COVID-19 PPE Supplies
This survey is being disseminated by Maine EMS in collaboration with the Maine Center for Disease Control and Prevention. It is intended to better understand the current supplies on-hand at licensed-EMS agencies throughout the State of Maine. We kindly ask that ONE individual from each service complete this survey with the most accurate information available.
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EMS Agency/Service and Respondent Information
Service Name *
If your agency is not listed above, please provide the agency name:
Name of Person Completing the Survey *
Best Telephone Number *
Best Email Address *
How many providers do you currently have working for your service?
Which medical supply organizations are you utilizing to source your PPE supplies?
Personal Protective Equipment Inventory
Number of N95, or higher, masks on hand
Number of Small N95 Masks
Number of Medium N95 Masks
Number of Large N95 Masks
Number of Extra Large N95 Masks
Have you attempted to order additional N95 masks since Jan. 24, 2020?
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Have you had any difficulties securing N95 masks since Jan. 24, 2020?
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If so, were you able to resolve those difficulties and have your order fulfilled?
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Does your service have access to powered air purifying respirators (PAPRs)? (PLEASE NOTE: Maine EMS, ME CDC, and U.S. CDC are NOT recommending the use of PAPRs vs. N95 masks for management of COVID-19 patients in the EMS environment)
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If so, when was the last time that staff had training on the use of these devices (including donning and doffing)?
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How many PPE gowns do you currently have on hand (estimations are acceptable)? (Please provide individual number not boxes, for example if there are 20 in a box and you have two boxes then you would enter 40 into the response area)
How many simple masks does your agency have on hand (estimates are sufficient)?
Have you received a copy of the Maine EMS Clinical Bulletin regarding COVID-19?
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What Maine EMS Region is your service in? *
Do you permit Maine EMS to share this information with your Regional Office? (Please note that this information is not exempt from a FOAA request) *
What county is your primary response area? *
Do you permit Maine EMS to share this information with your county's Emergency Management Agency (EMA)? (Please note that this information is not exempt from a FOAA request) *
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