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The collated experiences and lessons from recent Major Incidents experienced in the UK is now juxtaposed with the ‘new normal’ of the healthcare community and emergency services operating with the threat of COVID-19 and the associated considerations of PPE against Aerosol Generating Procedures.
Emergency service personnel and hospital clinicians will have trained with ‘universal precautions’ and risk-specific personal protective equipment for Health Emergency Preparation Exercises (HEPE) previously. COVID-19 has resulted in wide-spread adoption of single-use coveralls and respiratory protective equipment (facemask and powered hoods) beyond the specialist responders who would have normally exercised for major incidents whilst operating with these.
With a return to a new normality of service provision and emergency preparedness, the clinical and logistical challenges of operating in AGP PPE need to be factored into MI plans and future practical exercises across the emergency services and acute hospital care. These range from those issues at the operational level such as dynamic risk assessment, identification and communication between clinicians and commanders at scene, record keeping and identifying the need to use COVID PPE (or when no longer needed, keeping in mind its exertional toll) and don and doff areas with ancillary staff.
Tactical issues include conveyance platforms and options for patients from scenes to hospital – some of...
Tactical issues include conveyance platforms and options for patients from scenes to hospital – some of which may then need to be taken out of service for deep cleaning and Emergency Department reception with definitive care; particularly given that many hospitals are still reconfiguring services and pathways around ‘red’ and ‘green’ intensive care beds and theatres. This continues to evolve with the deployment of rapid and point-of-care tests to inform bed and theatre decisions
At the strategic level, all stakeholders involved in the response to Major Incidents now have business continuity experience in a post COVID-19 world. This now needs to inform the persisting need for regular HEPEs in preparation for major incidents, mass casualty and marauding terror attacks.