Challenges and Risks in Out-of-Hospital Transport of Patients During the Coronavirus Disease 2019 Pandemic.
Air Medical Journal · 2023-01-01 · Observational study
Abstract
OBJECTIVE: Norwegian critical care resources are regionalized making air ambulances transport of suspected or confirmed coronavirus disease 2019 (COVID-19)-positive patients a necessity. We prospectively observed pre- and interhospital transportation of patients with suspected or confirmed COVID-19 in our physician-manned emergency medical services. METHODS: This was a prospective, observational quality assurance study of primary and secondary missions conducted by 2 Norwegian air ambulances during the COVID-19 pandemic. RESULTS: Forty-one (24.1%) were primary missions, whereas 129 (75.9%) were interhospital transports. Most patients (158 [92.9%]) were transported with ground-based vehicles, and 12 (7.1%) were transported by rotor wing aircrafts. One hundred thirty-four of 170 patients (78.8%) were COVID-19 positive at the time of transportation. The median (interquartile range) fraction of inspired oxygen concentration was 0.60 (0.50-0.80), the positive end-expiratory pressure was 11 cm H2O (8-13.5 cm H2O), and the peak inspiratory pressure was 26 cm H2O (22-30 cm H2O). Some degree of elevated treatment challenge was reported in 157 (87.7%) transports, and in 139 (77.7%), the patient risk was considered elevated. The physician stated that some degree of elevated risk for the provider was elevated in 131 (73.2%) of the transports. CONCLUSION: The capacity of the physician-manned emergency medical services to safely transfer patients remains essential to maintain resilient critical care capacity, and the perceived elevated risks should be considered in capacity planning.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Mechanical ventilation · Time intervals · Helicopter & air ambulance · Prehospital physicians · Interfacility & critical care transport · COVID-19 pandemic
Related articles
- Obstetric Transport and Factors Associated With Transport to the Intensive Care Unit. (Air Med J, 2025)
- Emergency air evacuation of patients with acute respiratory failure due to SARS-CoV-2 from Mayotte to Reunion Island. (Medicine (Baltimore), 2021)
- Initiation of an inter-hospital extracorporeal membrane oxygenation transfer programme for critically ill patients with coronavirus disease 2019: bringing extracorporeal membrane oxygenation support to peripheral hospitals. (Interact Cardiovasc Thorac Surg, 2021)
- Oxygen Management During Collective Aeromedical Evacuation of 36 COVID-19 Patients With ARDS. (Mil Med, 2021)
- Aircraft transfer of pediatric patients with intractable cardiac or airway problems – single-institutional experience of a specialty hospital. (Circ J, 2015)
- Review of aeromedical intra-aortic balloon pump retrieval in New South Wales. (Eur J Emerg Med, 2013)