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Commission on Accreditation of Medical Transport Systems

Tag: CAMTS

AMPA statement – Covid19

March 20, 2020

After careful monitoring of the rapidly changing situation related to COVID-19, understanding that concerns for health, safety, and the impact on meeting attendance, among other issues, are affecting our conference, the difficult decision has been made to cancel CCTMC for 2020.  We are committed to maintaining appropriate health and safety measures, and we encourage you to follow guidelines recommended by the Centers for Disease Control and Prevention and the World Health Organization.  CCTMC attendees and exhibitors will be issued a full refund or may choose to roll their registration to the 2021 conference.  Watch our websites, Facebook and www.CCTMC.net for details for 2021 as they become available in the near future. You won’t want to miss it!Best regards,AMPA, ASTNA, IAFCCP

AMPA Position Statement


AMPA is attentive to the concerns of its membership in addressing the challenges associated with the transport of patients with suspected or confirmed infection with SARS-CoV-2. Recommendations regarding the personal protective equipment required to care for these patients remain fluid, and AMPA recommends that its members remain familiar with the recommendations of the World Health Organization as well as those of their local, regional, and national health protection authorities.

• AMPA supports social distancing and recommends seeking alternatives to gatherings of greater than ten people.
• AMPA supports the WHO recommendation to employ standard, contact, and droplet precautions when caring for and transporting patients with suspected or confirmed infection with SARS-CoV-2.

⁃ AMPA recommends that patients with suspected or confirmed infection with SARS-CoV2 wear a surgical mask during care and transport.

• AMPA supports the WHO recommendation to employ standard, contact, and airborne precautions when caring for and transporting patients with suspected or confirmed infection with SARS-CoV-2 who are undergoing aerosol-generating procedures such as nebulization, mask oxygenation, high flow nasal cannula oxygenation, non-invasive positive pressure ventilation, endotracheal intubation, bag valve mask ventilation, cricothyrotomy, tracheostomy, and cardiopulmonary resuscitation.

⁃ AMPA further supports the WHO recommendation to attempt to avoid performing aerosol-generating procedures in confined spaces.
⁃ AMPA therefore cautions against transporting patients anticipated to require aerosolgenerating procedures during transport and suggests mitigating the need for aerosolgenerating procedures prior to transport.
⁃ AMPA recommends the use of a certified bacterial and viral filter in the ventilator circuit of mechanically ventilated patients but recommends airborne precautions during transport to safeguard against unanticipated aerosol-generating procedures.
⁃ AMPA further recommends the mitigating use of a certified bacterial and viral filter (1) between the bag and the endotracheal tube or between the bag and the face mask of manually ventilated patients, and (2) in the circuit of patients being provided noninvasive positive pressure ventilation, when feasible.
⁃ AMPA further acknowledges that local, regional, or national practice may be to employ airborne precautions on a broader population of patients with suspected or confirmed infection with SARS-CoV-2 and that these recommendations remain fluid.

• AMPA recommends that pilots and other vehicle operators employ droplet or airborne precautions as appropriate, utilizing appropriately fit-tested personal protective equipment, unless the cockpit and patient compartment are completely separated.
• AMPA cautions that using a particulate respirator mask while wearing a flight helmet may render the mask ineffective unless appropriate fit testing has been performed while wearing the helmet.
• AMPA acknowledges that SARS-CoV-2 may survive in the environment for extended periods of time and recommends decontamination of all surfaces and open air ventilation of the patient compartment following the transport of patients with suspected or confirmed infection with SARS-CoV-2.

AMPA acknowledges that our understanding of potential best practices remains fluid at this time and recommends careful consideration of current guidelines and continuous reassessment of the potential benefits and risks surrounding the transport of patients with suspected or confirmed infection with SARS-CoV-2. AMPA will continuously review these recommendations and provide interim guidance as necessary.

Info on Transport of Patients w/ COVID19

March 16, 2020

In these uncertain times, we wanted to get some information out regarding transport of patients who are diagnosed with coronavirus. There are many variables that could affect your decision whether to transport or not but here are some thoughts from our Board members who are actively involved in Rotorwing, Fixed Wing and Ground transport.

