COVID-19 Response

Transporting patients during a pandemic

When the pandemic arrived in Maine in March 2020, it brought with it levels of uncertainty, complexity, stress, grief and worry that hadn’t been experienced in decades. Even as businesses closed, schools sent students home and people began a months-long quarantine, LifeFlight, like all of our healthcare colleagues on the frontline, jumped into action. The organization began the careful process of developing new procedures and protocols that would allow the flight crew to continue to care for critically ill and injured patients in an environment that would keep everyone safe from exposure to a new and deadly disease.

With no time to conduct comprehensive research, frontline healthcare teams cross the country and world had to look to each other to share experiential knowledge. From the beginning of the pandemic, LifeFlight’s leadership and medical directors participated in ongoing conversations to accelerate learning with air medical transport partners across New England and attended tri-weekly webinars hosted by federal partners at the HHS Office of Preparedness and the National Emerging Pathogens Training Center at Emory University incorporating thousands of physicians and clinicians from across the world in real time peer-to-peer learning for ICU, ED, and EMS care. From these peer sharing efforts leaders continually revised clinical protocols for the management of highly infectious respiratory disease and standard operating procedures for managing COVID patients. In turn, this allowed continual collaboration with EMS and hospital partners to rapidly advance new practices to protect clinical staff and patients.

In addition, LifeFlight crew members and managers met bi-weekly to share learning from the frontline — what was working, what wasn’t, what unexpected challenges cropped up. Armed with the real-time feedback, Medical Director of Quality Assessment and Performance Improvement Pete Tilney DO, Medical Director Norm Dinerman MD along with clinical and program leadership continually updated protocols, checklists and processes. Each iteration of these guiding documents helped the flight crew develop safer and more effective clinical and operational practice.

Providing critical care in a transport environment, especially an aviation environment, has always been a complicated endeavor. To mitigate the risk inherent in aviation operations, LifeFlight has embedded safety into the organizational culture at all levels. One way we do that is through intensive training and simulation which helps crew members develop safe habits and build muscle memory around desirable actions. Starting in March 2020, the flight crew used this training model to instill behaviors and processes developed in response to the new challenge of COVID-19

Caring for patients with COVID-19, or even transporting those patients who might be infected, added an unexpected layer of complexity to LifeFlight’s mission. Flight Nurse Chuck Hogan, LifeFlight’s Director of Clinical Operations, shared that one of the challenges brought about by the pandemic is the additional time spent on the overall planning of these missions.

“Deliberate and careful planning is absolutely essential to maintain the safety of our crews, patients and our hospital and EMS colleagues,” he said. “Our crew members must correctly don the appropriate level of PPE and maintain that barrier throughout the transport. Any supplies or equipment we might need must be carefully considered. And then there’s all of the cleaning and disinfecting that comes after the transport.”

To maintain a high degree of safety, the flight crew must master all of these new tasks and details. Nothing is left to chance. With that in mind, LifeFlight developed new checklists that include guidelines for cleaning the helicopters, airplane and ground ambulances, as well as a detailed process for performing a mission involving a known or suspected COVID-19 patient.

After just a few months of caring for patients during a pandemic, Chuck noted that the experience had already served as a reminder that attention to detail is critical in such a complex work environment. And that we can’t forget to take care of each other.