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DATE: April 15, 2020

TO: All Employees

FROM: Asad Ahmadzaa, President, Diamond Cab Company, Inc.

SUBJECT: COVID-19 Safety Procedures

To reduce risk and maximize safety, all Diamond Cab Company employees providing rides should follow the guidance in this document.

General Guidance

  • Sanitize frequently touched surfaces, areas, and objects, such as door handles, seats, and seat belts, before transporting another client. Wear disposable gloves during cleaning and then dispose of after each use.
  • Make facemasks readily available for patients if a client is sick or is caring for someone who is sick.
  • Both compartments’ air circulation should be turned off to maximize air changes that reduce potentially infectious particles in the vehicle.
  • Outside-air vents must be open in the driver compartment when transporting clients.
  • Wearing a single pair of disposable patient examination gloves should be implemented, and changing gloves if they become torn or contaminated, in addition to changing gloves between car rides.
  • Make sure to sanitize your hands often with soap and water. Use alcohol-based sanitizers with at least 60 percent alcohol on occasions you are unable to wash your hands.
  • Avoid frequently touching your eyes, nose, or mouth with your hands at all times.
  • Stay home when you are sick.
  • Cover your mouth with a tissue or clean cloth when coughing and/or sneezing, and dispose of the material immediately.
  • Get enough hours of rest, drink at least 8 glass of water a day, eat healthy foods, and manage your stress or avoid it as much as possible.

Vehicle Cleaning and Disinfecting to Prevent Spread of COVID-19

Cleaning Transport Vehicles

Employees should clean and disinfect any surfaces that a passenger may touch. The following are general guidelines for cleaning or maintaining transport vehicles and equipment for passenger transport:

  • You must leave the rear doors of the transport vehicle open after transport to allow for enough air changes to exterminate infectious particles. The completion of the patient transfer to the receiving facility and all documentation should promptly provide sufficient air changes.
  • Wear a disposable gown and gloves when cleaning the vehicle. Wearing a face shield or facemask and goggles should be implemented if splashes or sprays during cleaning are anticipated.
  • Ascertain that environmental cleaning and disinfection procedures are followed consistently and correctly, including adequate ventilation when chemicals are in use. Doors should remain open when cleaning the vehicle.
  • Sanitize and disinfect the vehicle. All surfaces or areas that may have come in contact with the patient or materials contaminated during patient care should be strictly and thoroughly cleaned and disinfected using an EPA-registered hospital-grade disinfectant following the product label.
  • Always sanitize and disinfect reusable patient-care equipment before use on another patient, according to the manufacturer’s instructions.

Detailed guidelines for cleaning and disinfecting surfaces

Hard (non-porous) surfaces

  • When cleaning and disinfecting areas and surfaces, wear disposable gloves. Gloves used should be discarded after each cleaning. Wash hands immediately after gloves are removed.
  • Surfaces should be cleaned using a detergent or soap and water before disinfection if they are dirty.
  • Use a product from the list of products approved by the EPA that are effectively working against COVID-19 to disinfect surfaces.
  • Follow the manufacturers’ instructions for all cleaning and disinfection products and procedures, including application method, correct concentration, contact time, etc.
  • Furthermore, diluted household bleach solutions are recommended to be used if appropriate for the surface. Follow the manufacturer’s instructions for application.
    • Ensure the product is still usable and is unexpired.
    • Allow proper ventilation during and after application.
    • Ascertain a contact time of at least one minute.
    • Do not ever mix household bleach with ammonia or any other cleanser. Household bleach that are not yet expired will be effective against coronaviruses when properly diluted.
  • Prepare a bleach solution by mixing:
    • 5 tablespoons bleach per gallon of water or
    • 4 teaspoons bleach per quart of water

Soft (porous) surfaces

  • Remove visible contamination for soft surfaces such as rugs, carpeted floors, and drapes, if present. Always sanitize with appropriate products that are EPA-approved for use against the virus that causes COVID-19 and that are suitable for porous surfaces.

Electronics

  • Electronic devices such as tablets, cell phones, remote controls, touch screens, and keyboards, you must remove visible contamination if present.
    • Follow the manufacturer’s instructions for all cleaning and disinfection products and procedures.
    • Consider using wipeable covers for electronics.
    • If the manufacturer guide book is present, consider using alcohol-based wipes or sprays containing at least 70% alcohol to disinfect touch screens. Thoroughly dry surfaces to avoid the pooling of liquids.

Personal protective equipment (PPE) and physical distancing protocols during medical transport

Recommended personal protective equipment (PPE)

  • Follow Standard Precautions when transporting a patient with a possible COVID-19 infection, and use the PPE as described below.
    • N-95 or a higher-level respirator; or facemask (if a respirator is unavailable). N-95 respirators or other respirators offering a higher level of protection should be used instead of a facemask when performing or present for an aerosol-generating procedure.
    • Eye protection such as disposable face shield or goggles fully covering the front and sides of the face. Eyeglasses or reading glasses and contact lenses are NOT eligible for eye protection.
    • Using a single pair of disposable patient examination gloves should also be strictly implemented. Immediately change to new pair of gloves if they become torn or heavily contaminated.
    • If there is a shortage of isolation gowns, they should be prioritized for care activities where splashes and sprays are anticipated, aerosol-generating procedures, and high-contact patient-care activities providing opportunities for transfer of pathogens to the hands and clothing of clinicians (e.g., changing positions, moving a patient onto a stretcher, etc.).
  • When an adequate supply is restored, fit-tested clinicians should again use N-95 (or better) respirators for patients with known or suspected COVID-19.
  • If drivers are providing direct patient care (e.g., moving and transferring patients onto stretchers), wearing all recommended PPE should be applied at all times.
    • The driver should remove and dispose of PPE and perform hand hygiene after completing patient care and before entering an isolated driver’s compartment to avoid soiling the compartment.
    • The driver should remove the gown, gloves, and face shield or goggles, and perform hand hygiene if the transport vehicle does not have an isolated driver’s compartment. A facemask or respirator should be continually used during transport.
  • After the patient is released to the facility upon arrival, staff must remove and discard PPE, and perform proper hand hygiene. The used PPE should be discarded under routine procedures.