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Application of a Standard Operating Procedure in Transporting Patients during the COVID-19 Pandemic in the Air Emergency Medical Services

Published online by Cambridge University Press:  04 October 2021

Mohammad Hossein Esmaeilzadeh ,
Mahmoudreza Peyravi Open the ORCID record for Mahmoudreza Peyravi [Opens in a new window]  and
Milad Ahmadi Marzaleh Open the ORCID record for Milad Ahmadi Marzaleh [Opens in a new window]
Mohammad Hossein Esmaeilzadeh
Affiliation:
PhD Student of Health in Disaster and Emergencies, Department of Health in Disasters and Emergencies, School of Management and Medical Information, Iran University of Medical Sciences, Tehran, Iran Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
Mahmoudreza Peyravi
Affiliation:
Department of Health in Disasters and Emergencies, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran
Milad Ahmadi Marzaleh*
Affiliation:
Department of Health in Disasters and Emergencies, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
*
Correspondence: Milad Ahmadi Marzaleh Department of Health in Disasters and Emergencies School of Management and Medical Informatics Shiraz University of Medical Sciences, Shiraz, Iran E-mail: miladahmadimarzaleh@yahoo.com
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Abstract

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Keywords

COVID-19healthhelicopterpandemicstandard operating procedure
Type
Letter to the Editor
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 6 , December 2021 , pp. 807 - 808
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Dear Editor,

Following the coronavirus disease 2019 (COVID-19) pandemic since December 2019, unforeseen challenges have arisen in the world that threaten the traditional health care delivery processes. One of these challenges is providing emergency services to the patients who are transported by indoor air ambulance services.Reference Albrecht, Knapp, Theiler, Eder and Pietsch1,Reference Tien, Sawadsky, Lewell, Peddle and Durham2 Due to the lack of information about these patients’ infectious conditions and the limited space of the emergency helicopters, the risk of disease transmission is higher for the members of the air emergency medical crew compared to other providers in hospitals or other medical departments. The risk of virus transmission also increases due to the nature of the services provided in the prehospital environment, the acute condition of most patients in this phase, and many medical procedures such as airway management and ventilation associated with aerosol production.Reference Hilbert-Carius, Braun and Abu-Zidan3,Reference Spoelder, Tacken, van Geffen and Slagt4

Following the outbreak of COVID-19 in many countries, standard operating procedures for infection prevention measures tailored to specific circumstances have been proposed based on the current recommendations of associations and national medical authorities. One of these methods is the wide-spread use of isolated patient compartments in many countries providing helicopter Emergency Medical Services (EMS) to effectively protect the medical crew, which eliminates the need for disinfection of patient cabins and increases the time to access critical helicopter EMS. In Switzerland, simulation training was used as another strategy to prevent the transmission of infection in a recent pandemic and other possible future pandemics in air rescue settings.Reference Albrecht, Knapp, Theiler, Eder and Pietsch1,Reference Hilbert-Carius, Braun and Abu-Zidan3

Other strategies, such as keeping a distance of at least two meters from the patient, reducing the number of health care providers in the patient cabin, and using standard personal protective equipment (PPE), are operational on the agenda of these centers. Furthermore, some European air emergency service providers have taken a major step towards maintaining the health of air emergency staff by allocating designated air relief centers equipped with an isolated infectious disease ward to transport COVID-19-approved patients.Reference Hilbert-Carius, Braun and Abu-Zidan3

Conclusion

Protection of the physical and mental health of the air emergency medical staff, as the main priority of health care organizations,Reference Tien, Sawadsky, Lewell, Peddle and Durham2 is possible via gaining the experiences of the flight crews involved in this issue, as well as the successful experiences of others. Countries have taken measures to implement the existing standards to improve the safety and health of this group of health system employees in Iran. By modeling and localizing the experiences of other successful countries, development of guidelines and special instructions for air emergencies in the Iranian health system can help make health services safer.

Acknowledgement

The authors would like to thank Ms. A. Keivanshekouh at the Research Consultation Center (RCC) of Shiraz University of Medical Sciences for improving the use of English in the manuscript.

Conflicts of interest/funding

The authors have no conflict of interest to declare.

References

Albrecht, R, Knapp, J, Theiler, L, Eder, M, Pietsch, U. Transport of COVID-19 and other highly contagious patients by helicopter and fixed-wing air ambulance: a narrative review and experience of the Swiss air rescue Rega. Scand J Trauma Resusc Emerg Med. 2020;28(1):40.CrossRefGoogle ScholarPubMed
Tien, H, Sawadsky, B, Lewell, M, Peddle, M, Durham, W. Critical care transport in the time of COVID-19. CJEM. 2020;22(S2):S84–S88.CrossRefGoogle ScholarPubMed
Hilbert-Carius, P, Braun, J, Abu-Zidan, F, et al. Prehospital care and interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective. Scand J Trauma Resusc Emerg Med. 2020;28(1):10.CrossRefGoogle Scholar
Spoelder, EJ, Tacken, MC, van Geffen, G-J, Slagt, C. 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. Scand J Trauma Resusc Emerg Med. 2021;29(1):41.CrossRefGoogle Scholar