mission impossible or border security – practical and effective infection control on air ambulances

Infection control on air ambulances is particularly difficult and although the principles have been well described in the hospital setting, not all of these can be applied to the air ambulance environment. Due to limited space, limited availability of running water and limitations on the amount of accessible equipment, the utmost care should be taken in upholding infection control principles. Infection control principles have to then be adapted to the air ambulance environment. These principles then have to be enforced by means of strict standard operating procedures (SOP’s) and continuous crew training. So what principles and SOP’s should be applied to create both practical and effective infection control programme for an air ambulance system? Various principles can be introduced into an air ambulance system to optimise infection control processes. These include the use of ”single use only” disposables, e.g., ventilator circuits and Bag Valve Masks, and needle-less systems. Furthermore, the ”bare below elbows” (BBE) principle should be enforced while working with the patient. Minimum acceptable levels of personal protective equipment (PPE) should also be promoted. Cleaning of equipment and aircraft post flight is of utmost importance. Flight crew should sign documentation post flight to declare the aircraft safe and ready for use, for both ground crews as well as subsequent flight crew. In conjunction with this all patients should be swabbed when being admitted into the receiving facility. To evaluate if these principles are followed, random swabs of equipment and the aircraft should be done regularly on a monthly basis. These principles have been applied to our air ambulance system based from Lanseria International Airport. By combining preventative and control measures, there has been no breach in our infection control strategies, as evidenced by no growth noted on specific and random swabs even when more and more ”super bugs” are being identified in hospital. As an air ambulance service flying patients from various African countries, we have the responsibility to conduct our own ”Border Security” to keep our hospitals, patients, aircraft and crews clean and safe. In this presentation we will share our ”Border Security” principles and experiences with the audience.