PHE forced to issue urgent guidance to combat covid spread in ambulances

Rotating clinicians and keeping ventilation running are among Public Health England’s (PHE) recommendations for how to avoid spreading covid while looking after patients in the back of ambulances outside emergency departments.

The suggestions are made in unprecedented new guidance issued by PHE amid sky-high rates of very long ambulance handovers outside hospitals.

This is because emergency departments (EDs) are struggling with attempts to maintain distancing for infection control, along with high occupancy and severe operational pressures elsewhere in hospitals. It has led over the past two months to large numbers of patients being looked after in ambulances for extended times while they wait for space in ED.

The PHE guidance, added last week to existing covid guidance for ambulance services, says it should only happen in “exceptional circumstances”.

But it says staff in this situation should adopt infection prevention and control procedures including:

• if more than one clinician is available, rotating them regularly, so allowing them time to change PPE and have a drink; 
• keeping ventilation systems running which may require the engine to be kept running;
• ensuring patients and any essential escorts wear surgical masks, as long as patient care is not compromised;
• minimising the number of people within the patient compartment and avoiding sitting face-to-face with patients; and
• decontaminating contact surfaces more frequently and during the delay if possible.

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Source: HSJ, 25 January 2021