Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

Abstract

Background COVID-19, the pandemic caused by the severe acute respiratory syndrome coronavirus-2, is challenging healthcare systems worldwide. Little is known about problems faced by emergency medical services—particularly helicopter services—caring for suspected or confirmed COVID-19 patients. We aimed to describe the issues faced by air ambulance services in Europe as they transport potential COVID-19 patients. Methods Nine different HEMS providers in seven different countries across Europe were invited to share their experiences and to report their data regarding the care, transport, and safety measures in suspected or confirmed COVID-19 missions. Six air ambulance providers in six countries agreed and reported their data regarding development of special procedures and safety instructions in preparation for the COVID-19 pandemic. Four providers agreed to provide mission related data. Three hundred eighty-five COVID-19-related missions were analysed, including 119 primary transport missions and 266 interfacility transport missions. Results All providers had developed special procedures and safety instructions in preparation for COVID-19. Ground transport was the preferred mode of transport in primary missions, whereas air transport was preferred for interfacility transport. In some countries the transport of COVID-19 patients by regular air ambulance services was avoided. Patients in interfacility transport missions had a significantly higher median (range) NACA Score 4 (2-5) compared with 3 (1-7), needed significantly more medical interventions, were significantly younger (59.6 ± 16 vs 65 ± 21 years), and were significantly more often male (73% vs 60.5%). Conclusions All participating air ambulance providers were prepared for COVID-19. Safe care and transport of suspected or confirmed COVID-19 patients is achievable. Most patients on primary missions were transported by ground. These patients were less sick than interfacility transport patients, for whom air transport was the preferred method.

Helicopter transport of critical care COVID-19 patients in the Netherlands: protection against COVID-19 exposure-a challenge to critical care retrieval personnel in a novel operation

“…The EpiShuttle® device (EpiGuard, Oslo, Norway) resembles the REGA’s PIU. A reusable comfortable single-patient isolation and transport system [ 10 ]. Retrieval teams could benefit from this device because it is airtight and equipped with negative pressure.…”

Analysis of European Air Medical Evacuation Flights of Coronavirus Disease 2019 Patients

“…For COVID-19 patients there are only a few numbers of studies available 14 , 15 . The analysis with the largest number of patients (n = 385) from Hilbert-Carius et al 14 has analysed 385 COVID-19 transports mainly on primary missions done by ground vehicles and for interfacility transport by helicopters. Patients on primary missions were less sick than interfacility transport patients, for whom air transport was the preferred method.…”

Operational experience of the Dutch helicopter emergency medical services (HEMS) during the initial phase of the COVID-19 pandemic: jeopardy on the prehospital care system?

“…Safety procedures and protective measures are, therefore, crucial for HEMS and emergency medical staff. The safety protocol used in the present study can be considered similar to those used by other European HEMS services, as described by Hilbert-Carius et al [ 17 ]. These guidelines can be used to ensure safe and sustained operability of emergency medical services.…”