The COVID-19 pandemic has brought uncertainty to Western Canadians for many months. At STARS, you should know we remain committed to being there for the next patient who needs us.
One of our crew members leading the effort to ensure we provide uninterrupted care is Dr. Jamin Mulvey, a transport physician. Dr. Mulvey pointed to an organization-wide effort to ensure necessary policies, procedures and supplies are in place.
“We have good resources, adequate supplies of personal protective equipment (PPE), and redundancy programs in place in case there is a PPE shortage,” said Dr. Mulvey, a member of STARS’ COVID-19 clinical communication working group. “The policies are there, the training is there, and we are organizationally ready for any type of patient volumes.”
The safety of our air medical crew, pilots and patients remains at the forefront of every decision we make. Currently, that means enhanced PPE measures for our teams and meticulous PPE removal procedures, also called doffing. For non- presumptive cases, the minimum PPE requirements are gloves, a surgical mask, eye protection and gowns, where practical.
“This includes scene calls where the patient is unlikely to have COVID-19 but we are unable to receive confirmation from the patient or the family to rule it out,” Dr. Mulvey said. “The next level is for presumptive COVID-19 which may be a patient with respiratory distress, cough, cold and the story sounds like the virus. On top of that, minimum PPE are airborne precautions, which are the N95 respirator, plus or minus a face shield.”
Dr. Mulvey noted because COVID-19 can “sit on” droplets on a contaminated patient or surface, the PPE doffing procedure is critical to avoiding self- contamination.
“We have a buddy system where you are supervised to make sure mistakes don’t happen and you don’t inadvertently touch your face when you have contaminated hands.” A rigorous decontamination of each helicopter is also part of the post-mission routine.
As agencies throughout the world battle this virus, Mulvey said patients have benefited from international cooperation, shared learnings and best practices. In that spirit of cooperation, the STARS education team has created an online portal where other medical organizations can access information on a variety of COVID-19-related topics. http://stars.ca/covid19clinical/
“There is also an international consortium and we have been sharing lessons on a larger level to really improve the system because we are learning on the fly and a lot of this is new. We want to make sure we are all handling this correctly.”
STARS has carried patients with suspected or confirmed COVID-19. In addition, Dr. Doug Martin, STARS medical director, Winnipeg, said our transport physicians have helped the overall pandemic response by providing “expert advice to air medical crew and sending hospitals on this patient group, which can be quite difficult to manage in terms of oxygenation and ventilation.”
Some of the contributions STARS physicians have made to treat COVID-19 patients aside from front-line care include: developing procedures for in-hospital resuscitation and bedside ultrasound; creating protocols for airway management by ground paramedics; conducting airway management simulation training for hospital- based doctors; providing resources and advice to fixed-wing air ambulance operators and offering pandemic contingency planning resources and guidance to First Nations partners.
“The pandemic shows the degree to which the STARS transport physicians are part of, and contribute to, the fabric of the larger health-care system,” said Dr. Martin.