Survival Flight: A Bird's-Eye View of Patient Transport During COVID-19
From high above the clouds, the coronavirus might appear to be a distant, ground-level concern—but this couldn’t be further from the truth.
“I think the cohesion of the team as we encounter this patient population is the biggest victory we have experienced. ”
Transferring a patient safely between hospitals, or moving them from an austere environment like the scene of an accident, requires a tightly coordinated team effort even when it’s “business as usual”. In the time of a pandemic, however, the already sophisticated process of patient transport takes on additional challenges associated with the management and containment of a highly infectious disease.
To better understand how COVID-19 affects this crucial area of critical care, MCIRCC spoke with Jeff Thomas, RN, a flight nurse with the University of Michigan’s Survival Flight team.
How has the Survival Flight team adapted to the new challenges brought about by COVID-19?
First, we are taking every possible step we can to protect our staff. COVID-19 presents differently case to case, so we are running with the assumption that most of the patients we encounter are at least patients under investigation (PUI). We are also working with pandemic-level PPE, which is a new paradigm for us. Everything is in plastic bags—our equipment, even our paperwork.
The flight team’s equipment is loaded up and ready for the next transport. The equipment is encased in plastic bags to prevent contamination.
Photo Credit: Paul Munger
From an operations standpoint, we have combined the staff at our two bases to form 3-provider transport teams. We keep a “thousand-foot view” of all of the variables that add to patient care. We also have staff that have volunteered to take calls and come in from home to staff second and third simultaneous transports.
As a flight nurse, what is on your wish list when treating critically ill or injured patients.
The burden of PPE is heavy, and, equipment-wise, we can always use more. However, I think what we as a society need most right now is access to mental health services.
It is well studied that patients and families experience PTSD from “regular” disease patterns and ICU care. But what are the impacts now, in a pandemic of this scale, when families are sitting in their cars in hospital parking lots just so they can be close to their loved ones? As we study IL-6 inhibitors and their response to COVID and pathogen transfer patterns of viruses, we are also quietly looking at our protocols for overdoses and non-accidental trauma.
We are also seeing the mental toll of COVID-19 affecting our colleagues in health care worldwide. Among the Survival Flight team, we make sure to support each other in this as much as we do our work. We don’t let things sit; we address situations as they arise. We also make sure to call out excellence.
We often hear about the difficulties associated with COVID-19, but what victories are being celebrated by the Survival Flight team?
“Working with pandemic-level PPE was a new paradigm for us.” - Jeffery Thomas
Photo Credit: David Roberts
I think the cohesion of the team as we encounter this patient population is the biggest victory we have experienced. We are constantly learning, adapting, mentoring each other. We are “rising to our level of training”—complicated ventilator settings are being matched or improved upon, and acute emergencies are being effectively responded to.
Many of the innovations developed by MCIRCC members in response to COVID-19—such as a portable negative pressure helmet—can also be adapted for care scenarios beyond the current crisis. How do you think innovations like these might help in this pandemic or in helicopter transport?
At the end of the day, we want the care and protection we provide in-transport to match that of the hospital.
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From the Survival Flight cockpit to bedsides in the PICU, MCIRCC members are developing innovative new therapies, devices, and diagnostics that span echelons of care. As we weather the COVID-19 pandemic, we have pivoted many of our major research initiatives to focus on addressing the present crisis.