Operational Policies and Procedures for Critical Care Transport During a Respiratory Pandemic

Area of Science:

• Emergency Medicine
• Public Health
• Healthcare Management

Background:

• The 2020-2021 COVID-19 pandemic presented significant operational challenges for healthcare organizations, particularly in critical care transport (CCT).
• CCT services experienced shifts in patient demographics, moving from trauma and pediatrics to a majority of adult patients with acute hypoxemic respiratory failure.
• Early pandemic conditions posed risks to CCT teams due to evolving understanding of personal protective equipment (PPE) effectiveness against SARS-CoV-2.

Purpose of the Study:

• To outline the critical operational adjustments and best practices implemented by CCT organizations during the COVID-19 pandemic.
• To share lessons learned regarding adaptability, communication, and safety protocols.
• To provide insights applicable to future respiratory epidemics and pandemics.

Main Methods:

• Review of operational changes and protocol development within CCT organizations during the COVID-19 pandemic.
• Analysis of challenges related to patient population shifts and safety measures.
• Identification of key elements contributing to successful adaptation, including agility and communication.

Main Results:

• CCT organizations rapidly developed and implemented new protocols and guidelines in response to the pandemic.
• Adaptability, efficient communication, continuous reassessment, and novel approaches were crucial for operational evolution.
• Standardization of definitions (e.g., person under investigation for COVID-19) varied between institutions, creating initial conflicts.

Conclusions:

• The COVID-19 pandemic necessitated unprecedented agility and rapid protocol development in CCT services.
• Key strategies included prioritizing crew and patient safety, adapting to changing patient needs, and fostering efficient communication.
• The operational lessons learned from the SARS-CoV-2 pandemic offer valuable insights for managing future respiratory outbreaks and improving routine CCT operations.