A Scoping Review of EMS and Emergency Department Worker Masking Behaviors

Introduction: Emergency Department (ED) and Emergency Medical Services (EMS) workers are regularly exposed to undifferentiated patients during daily work activities. Patient encounters often occur before the full elucidation of the patient’s symptoms. As such, it may be supposed that ED and EMS workers are regularly exposed to respiratory illnesses and pathogens prior to clinicians being aware of the risk of exposure. This review sought to assess the literature about the masking behaviors of EMS and ED workers. Methods: A literature review was conducted using key terms to look at ED and EMS populations. Terms focused on papers with respiratory surveillance data and masking behaviors. Papers written in English were included. 577 papers were included per the search terms, and nine were eligible for data extraction. Results: Eight papers from 2020-2022 focused on the COVID-19 pandemic. One paper from 2015 studied MERS exposure in an ED. Three papers focused on EMS, while the remaining six focused on ED workers. Six papers were a one time survey and not longitudinal, and two were retrospective chart reviews. Only one paper had weekly surveys assessing behaviors. Data were heterogeneous, and masking behaviors varied widely from no masks worn to full personal protective equipment (PPE) worn. In the final presentation, masking rates, a PRISMA diagram, and an evaluation of the strength of evidence will be included. Conclusion: There is limited data about longitudinal masking and PPE behavior among EMS and ED workers. One time surveys limit assessing true masking behaviors. The majority of papers collected data during the height of the COVID-19 pandemic (2020-2022), therefore, further research must be conducted to look at changes in masking behaviors, symptoms, and sick leave as COVID-19 rates fluctuate, change, and coexist with other respiratory illnesses.