Sars

[Hingeless Rotor]

I was asked yesterday by the medic if we were prepared to carry SARS patients. We are not normally a medical transfer aircraft but have the provisions for oxygen and stretchers if our contract provider requires the emergency extraction of an employee.

My answer involved many uum’s and aar’s but inevitably I said that if we had the same equipment issued to us as the medical officers then I couldn’t see a problem.

Should I now regret this answer if in the unlikely event we are actually required to carry a patient with SARS or any other virus for that matter?

Is there guidelines within an EMS operators Op’s manual that covers the transfer of patients with infectious diseases?

I think I will just turn on the ECS …………………… :cool:

[topcat450]

You'll be fine so long as you don't breath in. :ok:

[Red Wine]

:\ :\

Its interesting to note that downunder....1700 - 2000 people die each year of the common flu...........and around 3000 killed on the roads.
Not to mention AIDS and Hep A + B + C

And thats just Oz.........[population 19 m......work the ratio out for the USA with 280M...UK 65M...China 1.4 B....and India 1.2 B.]

Why has the WHO got so focused on a problem that has killed less than 200 worldwide......???

Perhaps someone wants more funding.......or perhaps it is serious.....not sure.

[NickLappos]

Red Wine,

I, too, think we are getting much hype about SARS, but the facts are scarey. SARS kills about 6% of all who catch it, as opposed to a bare fraction of that for flu. In fact, SARS kills young healthy people, even when they are in the hospital, hooked up to the latest support systems.

If SARS were to sweep the US, and 10% of the population caught it (common number for flu) and 6% of those who caught it died, there would be 1.5 million deaths! This last occurred in an outbreak in 1919, which did cause such numbers.

[flapsforty]

HR, I've been wondering about some similar stuff, (I'm a flight attendant with a large international airline) so have just posted a query on the Medical forum, perhaps the experts there have some insights.

Mr Lappos; Prof Roy Andersson in the UK said last week that the mortality rate for SARS is starting to climb to over 10% now.....
As you say, scary.

[pohm1]

I think it was Steve76 that posted a picture on another thread of himself on the sticks wearing a surgical mask during medivac's. Maybe some operators are taking it more seriously than others.

[jstr4753]

I was discussing the same thing with a UK operator just yesterday. Found CDC guidelines for EMS SARS transport on the internet:

http://www.cdc.gov/ncidod/sars/emtguidance.htm

Think with the mortality rate climbing by the day its worth taking some precautions.

[NickLappos]

the 1919 flu pandemic killed about 20 to 40 million people, about 2.5% of those who caught it.
Here is a Stanford University web site about it:

http://www.stanford.edu/group/virus/uda/

and another:

http://www.pbs.org/wgbh/aso/databank/entries/dm18fl.html

[fu 24 950]

Sars , Hong Kong Population is 7 million and tonight's new's the death toll was 138. I have got more chance of a pay rise than catching SARS

[radiohead]

Nick - your comments are sadly typical of the media reaction to Sars worldwide. Stating that such-and-such a percentage of those who catch the disease die is irrelevant - how many of those unfortunate enough to catch ebola die? Or even 'normal' pneumonia? Media hype is sweeping the world.

[Steve76]

We now have to wear gloves (medical variety) and the I95 mask with all patients. If near the stretcher we have to gown up as well. It is impossible to fly with the gown on, so that gets ditched ASAP.
We have new proceedures for venting the cabin when we have a suspected respiratory case. It involves facing forward the pilots popout vents thus positively pressurising the cockpit. This area is separated by a screen from the cabin area which is then negatively pressurised by reversing the window vents. Sounds micky mouse but we hope it works.
I hope this is under control by next winter as I am not sure whether I want a pressurised stream of -25 C + wind chill blasting my willie......:uhoh:

[Thomas coupling]

Give this topic another couple of weeks and the media will grow bored at the rate of change of SARS infections. Already places like Singapore and vietnam have statistically restrained the virus. There have been no new cases in Vietnam since April 8th. The incubation period for a virus of this transmissitivity and complexity is normally 10 days. The WHO have doubled this incubation period to be safe and still Vietnam beats the deadline.
Just a massive storm in a tea cup.
The real threat would be if SARS made its way to third world countries, then you'd see epidemic proportions.

Population of China is 1,300,000,000 (ish). Number of SARS infected persons (known) 3000 to date. Currently this accounts for 0.00023% of the population.
For the US this would equate to 644 catching it and 38 dying from it to date (6%). Probably the same mortality rate as a blind man with a wooden leg crossing the grand canyon on a wire, with woodworm in his stump whilst being struck by a hijacked low flying helo.

What will the media turn their attention to next, I wonder................... :uhoh:

[IHL]

I have spent a lot of years flying EMS in a variety of helicopters and have always been concerned with the lack of concern for the front end crew.

On one night flight in the mid eighties The medics showed up all gowned up ready to go with a highly infectious patient, we as a contacter had no suits; I held my ground and said" come across with the suits or no transfer". They got us some suits and we did the transfer.

For such aborne deseases as meningitis, TB, or SARs it would be a simple solution to plumb in oxygen to the pilots and crew. O2 is available on all EMS aircraft; all that would be required is the plumbing and o2 aviator masks.


Steve 76 : your mail box is full.

[Steve76]

IHL,

Try my PM's now. I have had a little finger trouble :)

[B Sousa]

You folks worry too much. SARS is 6,10, 15 %......Ok.
AIDS is 100%. So breathing is not the problem......In Foreign Countries your breath is not going to get you killed. Its what you say or who you do........

[What Limits]

The two major EMS providers in the UK both have SARS in the 'Do not carry' category.

[Anton van Dellen]

CDC recommendations very comprehensive and recommended.

Don't forget to put a mask on the patient. Main purpose of standard (surgical) mask is to protect against droplet egress from the patient. People around the patient need an N-95 fit-tested respirator type mask, not just a standard surgical mask.

Certain medical procedures appear to be higher risk for spreading infection, namely nebuliser use and the act of intubation.

Full PPE:

N-95 respirator mask
Goggles/face shield
gloves
alcohol wipes for post-glove removal
disposable gown (not just plastic apron)

Probably not a good idea to move these patients by air if possible due to detailed decontam requirements for patient compartment and associated medical equipment - suspect you will be off-line for min. 2 hours or longer turn-around.

ITU admission rates for ventilation seem to be around 20%.

Yes, there are other diseases around - this one is par. noticeable due to the fact that the medics seem to get affected and die, unlike malaria, etc.:uhoh: