This page provides strategies that emergency medical services (EMS) providers may find helpful to reduce patient and family stress in the prehospital environment.
Day to day operations for 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 healthcare clinicians, which may ultimately contribute to an increase in mortality and morbidity. This document contains strategies that may be helpful in reducing patient and family stress.
The expected surge of healthcare 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 with the expectations that patients and families have about prehospital care and other health care, and 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 agencies' individual needs and practical considerations (e.g. limited resources and staff) as approved by the medical director.
Patients may be scared for themselves or others, may feel guilty, stigmatized, or may be worried about not only practical issues (e.g., who will take care of dependents or pets, how will bills get paid, will they lose their job), but also if they may die from the COVID-19.
I want my family to go to the hospital with me.
It's normal to feel scared in this situation and it’s important for you to connect with your family but at this time it is safer for them to stay home while we take you to the hospital.
If local hospitals have policies in place to not permit family or visitors in the hospital, explain that as well.
While in-person visits may not be possible, consider ways that patients can stay in contact with their social support system (e.g., family, friends, spiritual support). Consider strategies to promote social support for these populations:
If transporting alone to healthcare facility
If patient assessed and determined not to need transport
This guidance was developed by the Federal Healthcare Resilience Task Force (HRTF). The HRTF is leading the development of a comprehensive strategy for the U.S. healthcare system to facilitate resiliency and responsiveness to the threats posed by COVID-19. The Task Force's EMS/Pre-Hospital Team is comprised of public and private-sector EMS and 911 experts from a wide variety of agencies and focuses on responding to the needs of the pre-hospital community. This team is composed of subject matter experts from NHTSA OEMS, CDC, FEMA, USFA, U.S. Army, USCG and non-federal partners representing stakeholder groups and areas of expertise. Through collaboration with experts in related fields, the team develops practical resources for field providers, supervisors, administrators, medical directors and associations to better respond to the COVID-19 pandemic.
Primary Point of Contact: NHTSA Office of EMS, email@example.com, 202-366-5440