Exposure Risk Assessment and Management of Pre-hospital Paramedics During the COVID-19 Pandemic

Background: Pre-hospital paramedics providing immediate care to patients with contagious disease are at a high risk of infection. This study aimed to assess the exposure risk and risk management practices of pre-hospital paramedics during the COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted among 335 paramedics from 49 emergency medical stations in two cities located in northwestern of Iran, who were recruited through census. Data were collected using a World Health Organization (WHO) questionnaire to assess the COVID-19 exposure risk among health workers. Results: The results showed that the highest risk of exposure (86.0%) was in the domain of occupational exposure, and 55.2% of paramedics were at high risk of exposure to COVID-19. Among paramedics, 95.2% used personal protective equipment (PPE) when caring for patients and 93.1% when performing aerosol-generating procedures. Conclusion: A significant number of pre-hospital paramedics were found to be at high exposure risk to COVID-19 during ambulance missions. Therefore, adherence to contact and droplet precautions, implementation of airborne precautions during aerosol-generating procedures, access to appropriate PPE, proper use of PPE, and participation in appropriate training courses may lead to improved exposure risk management and enhance their safety.