CASE STUDY: Transporting highly contagious patients
Missions to transport contagious patients are demanding, and part of the everyday work of the crews of Swiss Air-Rescue (Rega). Thanks to Rega’s strong innovative drive, repatriating patients on board ambulance jets or flying them by rescue helicopter to a central hospital for further treatment, means the crews can conduct transports of this kind efficiently and safely for all concerned.
How it all started: the outbreak of Ebola in West Africa in 2014 made it only too apparent that there were as good as no safe concepts for transporting highly contagious patients. This gave Rega the impetus to work with partners to design a so-called patient isolation unit (PIU) for airborne transport and an accompanying transport concept. The objective was to be able to transport contagious patients safely with a minimum of personnel – not only with regard to the Ebola virus, but also to highly contagious diseases in general. It was a complex new development, because isolation needed to be guaranteed not just during the flight, but also throughout the entire transport, i.e. from hospital bed to hospital bed. In February 2015, Rega was in the position to evacuate a patient from the Ebola region in the PIU.
Well protected and cared for
As the PIU is a closed system, the medical crew are not required to wear protective clothing during the flight. Thanks to the ingenious design, they always have indirect access to the patient in the PIU and can provide them with the necessary medical care. After the Ebola epidemic ended, Rega crews performed three or four PIU transports a year – such as for patients with open tuberculosis. So when Covid-19 rapidly spread at the beginning of 2020, Rega was able to draw on this experience and has since repatriated several hundred Covid patients in the PIU.
Drawing on a wealth of experience
The desire to further optimise even the tried-and-tested is in Rega’s DNA. The experience gained in practice should be used to further improve the PIU. This was the task of a project team composed of various specialists: Rega Medical Director Roland Albrecht, representatives from the Jet Medical Care Service and the Helicopter Rescue Service, and the in-house Design and Development Centre. Their aim was to enable crews to use the PIU in a more flexible and modular way – and in both the ambulance jets and the rescue helicopters. The Rega engineers succeeded in making the PIU even lighter and more compact, a great advantage given the limited space available in the cabin.
Another innovation opened up brand new possibilities in terms of usage. Before, the high-performance particulate filter at the foot end of the PIU converted contaminated air from inside the unit into clean air and then released it into the environment. Now a second filter is mounted at the head end. The two filters are powered by a motor that draws the air through the unit, which means that germ-free air is also guaranteed inside the PIU. As a result, in future, crews will also be able to use the PIU to transport immunocompromised persons – patients who are dependent on germ-free air before or after an organ transplantation.
Self-testing and certification
In the field of aviation, everything that is carried on board an aircraft must comply with the strictest requirements and pass inspection by an independent body. The new PIU, too, is being subjected to a stringent testing procedure. The great advantage of Rega’s in-house development facility is that it is accredited by the European Union Aviation Safety Agency (EASA) and can approve modifications such as those made to the PIU itself. The new improved PIU should be ready for its first missions to help patients by the end of 2023.