HIGHLIGHTS | COVID-19 Policy in Air Medicine
- The new COVID-19 policy is based off the SARS policy.
- It has been worked on by emergency medicine and infectious disease experts.
- Airlift Northwest is sharing its COVID-19 policy to help other air medicine organizations.
- Airlift is opening its base as a decontamination zone for other air medicine companies flying out of Seattle.
Seattle became the early epicenter for the COVID-19 outbreak in the United States, and Airlift Northwest had to rapidly adapt its procedure and policy to safely transport patients and flight crew. Other air medicine programs, both regionally and nationally, have been adopting this procedure.
Sharing with competitors
Airlift has been sharing its COVID-19 air transport guidelines with anyone that asks — both partners and competitors alike. It’s the bottom line of Airlift's founding mission: If you can help, you must act.
And Airlift is taking action and helping others so that they can do the same.
Along with sharing COVID-19 air transport protocol, Airlift’s Seattle base offered to assist with plane and crew decontamination (showers for the crew and cleaning of the aircraft) for any air medicine companies that fly in and out of Seattle. Other bases have reciprocated that offer.
Building off of an existing SARS policy, medical directors Richard Utarnachitt, MD, Andrew Latimer, MD, and Jessica Wall, MD, worked with infectious disease experts like John Lynch, MD, PhD, to build a policy that addresses all types of patients and needs.
Chief flight nurse, Brenda Nelson, RN, describes it as a living document.
“We are changing the policy as we learn more — it even changed today,” says Nelson. “We are constantly asking: How do we take care of patients and protect staff?”
COVID-19 is transmitted through respiratory droplets, so controlling the amount of secretions that get aerosolized is essential to patient and provider safety.
Ways the Airlift team is currently minimizing aerosolized transmission include:
- Filter systems on intubation tubes, which catch many of the patient’s secretions from the airway.
- Limiting disconnection of the ventilator tubing. (e.g., administering medications through access ports and inline suctioning) by advance planning.
- Placing surgical masks over supplemental oxygen masks to create a barrier.
Personal protective equipment (PPE)
When entering the room of a known or suspected COVID-19 patient, the crew wears a mask, gloves, goggles and a gown over top of their fire-resistant flight suits. The gowns, although essential for personal protection in the clinic, are plastic and flammable. To keep safe during the flight and after, the crew removes the gown before flying (keeping on all their other personal protective equipment) and changes their flight suit before the next flight.
Every surface on the plane must be wiped down. This task poses certain challenges since many parts of the aircraft can only be cleaned with an alcohol spray. All other surfaces are cleaned using a virucidal disinfectant.
“We wipe down every surface of the aircraft that can be seen,” says Nelson. “This puts our aircraft out of service from 30 minutes to an hour after a flight.”
This process is time consuming, but it has to be done. Everyone in the field is taking extra steps to ensure safety at all levels of the emergency care chain.
Showing up for one another
The COVID-19 pandemic has forced our healthcare system to rapidly change and adapt. It has brought times of uncertainty and fear. But it has also shone a spotlight on the kindness, dedication and willingness to step up and be of service.
“This team is amazing. I have watched our flight nurses teach pilots how to wear PPE, I have a list of people volunteering to work outside of their roles in the greater UW Medicine system, and we have retired or per diem flight nurses that are willing to come back full time,” says Nelson.
Nelson describes the climate at Airlift Northwest as proud — proud to be a leader in this challenging situation, to be collaborative with so many people and organizations, and to be part of the UW Medical system as a whole.