

N95 mask, Covid-19 specific eye protection, gown

Some other combination

Clear selection

Have you been briefed and have you/your agency implemented the Covid-19 patient screening guidelines?

YES, I am using them.

YES, Im aware of it, but my agency has not implamented it.

Clear selection

Have you been briefed and have you/your agency implemented the current patient interface procedures? These include the having only 1 provider touching/assessing the patient, maintaining 6 feet distance from patient when possible, encouraging patients to come outside or into an open space.

YES, I am following these guidelines.

YES, I am aware, but have not implemented these procedures.

Clear selection

Have you been briefed on the Transfer of Care guidelines and how they relate to pt hand-off at the hospital, and dealing with nursing and long term health care facilities?

YES, I am following these guidleines

YES, I am aware, but have not implemented these.

Clear selection

If you answered NO to either of the previous 3 questions, are you aware of who you can contact to receive this information?

YES

Clear selection

Have you been briefed on the current Cardiac Arrest changes?

YES

Clear selection

Do you have substantial concerns regarding these changes?

YES

Clear selection

If you answered YES to the previous question, do you have a point of contact to address these concerns?

YES

Clear selection

Do you have reservations, concerns regarding your access to appropriate PPE, guideline changes, and all Covid-19 updates? If so, please briefly address them below.

Submit

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