LifeFlight Retrieval Medicine, PO box 15166, City East, QLD, 4002, Australia.
Air Ambulance Department, Oslo University Hospital, Oslo, Norway.
Scand J Trauma Resusc Emerg Med. 2020 May 25;28(1):43. doi: 10.1186/s13049-020-00736-7.
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.
新型冠状病毒 SARS-CoV2 于 2019 年 12 月出现，现已在全球流行。初步分析表明，5%的感染患者需要重症监护，需要插管的呼吸衰竭与高死亡率相关。患病患者分布在不同地区：大多数患者在需要重症监护之前将留在原地。此外，可能有需要检索的患者，但他们碰巧感染了 SARS-CoV-2 或正在排出病毒。因此，COVID-19 大流行对重症监护检索系统构成了挑战，这些系统通常依赖于少数生活和工作密切相关的专家小团队。这些工作人员的一小部分被感染或被隔离，可能会灾难性地影响服务的提供。在大流行期间，避免职业暴露于 COVID-19，从而确保服务连续性，是航空医疗检索服务的首要目标。在本文讨论中，我们与全球直升机紧急医疗服务（HEMS）合作，确定了检索 COVID-19 患者的风险，并制定了减轻这些风险的策略。涉及整个航空医疗检索团队的模拟确保了在制定标准操作程序期间可以解决安全问题。一些服务在航空医疗环境中使用模拟测试了个人防护设备和协议。我们还整合了来自多个国际 HEMS 服务的经验、标准操作程序和方法。通过这种合作，我们概述了安全检索 COVID-19 患者的方法，并描述了如何使用该框架来制定本地标准操作程序。
