EUROCAE is a non-profit organisation, created in 1963 as The European Organisation for Civil Aviation Equipment, and is an internationally recognised Standard Developing Organisation (SDO) known for its high quality, safety critical standards. The initial focus was the development of standards for aircraft equipment/system, but now its portfolio includes any aviation-related equipment, system, services or process aspects. To date, over 4,500 experts from association members contribute to the production of EUROCAE Documents (EDs).
Covid patient transportation
The Covid-19 pandemic has changed society and economy on an unprecedent scale. Commercial aviation was, and still is, severely affected. At the same time, the pandemic has resulted in high demand for air medical transport of seriously ill patients, both domestically and on international missions.
In early 2021, the EUROCAE secretariat was contacted by an air ambulance organisation as the aeromedical industry found it was lacking a set of common and cohesive guidelines for the safe handling and transportation of infectious passengers. The movement of patients with highly infectious diseases (HID) between hospitals in air ambulance aircraft is a technical, logistical, and medical challenge, with significant risks for the safety of the patient, the crew and the public.
Of course, the main reason for this request was related to the Covid-19 pandemic; however, it is likely that other pandemics will impact the aviation industry in the future, never mind other infection risks during regular ambulance operations. Air ambulance providers are a niche set of operators in the world of aviation, and therefore are not being recognised sufficiently in ongoing standardisation activities neither in neither the medical nor aviation domains. Therefore, a framework of guidelines is considered to be a means by which to foster crisis response and help combat the impact of infectious diseases in the future.
Actions taken to remedy the lack of clarity for air medical operations
Following the process for a new activity at EUROCAE, this initiative was first discussed at the Technical Advisory Committee (TAC) level, where a group of technical experts assessed the rational and expected outcomes. In November 2021, the creation of a specific Working Group (WG) was agreed by the Council – the EUROCAE governing body representing our members. To avoid any duplication with existing work or documentation, the scope of this new WG-123 was limited to air ambulance operations only, with a mandate ‘to develop guidelines for aeromedical passenger handling and transport in respect to Covid-19 and other infectious diseases’.
At the moment, 14 organisations representing diverse affected sectors are registered in the group
WG-123 was requested to produce, following our approved development process, a document that would specify the expected international framework and include all measures related to risk prevention, management of incidents, training, and tracking with regards to infectious passenger handling. This ED is expected to be ready in about one year for the Open Consultation phase, where the content is submitted to the review of all experts, within and even outside EUROCAE.
The kick-off meeting of this new activity took place virtually on 10 February 2022, with around 20 participants from around the globe.
A global perspective on a global problem
Experts with a wide range of expertise and origin joined the initial meeting; and newcomers are always welcome to improve the quality of the work. At the moment, 14 organisations representing diverse affected sectors are registered in the group, including air ambulances, medical teams, medical equipment makers, aircraft manufacturers, research and development and airspace regulatory authorities. The participants come from 10 nations, and while most are European, we are also pleased to welcome input from professionals in Australia, China, Korea and the US. The participation of representatives from the United Nations and from the military medical community is also to be noted, and serves as an indication of the strong interest we have seen in our work from the global community.
The aim of the first meeting was to establish a common understanding of the task and adopt a methodology for the coming months. Following an introduction of the various organisations in the audience, the leadership team was elected, with Dr Alex Veldmann and Dr Walter Klimscha, both from UNICAIR, as WG Co-Chairs and Dr Cai Glushak, from EURAMI, as WG Secretary.
Since February, several meetings have been organised to progress the document, firstly agreeing on a table of contents, then integrating inputs provided by the different contributors. The guidance document is expected to include:
- Considerations about the notion of isolation of patients with HIDs
- Guidance regarding isolation in aeromedical transport, through Personal Protective Equipment or isolation units
- A risk-benefit analysis for the crew and the patient
- Recommendations for, and special considerations of, the patient, the aircraft cabin, and medical equipment.
Of course, a preliminary chapter on the purpose and scope of the WG will be included, and a concluding chapter will complement the document, according to the EUROCAE template.
From the beginning, all meetings were organised virtually to optimise the agenda of the different experts, as most of them are frequently involved in the provision of emergency medical services on the ground and in the air. The next meeting is planned to be virtual on 26 September, and will see a first draft document made available for review by all members. We expect that by the end of the year, as the document matures, an in-person meeting will allow direct contact of all WG members and will facilitate progression of the project, as was the norm in the pre-Covid years for a standardisation activity.