COVID-19 Operations & Training Guidance

TMRU COVID-19 Training Guidance

Updated: 7/06/2020

State SAR Coordinator

“Per the State SAR Coordinator … –if you practice safe social distancing and proper PPE you may train in groups of 5.,…I think that could go to 6 to provide even carries as long as all other NPI were followed. I suggest you have a ‘safety’ person designated to watch the distance and PPE/NPI use.”  ~ Norma Pancake, Pierce County EMS Office, May 18, 2020,

Pierce County

WA State for Volunteers

Cleaning and Disinfecting

WA Department of Health – 2019 Novel Coronavirus Outbreak

Center for Disease Control – Coronavirus (COVID-19)


Any TMRU team members that are involved with a potential or known COVID-19 patient should inform the Medical Director, Dr. Ben Constance.

For more information contact: Dennis Eller, TMRU Training Chair,

TMRU COVID-19 Operations Guidance

Updated: 5/08/2020

Based on the increasing threat of COVID-19 and limiting potential impacts and exposure, TMRU will be following the following best management practices until further guidance from County, State, or Federal resources.

Responding to Missions:

  • Do not respond to missions if you exhibit any symptoms of COVID-19, Flu or cold. These include:
    fever (temperature above 100°F), dry cough, shortness of breath, chills, muscle pain, sore
    throat, new loss of taste or smell.
  • Reconsider missions with a potential COVID-19 patient if you are in a high-risk category. This will
    mostly apply to walk away type of missions.
  • If you believe you are at risk from exposure to COVID-19 and are within your 14-day quarantine
    window, do not respond to missions.
  • Bring and wear a cloth face mask and clear eye protection.
  • Avoid sharing common items such as: clipboards, sign in pens, etc.
  • Plan to transport yourself. Team trucks are limited to 2 operators maximum per vehicle.

During Mission:

  • If a patient presents with respiratory distress or fever in line with COVID-19 signs and symptoms,
    the SAR team will use the following safety measures:

    • Give the patient a surgical mask (non-N95).
    • Wear a mask (surgical or N95), eye protection and gloves while interacting with the
    • Limit engagement with the subject to 1x provider with the highest level of training.
    • Utilize EMTs as much as possible for patient care and handling and hand-off to EMS as
      soon as possible.
  • ITC will ask dispatch or IC if they have asked COVID-19 screening questions. If not, the STL will
    ask the subject upon contact.
  • Maintain 6 feet of separation between rescuers as much as possible.
  • Teams will depart with the following PPE per rescuer. This PPE will not be used until the subject
    is contacted (this gear is in addition to normal rescue gear).

    • Mask (surgical or N95)
    • Eye Protection
    • Nitrile or latex gloves
    • Plastic bag (for post mission clothes gathering)
  • Upon contact with the subject TMR will use the following protocol:
    • Only 1 team member will approach the subject. This team member will don PPE.
    • Conduct interview at least 6’ from subject.
    • Require the subject to don a mask.
      • Provide a surgical mask for the subject and ask the subject to put it on.
      • If the subject refuses, explain that it is for the safety of the rescuers.
      • If subject continues to refuse verify subject is oriented to person, place and time
        to establish conscious refusal and notify IC.
      • Notify the IC that the subject’s actions are impacting rescuer safety and that the
        team is unable to safely continue.
    • Initial rescuer will notify team of required assistance. Additional rescuers assisting with the subject will don PPE.
  • Upon transfer to EMS, if EMS personnel need assistance, then assistance should be limited to
    those rescuers that have had contact with the subject.
  • After transferring the subject to higher care and before returning from the mission personnel

    • Doff disposable PPE and place in a plastic bag for disposal.
    • Doff outer layers as much as possible and place into a plastic bag to launder at home.
    • Sanitize hands using hand sanitizer or hand soap.
    • Don a cloth mask.

Post Mission:

  • If TMRU members respond to a COVID-19 patient without proper PPE it is recommended that
    they seek medical advice from their provider and consult the WA Health Department regarding
    quarantine and testing recommendations.
  • Team Leaders will provide detailed notes detailing involvement with the patient and handling,
    as well as a roster to the Medical Director at the completion of any mission involving a potential
    or known COVID-19 subject.
  • Any equipment that had exposure to the patient will be cleaned using a disinfectant per CDC
    disinfection guidelines (link below)
  • Personnel will wear gloves. Goggles will be worn if there is anticipated splash back from
    cleaning.At the completion of all missions, team members will wipe down commonly touched surfaces
    and equipment utilizing disinfectant cleaner before leaving the cache.
  • It is recommended that rescuers shed clothes used during the mission upon returning home and
    immediately shower.

TMRU members may deviate from these protocols if the deviation is necessary to save life, limb or
eyesight and if there is no reasonable alternative to the deviation. The STL, in coordination with the IC, is
the only authority authorized to approve any deviations.

Any TMRU team members that are involved with a potential or known COVID-19 patient should inform
the Medical Director, Dr. Ben Constance. He will assist with communication with providers, help initiate
L&I coverage if possible and work with follow-up through the Health Department.

If you have any questions or concerns, please let me know.

For more information contact: Justin Ramsey, TMRU Operations Chair,


King County EMS COVID-19 Lecture

Cleaning and Disinfecting

WA Department of Health – 2019 Novel Coronavirus Outbreak

Center for Disease Control – Coronavirus (COVID-19)