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Air Medical Physician Association Position Statement on COVID-19

  • Air Medical Physician Association Board of Trustees
Published:April 08, 2020DOI:https://doi.org/10.1016/j.amj.2020.03.006
      AMPA is attentive to the concerns of its membership in addressing the challenges associated with the transport of patients with suspected or confirmed infection with SARS-CoV-2. Recommendations regarding the personal protective equipment required to care for these patients remain fluid, and AMPA recommends that its members remain familiar with the recommendations of the World Health Organization as well as those of their local, regional, and national health protection authorities.
      • AMPA supports social distancing and recommends seeking alternatives to gatherings of greater than ten people.
      • AMPA supports the WHO recommendation to employ standard, contact, and droplet precautions when caring for and transporting patients with suspected or confirmed infection with SARS-CoV-2.
        • AMPA recommends that patients with suspected or confirmed infection with SARS-CoV-2 wear a surgical mask during care and transport.
      • AMPA supports the WHO recommendation to employ standard, contact, and airborne precautions when caring for and transporting patients with suspected or confirmed infection with SARS-CoV-2 who are undergoing aerosol-generating procedures such as nebulization, mask oxygenation, high-flow nasal cannula oxygenation, non-invasive positive pressure ventilation, endotracheal intubation, bag valve mask ventilation, cricothyrotomy, tracheostomy, and cardiopulmonary resuscitation.
        • AMPA further supports the WHO recommendation to attempt to avoid performing aerosol-generating procedures in confined spaces.
        • AMPA therefore cautions against transporting patients anticipated to require aerosol-generating procedures during transport and suggests mitigating the need for aerosol-generating procedures prior to transport.
        • AMPA recommends the use of a certified bacterial and viral filter in the ventilator circuit of mechanically ventilated patients but recommends airborne precautions during transport to safeguard against unanticipated aerosol- generating procedures.
        • AMPA further recommends the mitigating use of a certified bacterial and viral filter (1) between the bag and the endotracheal tube or between the bag and the face mask of manually ventilated patients and (2) in the circuit of patients being provided non-invasive positive pressure ventilation, when feasible.
        • AMPA further acknowledges that local, regional, or national practice may be to employ airborne precautions on a broader population of patients with suspected or confirmed infection with SARS-CoV-2 and that these recommendations remain fluid.
      • AMPA recommends that pilots and other vehicle operators employ droplet or airborne precautions as appropriate, utilizing appropriately fit-tested personal protective equipment, unless the cockpit and patient compartment are completely separated.
      • AMPA cautions that using a particulate respirator mask while wearing a flight helmet may render the mask ineffective unless appropriate fit testing has been performed while wearing the helmet.
      • AMPA acknowledges that SARS-CoV-2 may survive in the environment for extended periods of time and recommends decontamination of all surfaces and open air ventilation of the patient compartment following the transport of patients with suspected or confirmed infection with SARS-CoV-2.
      Tabled 1
      Air Medical Physician Association Board of Trustees

      20 March 2020
      Brendan Berry, MDSteven Bott, MDBenjamin Lawner, DO
      Ryan Wubben, MDSamantha Gee, MDMichael Peterson, DO
      Doug Swanson, MDSteven Hancock, MB, ChB

      Michael Jasumback, MD
      Charles Sheppard, MD