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CCG/6102 National Standard Operating Procedure (NSOP)
502 COVID-19 - Instructions for Rescue Specialist and Marine First Responders in Assisting a Suspected COVID-19 Patient

Original: 2020-03-20 Revised: 2021-03-29 Approved by Daniel Breton, Director General, Response, on March 29, 2021.

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502 COVID-19 - Instructions for Rescue Specialist and Marine First Responders in Assisting a Suspected COVID-19 Patient
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Purpose

The purpose of this national standard operating procedure (NSOP) is to outline the steps to be followed when a rescue specialist or marine first responder is tasked to a marine or search and rescue incident during the COVID-19 pandemic, with suspected cases of COVID-19.

This NSOP should be used in conjunction with, and to augment, existing rescue specialist and marine first responder's protocols and procedures.

Procedures

All personal information collected is to be managed according to Protected B protocols.

Procedures for screening and hailing
Step Procedures
1.
  1. Marine Communications and Traffic Services (MCTS) / Joint Rescue Communication Centre (JRCC) / Marine Rescue Sub-Centre (MRSC) will carry out screening previous to the tasking phase as best as practicable and as the distress phase dictates.
  2. Confirm with MCTS, JRCC or MRSC that screening has been completed.
2.
  1. On-scene screening may be required if there is incomplete information, lack of initial screening, or to validate initial screening information.
  2. Screening questions should be directed to the master of the subject vessel.
3.
  1. Screening questions:
    • 1.1. What are the concerning signs or symptoms? Do they fall within known COVID-19 symptomsFootnote 1?
      • Fever alone (37.5 °C and above) or in combination with any of the following:
      • New or worsening cough
      • Shortness of breath or difficulty breathing
      • Temperature equal to or over 37.5 °C
      • Feeling feverish
      • Chills
      • Fatigue or weakness
      • Muscle or body aches
      • New loss of smell or taste
      • Headache (new, persistent, unexplained, unusual or long-lasting) (not related to other known causes or conditions)
      • Gastrointestinal symptoms (abdominal pain, diarrhea, vomiting)
      • Feeling very unwell

      (Children tend to have abdominal symptoms and skin changes or rashes. Symptoms may take up to 14 days to appear after exposure to COVID-19.)

    • 1.2. Has the patient travelled from or transited through a location with confirmed COVID-19 in the past 14 days?
    • 1.3. Has the patient been in close contact (respiratory fluids contact possible) with a suspected case of COVID-19 or close contact with someone who has travelled from or transited through a location with confirmed COVID-19 in the past 14 days?
4. Conduct radio medical as per existing procedures
5.
  1. Answers from these questions must be logged and reported to the local telemedical assistance services (TMAS) supporting physician and JRCC/MRSC.
  2. The decision to proceed requires consultation with JRCC/MRSC and TMAS.
6. Emergency response must only take place once the crews have the appropriate personal protective equipment (PPE).
Procedure for pre-boarding
Step Procedure
1.
  1. Conduct pre-job safety assessment, take all necessary precautions to mitigate exposure.
  2. Donning and doffing of PPE must occur in an area separate from patient location to minimize the risk of contact with the patient or any other personnel on board.
2.
  1. The patient must be isolated on the subject vessel or quarantined on board the responding vessel.
  2. Any area chosen for quarantine must be decontaminated in its entirety.
    See NSOP 518 COVID-19 – Cleaning and Disinfection Routine of the Workplace.
Procedure for donning PPE
Step Procedure
1.
  1. Wash hands before donning PPE.
  2. Inspect PPE for suitability; damaged PPE should be replaced.
  3. Appropriate COIVD-19 PPE includes :
    • gloves
    • long-sleeved gown or disposable coverall (for example, TyvekFootnote 2)
    • procedural or surgical mask
    • eye protection (face shield or goggles)
    • boots (rubber boots recommended for easy cleaning)

    Note:

