Guidance on Air Medical Transport for SARS Patients 2
Guidance on Air Medical Transport for SARS Patients
This updated guidance is intended to assist air medical transport (AMT) service providers in using specialized and/or specially equipped aircraft to transport SARS patients while ensuring the safety of patients and transport personnel. It should not be generalized to commercial passenger aircraft. The recommendations are based on standard infection control practices, AMT standards, and epidemiologic information from investigations of SARS, including experience from air transport of patients during the 2003 outbreak.
Currently recommended infection control measures for hospitalized patients with SARS http://www.cdc.gov/ncidod/sars/guidance/I/index.htm include Standard Precautions (with eye protection to prevent droplet exposure) plus Contact and Airborne Isolation Precautions. Respiratory protection using respirators providing at least 95% filtering efficiency (e.g., NIOSH-certified N-95 or higher-level filtering facepiece respirator) with appropriate fit-testing (www.osha.gov/SLTC/etools/respiratory/oshafiles/fittesting1.html) is recommended.
A. Air Transport of SARS Patients: General Considerations
• SARS patients should be transported on a dedicated AMT mission with the minimum number of crew members. Whenever possible, no passengers or patients who do not have SARS should be on board. If a parent is accompanying a sick child, the parent should use personal protective equipment (PPE) during transport as described in “Infection Control,” below.
• If possible, a primary caregiver should be assigned to the SARS patient.
• The number of caregivers should be limited to those required to provide essential care during the trip.
• Infection control measures should focus on:
o Source control (i.e., confining the spread of respiratory secretions at the patient level)
o Engineering controls to limit airborne dissemination of the virus
o Containment of the area of contamination (i.e., designating “clean” and “dirty” areas on the aircraft)
o Use of PPE
o Use of safe work practices to prevent exposure
The size and type of aircraft will influence the extent to which these measures can be implemented. When available, use of a portable isolation unit may be considered.
• Consideration must be given to the need for “PPE breaks” during long trips. Personnel will need to use the lavatory and have meals; removal of respiratory protection is unavoidable. An area at the front of the plane (or “upwind” from the patient, depending on cabin air flow), as far as possible from the patient, should be designated for this purpose.