Decision support tool and suggestions for the development of guidelines for the helicopter transport of patients with COVID-19

Abstract

The novel coronavirus SARS-CoV2 emerged in December 2019 and is now pandemic. Initial analysis suggests that 5% of infected patients will require critical care, and that respiratory failure requiring intubation is associated with high mortality.Sick patients are geographically dispersed: most patients will remain in situ until they are in need of critical care. Additionally, there are likely to be patients who require retrieval for other reasons but who are co-incidentally infected with SARS-CoV-2 or shedding virus.The COVID-19 pandemic therefore poses a challenge to critical care retrieval systems, which often depend on small teams of specialists who live and work together closely. The infection or quarantining of a small absolute number of these staff could catastrophically compromise service delivery.Avoiding occupational exposure to COVID-19, and thereby ensuring service continuity, is the primary objective of aeromedical retrieval services during the pandemic. In this discussion paper we collaborated with helicopter emergency medical services(HEMS) worldwide to identify risks in retrieving COVID-19 patients, and develop strategies to mitigate these.Simulation involving the whole aeromedical retrieval team ensures that safety concerns can be addressed during the development of a standard operating procedure. Some services tested personal protective equipment and protocols in the aeromedical environment with simulation. We also incorporated experiences, standard operating procedures and approaches across several HEMS services internationally.As a result of this collaboration, we outline an approach to the safe aeromedical retrieval of a COVID-19 patient, and describe how this framework can be used to develop a local standard operating procedure.

Challenge of COVID-19 crisis managed by emergency department of a big tertiary centre in Saudi Arabia

“…We applied the principles learnt from MERS CoV-1 for managing the COVID-19 crisis. Successful previous experiences, go a long way in managing surges [ 9 ].…”

Airflow Characteristics in Aeromedical Aircraft: Considerations During COVID-19

“…The results may assist clinicians with the positioning of patients in flight to minimise the risk of COVID-19 exposure. The safe and wise approach to the aeromedical transfer of confirmed or suspected COVID-19 patients in our current climate is to strictly adhere to accepted safety guidelines and infection control procedures (7,13,31).…”

“…Key strategies for the safe and effective transport of COVID-19 patients include selection of appropriate patients for transport (6), minimising the utilisation of aerosol generating procedures (AGPs), and ensuring the correct use of personal protective equipment (PPE) (3,7). Despite some consensus on personal protective equipment (PPE) guidelines (8)(9)(10), the utilisation of these guidelines is challenging for clinicians and aircrew in both rotary and fixed-wing aircraft.…”

Transferts héliportés interhospitaliers de patients atteints de COVID-19 : expérience du SDIS du Bas-Rhin

“…Les transferts interhospitaliers des patients COVID positifs n’ont pas fait l’objet d’une abondante littérature. Les quelques travaux ont porté sur les choix logistiques entre moyens aériens, et sur la protection des personnels par isolement du patient dans un caisson étanche [1] , [2] , [3] , [4] . Nous avons fait le choix de protéger les personnels soignants par le port d’EPI et d’isoler le cockpit de la soute pour protéger l’équipage.…”