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Table 1 Decision support framework

From: Decision support tool and suggestions for the development of guidelines for the helicopter transport of patients with COVID-19

ThemeTopicConsiderations
Selection of patients for transportRegional risk assessmentVehicle availability. Availability of alternative platforms.
Risk of occupational infection on different platforms.
HEMS continuity and the impact of suspending HEMS/aeromedical services and redeploying staff.
Planned management of patients without COVID-19 symptoms
Infection control strategiesPPEPPE supplies
PPE training (including aircrew)
PPE compatibility with aviation safety and communications equipment
PPE compatibility with working environment (eg heat stress, visibility)
Minimise exposure: peopleProtecting the flight crew from patient contact (screens, no patient handling)
Reducing flight crew numbers
Aligning medical/aviation shift patterns to avoid exposure of multiple crews
Minimise exposure: equipmentRemoval of extra medical/rescue equipment
Removal of some aviation safety gear
Packaging equipment in wipe-down packaging
Choosing a route through the hospital to minimise cross-contamination
At the hospitalAccessing the patientTime and place for handover and donning PPE
Need for extra staff on ground (e.g. a runner in clean PPE to open doors/operate lifts)
IntubationLogistics of performing intubation in PPE
Policy for use of PPE during the intubation of non-COVID-19 patients during pandemic COVID-19
PackagingHow to package the patient to reduce their infectivity
At mission completionWaste disposalManagement of increased clinical waste
Sorting of waste to minimise clinical waste
DecontaminationSuitable aircraft cleaning products, and their availability
Where and by whom the aircraft will be cleaned
Follow-upManagement of PPE breaches
Management of exposed or symptomatic staff
In the communityBase livingModifications to cleaning schedule
Minimising staff on base
Maintaining morale
Social distancing off-duty