Mr John Lewis1, Dr Tim Parker1
1Aspen Medical, Brisbane, Australia
Introduction:
Provision of high-quality critical care in the austere aeromedical environment presents a unique set of challenges for retrieval teams, whilst the global COVID-19 pandemic has added multiple layers of further complexity to both mission co-ordination and execution.
Case Overview:
A non-English speaking, SARS-CoV-2 positive, 44-year-old male, developed increasing respiratory distress on board an international cargo ship situated off the north-western coast of Queensland, with no medical support available. The patient was initially retrieved from the vessel via helicopter to a small mainland domestic airport for nurse-escorted secondary transfer via fixed-wing jet to a designated COVID-19 receiving tertiary centre, located 2,500 km south. He was found to hypoxaemic to 83% on room air, tachypnoeic with moderate work of breathing, and required initial assessment, management, and stabilisation for long-range transport on the tarmac, in ambient temperatures of 36oC, whilst staff were donned in full personal protective equipment (PPE).
Discussion:
Longitudinal assessment of this case will both outline, and demonstrate an approach to, the myriad concurrent competing considerations that characterise aeromedical transport of critically ill COVID-19 patients across a region of widely varying climate and vast geographical distance. Particular focus will be given to the need to prevent horizontal SARS-CoV-2 transmission during provision of patient care through appropriate PPE use, balanced against mitigation of crew heat stress exposure in a tropical environment.
Biography:
John Lewis
John is a U.K Emergency Medicine Trainee, currently on out of programme training, working as a Retrieval Registrar for RFDS South Eastern. He is Loving the fresh plains of Dubbo after the smog of East London.