Response from Mike Brunko, MD, Flight for Life Medical Director (CAMTS Board Member)

Many programs, including mine, have halted transport of patients diagnosed with coronavirus by rotor, primarily because of inability to control and to be able to protect crew and pilots from patient contact (especially in helicopters where it is not possible to  physically separate the infected patient from the pilot) and/or the inability to get adequate N95 fitting with helmets. In our case, we have the added pressure of flying above 12000 feet, with oxygen on. It is difficult to decontaminate a helicopter as opposed to an airplane or ambulance and the air flow is not as easy to control. Right now, many busy academic programs are not transporting by rotor, but are by fixed wing or ground. Some are only doing intubated patients where we can control the filtration of inhalation and exhalation and lessen/prevent the aerosol exposure.

The AMPA Board Is actively discussing the literature, experience and their institutions’ recommendations. Most programs’ crews were fitted and tested for PAPR and N95s without helmets and likely didn’t consider the importance of separate testing (a standard we will need to address in the future). Today, I feel, ground and FW should be used and rotor CONSIDERED only for time sensitive critical ARDS patients where ECMO or ventilation strategies are necessary. This truly is a dynamic situation which may change tomorrow.

Webinar from Ashley Smith – NATA representative

Specific to fixed wing transports – please see the link on the www.camts.org website to the NATA webinar that our board member, Ashley Smith, made available last week.

Aviation & Safety Advisory Committee (A&SAC)

mercy-air-culture

The Commission on Accreditation of Medical Transport Systems (CAMTS) has re-established an Aviation & Safety Advisory Committee (A&SAC) to provide recommendation to the CAMTS Board of Directors that will increase the level of safety for air transport of patients using a CAMTS accredited organization.  To ensure a broad level of professional aviation safety experience, the committee includes industry representatives that are not members of the CAMTS Board of Directors. The current focus of the A&SAC is to review and propose changes to the accreditation standards.  The committee plans to review the standards annually and develop strategic chnges that will raise the level of safety for the industry.  Additional tasks of the A&SAC include:

  •  Address site visit findings by the Quality Management Committee to track and trend aviation and operational issues identified during a site visit.
  • Refine the aviation track syllabus for site surveyor initial and recurrent training.
  • Review and update the maintenance checklist for use during site visits.
  • Develop or endorse third-parties’ (e.g. IHST) safety promotion material that can be shared via the CAMTS website or presented at industry conventions/seminars, e.g. AMTC, AIRMED etc.
  • Monitor aviation safety trends and summarize for the Board, at least annually, accident causes and industry best practices.
  • Address Safety Culture Surveys tracking and trending – protected information that should/could go through a third party.
  • Monitor, analyze, and when applicable address, aviation regulatory actions, standards or activities that may impact CAMTS standards.   When applicable present such changes to the Board and/or train site surveyors on such changes.
  • Serve as advisors, via email or telephonically, to CAMTS Board members who may have an aviation related question.

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The A&SAC is currently comprised of the following members:

Charter members and CAMTS Board Directors

Fred Brisbois – Chairman, CAMTS Ad-Hoc Member (retired Sikorsky, U.S. Army & IHST)

Ashley Smith – National Air Transportation Association (NATA); Jet Logistics 

Eileen Frazer – CAMTS Executive Director

Kim Montgomery – Air Medical Operations Association (AMOA); Seven Bar Enterprises

Stefan Becker – (European HEMS and Air Ambulance Committee (EHAC); Rega

Terry Palmer –  CAMTS Ad-hoc member; Metro Aviation

Rick Ruff – National EMS Pilots Association (NEMSPA); Boston MedFlight

Non-CAMTS Board Committee members:

Dudley Crosson, Delta P and ALEA aeromedical liaison

Gerry Pagano – AAMS and Trauma Hawk Aeromedical Program

Ken King, STARS

Noah Sanders, AeroCare Medical Transport

Wade Neiswender, Seven Bar Enterprises

Ed Stockhausen, Air Methods

Chris Young, Professional Resources In System Management, LLC (PRISM)

Chris Eastlee, Air Medical Operations Association (AMOA)