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Multicenter Study
. 2020 Sep 22;28(1):94.
doi: 10.1186/s13049-020-00789-8.

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

Peter Hilbert-Carius  1   2 , Jörg Braun  3 , Fikri Abu-Zidan  4 , Jörn Adler  5 , Jürgen Knapp  6 , Didier Dandrifosse  5 , Désirée Braun  3 , Urs Pietsch  7   8 , Patrick Adamczuk  5 , Leif Rognås  9   10 , Roland Albrecht  7   8
Affiliations
Multicenter Study

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

Peter Hilbert-Carius et al. Scand J Trauma Resusc Emerg Med. .

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.

Keywords: COVID-19; Emergency medicine; Fixed wing aircraft; Helicopter; Infection; Medical staff; Prevention.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures

Fig. 1
Fig. 1
A decision tree for use in evaluating safe transfer during COVID-19-related missions. This one, from the DRF-Luftrettung, is the “Primary mission algorithm for aeromedical crews”
Fig. 2
Fig. 2
The EpiShuttle® of the DRF-Luftrettung (©DRF-Luftrettung – Germany). The EpiShuttle is used only for interfacility transport. It is fitted into the helicopter (EC 145 / H 145) before the mission. The DRF-Luftrettung has an exemption according to article 71 (1) of regulation (EU) 2018/1139 by the “Luftfahrt-Bundesamt – LBA” (civil aeronautics board of Germany) to use the EpiShuttle in the Eurocopter 145 and Airbus Helicopter 145 rotor wing aircrafts of the company
Fig. 3
Fig. 3
PIU owned by the REGA (©REGA - Switzerland). The REGA PIU is mainly used in the fixed wing aircrafts (Challenger 650) of the company. Transport of 2 PIU per flight are possible in the Challenger 650
See this image and copyright information in PMC

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