    N95 mask is required when providing direct care to COVID-19 patients in settings where aerosol-generating procedures are frequently in place. Aerosol-generating procedures are: tracheal intubation, non-invasive ventilation, tracheotomy, cardiopulmonary resuscitation, manual ventilation before intubation, bronchoscopy.Footnote 3

  4. Don PPE as recommended to ensure adequate protection.
2. Put on long-sleeved gown or disposable coverall (for example: Tyvek).
3. Put on face mask and eye protection.
4. Put on gloves, ensuring no gaps between gloves and sleeves (you may make thumb hole in PPE sleeve and cover with glove).
5. Have a “buddy” inspect the donned PPE to ensure adequate coverage and no seal gaps.
Procedure if rescue specialist or marine first responder is informed that a person suspected to have COVID-19 on board a CCG vessel or in a remote location
Step Procedure
1. Rescue specialist or marine first responder to don appropriate PPE (see procedures for donning PPE above) and conduct initial patient assessment (if possible, in a room with a bathroom in case the patient has to be isolated).
2. Provide a mask to the patient, as appropriate, by placing it in arm's reach of the patient if possible. Observe that the patient dons the mask appropriately.
3. Record vital signs. If COVID-19 symptoms are observed, place patient in isolation area immediately, with a bathroom if possible (if no bathroom, patient must don procedural or surgical mask to exit isolation). Rescue specialist or marine first responder will continue to monitor.
4. Exposure of any crew with patient must be limited and meals with disposable packaging are to be dropped off (refer to NSOP 518 COVID-19 - Cleaning and Disinfection Routine of the Workplace).
5. Rescue specialist or marine first responder to decontaminate themselves and discuss further actions with the commanding officer and local TMAS provider.
6.
  1. If it is determined that the patient must disembark the vessel, the patient must wear a procedural or surgical mask at all times and be confined to only necessary areas for departure.
    • 1.1. Departure by fast rescue craft (FRC): in addition to regular appropriate floatation, crew must don appropriate PPE (see above). FRC must be disinfected after use
    • 1.2. Departure by CCG helicopter: in addition to regular helicopter PPE, crew must don appropriate PPE (see above). Helicopter must be disinfected after use
7. Once alongside, depending on severity of the patient's condition, a pre-arranged ambulance should be notified of a patient who is suspected to have COVID-19, and requirement for transport to the hospital. Otherwise, follow NSOP 505 COVID-19 - Seagoing Personnel and follow reporting procedures.
Procedure for decontamination of rescue specialist or marine first responder
Step Procedure
1. Carefully remove PPE as per protocols and procedures using universal precautions and practicing hand sanitization between each piece of PPE. Remove PPE in an open area that may be easily cleaned after removal.
2. Remove floatation and place in secondary bag, wash following manufacturers instructions.
3. Untie gown or unzip suit.
4. Remove gloves without touching any area that is likely to become infected, deposit in garbage bag. Practice hand sanitization.
5. Remove gown or Tyvek. Deposit in garbage bag. Practice hand sanitization.
6. Remove goggles/face shield and place in secondary bag, wash following manufacturers instructions. Practice hand sanitization.
7. Remove face mask, deposit in garbage bag. Practice hand sanitization.
8. Shower as soon as possible.
9. Clean and disinfect all reusable PPEs and contaminated areas in accordance with cleaning protocols.
Procedure for disposal of PPE
Step Procedure
1. The final disposal of all materials must be in accordance with Fleet Safety Manual 7.E.6 Handling and Discharge – Solid WasteFootnote *.
2. Decontamination team to remove own PPE (in accordance with procedure above), wash clothes and shower.

Refer to NSOP 518 COVID-19 - Cleaning and Disinfection Routine of the Workplace.

It is normal to be concerned about the COVID-19 pandemic, especially if you or those you know are directly affected by the situation. If you have concerns and would like to speak to someone, contact the Employee Assistance Program (EAP) at 1-800-268-7708 and/or speak directly to your supervisor.

Enquiries

Enquiries regarding this procedure should be directed to:

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