An Updated Review of Literature for Air Medical Evacuation High-Level Containment Transport During the Coronavirus Disease 2019 Pandemic

Jocelyn J Herstein; Claire E Figi; Aurora B Le; Elizabeth L Beam; James V Lawler; Elizabeth R Schnaubelt; Gary W Carter; John J Lowe; Shawn G Gibbs

doi:10.1016/j.amj.2022.12.007

An Updated Review of Literature for Air Medical Evacuation High-Level Containment Transport During the Coronavirus Disease 2019 Pandemic

Air Med J. 2023 May-Jun;42(3):201-209. doi: 10.1016/j.amj.2022.12.007. Epub 2023 Jan 3.

Authors

Jocelyn J Herstein¹, Claire E Figi², Aurora B Le³, Elizabeth L Beam⁴, James V Lawler⁵, Elizabeth R Schnaubelt⁶, Gary W Carter⁷, John J Lowe⁸, Shawn G Gibbs⁹

Affiliations

¹ Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE; Global Center for Health Security, Omaha, NE. Electronic address: jocelyn.herstein@unmc.edu.
² Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX.
³ Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI.
⁴ Global Center for Health Security, Omaha, NE; College of Nursing, University of Nebraska Medical Center, Omaha, NE.
⁵ Global Center for Health Security, Omaha, NE; Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, NE.
⁶ Global Center for Health Security, Omaha, NE; Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, NE; United States Air Force School of Aerospace Medicine, Dayton, OH.
⁷ National Strategic Research Institute, Omaha, NE.
⁸ Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, Omaha, NE; Global Center for Health Security, Omaha, NE.
⁹ Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX.

Abstract

Objective: In 2019, our team conducted a literature review of air medical evacuation high-level containment transport (AE-HLCT) of patients infected with high-consequence pathogens. Since that publication, the coronavirus disease 2019 (COVID-19) pandemic has resulted in numerous air medical evacuations. We re-examined the new literature associated with AE-HLCTs to determine new innovations developed as a result of the pandemic.

Methods: A literature search was performed in PubMed/MEDLINE from February 2019 to October 2021. The authors screened abstracts for the inclusion criteria and reviewed full articles if the abstract was relevant to the aim.

Results: Our search criteria yielded 19 publications. Many of the early transports of patients with COVID-19 used established protocols for AE-HLCT, which were built from the most recent transports of patients with Ebola virus disease. Innovations from the identified articles are subdivided into preflight considerations, in-flight operations, and postflight operations.

Conclusion: Lessons gleaned from AE-HLCTs of patients with COVID-19 in the early weeks of the pandemic, when little was known about transmission or the severity of the novel disease, have advanced the field of AE-HLCT. Teams that had never conducted such transports now have experience and processes. However, more research into AE-HLCT is needed, including research related to single-patient portable isolation units as well as containerized/multipatient transportation systems.

Publication types

Review

MeSH terms

Air Ambulances*
COVID-19*
Humans
Pandemics
Patient Isolation