Covid19 – Medical Transport

by camtsblog

March 18, 2020

This is today’s update. We will continue to post as new information and changes occur. We will continue to answer all your questions as best we can. We are all in this together!

EXPIRATION DATES

We received many questions about currencies such as ACLS, ATLS etc. Courses have been canceled and programs are not able to schedule staff with expired or expiring certifications. We all need to adjust to new realities and CAMTS understands delays and expiration dates will be affected. Aviation managers may be experiencing the same thing with scheduling simulators for staff. There are no penalties as we adjust and cope to carry out our primary mission: taking care of our patients and each other.

Accreditation expiration dates are also affected by the timeliness of site visits. We were able to complete all but three scheduled site visits for this quarter of 2020. Programs who are on hold for a site visit receive an approved extension to their tenure of accreditation as noted on the website listing. We are looking at scheduling site visits again in late May and June but we are all operating under the assumption we may need to change as this pandemic progresses. Contact our executive staff: eileen.frazer@camts.org, dudley.smith@camts.org or jan.eichel@camts.org    with any questions or concerns.

Visit cdc.gov/coronavirus for up to date information.

COMMENTS FROM ACCREDITED PROGRAMS

From Jason Cohen, MD, Medical Director at Boston MedFlight

“We have decided to consider RW transport for these cases on a very limited basis.  Whenever possible, these will be deferred to ground, but some of our geography would require us to fly (i.e., islands with limited available healthcare).  We don’t require crew oxygen at our usual operating altitude, unlike the mountains in Colorado.  A decision to accept requires a clinical conversation between the sending physician and myself, along with the crew, as well as a conference call with aviation management to discuss any mechanical mitigation for spread based on the environment (for example, not running the HVAC).”

“Our RW clinical crew wears full PPE including N95, with surgical mask over the patient (unless intubated).  The pilot wears an N95 mask – does not seem to interfere with radio communication.”

“We are not using FW for transport of potential COVID patients – mostly due to the required recirculation in the aircraft at pressure without ability to upgrade to HEPA filters.”

FROM CAMTS

For fixed wing services, who conduct both air medical and charter flights: We recommend complete separation of staff, pilots and airplanes.  Airplanes should be configured for a single purpose at this time. Reconfiguring the interior to meet the mission – either passenger or patient – puts patients, passengers and staff at a higher risk.

For all modes of transport

The donning and doffing procedure is a simple one for personnel to follow if in contact with the patient or aircraft with suspected or diagnosed exposure, including maintenance personnel. See the website: PPE Doffing Procedure from the Provincial Health Services Authority of Canada: http://www.phsa.ca/Documents/Occupational-Health-Safety/FactSheetPPEDoffingProcedurePoster.pdf

Patients should wear masks in addition to the medical staff. Luggage should be wrapped in plastic or in plastic bags by personnel other than the patient.   Crew members should wear masks and gloves while loading and unloading, and proper doffing procedures should apply after unloading is complete. Aircraft interiors needs to be properly cleaned and disinfected between transports.

Recommended clean-up is a mixture of 50% Sodium Hypochlorite (Clorox) to 50% warm water on solid materials. If the aircraft is lined in fabric or carpeting, we recommend you do not transport known or suspected coronavirus patients as these surfaces cannot be properly cleaned (also against CAMTS standard 03.06.01 21.  “Non-fabric sides/ceilings are strongly encouraged. Floors are not carpeted.”) 

For Communications Centers

Be creative in providing 6 feet of separation between communications specialists. This may be difficult but perhaps staggering shifts and/or relocating non-essential furnishings is possible.

Hand washing, of course, is required between starts and stops or antiseptic hand wipes. Hard surfaces should be cleaned at stations with each personnel change, especially phones, headsets, keyboard, screens etc.