Lessons learned from the first 50 COVID-19 critical care transfer missions conducted by a civilian UK Helicopter Emergency Medical Service team.

BACKGROUND: The COVID-19 pandemic has placed exceptional demand on Intensive Care Units, necessitating the critical care transfer of patients on a regional and national scale. Performing these transfers required specialist expertise and involved moving patients over significant distances. Air Ambulance Kent Surrey Sussex created a designated critical care transfer team and was one of the first civilian air ambulances in the United Kingdom to move ventilated COVID-19 patients by air. We describe the practical set up of such a service and the key lessons learned from the first 50 transfers. METHODS: Retrospective review of air critical care transfer service set up and case review of first 50 transfers. RESULTS: We describe key elements of the critical care transfer service, including coordination and activation; case interrogation; workforce; training; equipment; aircraft modifications; human factors and clinical governance. A total of 50 missions are described between 18 December 2020 and 1 February 2021. 94% of the transfer missions were conducted by road. The mean age of these patients was 58 years (29-83). 30 (60%) were male and 20 (40%) were female. The mean total mission cycle (time of referral until the time team declared free at receiving hospital) was 264 min (range 149-440 min). The mean time spent at the referring hospital prior to leaving for the receiving unit was 72 min (31-158). The mean transfer transit time between referring and receiving units was 72 min (9-182). CONCLUSION: Critically ill COVID-19 patients have highly complex medical needs during transport. Critical care transfer of COVID-19-positive patients by civilian HEMS services, including air transfer, can be achieved safely with specific planning, protocols and precautions. Regional planning of COVID-19 critical care transfers is required to optimise the time available of critical care transfer teams.

Public Awareness of Knowledge, Belief, and Attitude Regarding Organ Donation and Organ Transplantation: A National Survey From the United Arab Emirates.

BACKGROUND: Organ donation in the United Arab Emirates (UAE) was restricted until recently to living donation. This survey was conducted to explore the public knowledge, belief, and attitude regarding donation during life and after death. METHODOLOGY: A 31-item survey was distributed among 900 participants (UAE residents) of whom 495 completed the forms and were considered for further analysis. RESULTS: Among the participants, 293 (59.2%) were women and 202 (40.1%) were men. With 8 items as the highest possible score, the mean score of knowledge was 4.42 (SD = 1.54) and 436 (88%) of the participants knew about a brain-dead condition. However, their awareness on organ donation and transplantation legislation in the UAE was not consistent, and less than 198 (40%) had correct knowledge in this regard. Religious belief regarding organ donation was scored at 80 and the mean of the beliefs score obtained was 56.56 (SD = 6.39). Together, 369 (74.6%) of the participants had positive religious sentiments regarding the issue. Participants' attitude toward organ donation and transplantation was scored at 14.7 out of 20 possible score (SD = 2.46) with 396 (80%) acknowledging the fact that organ donation and transplantation prolongs and improves recipient's quality of life. LIMITATIONS: The small number of respondents (n = 495) in the survey was a limitation of the study. CONCLUSIONS: The population of the UAE was moderately well informed and motivated about organ donation and transplantation. Although a knowledge gap about the current legislation prevailed, the majority of the participants were knowledgeable, they nurtured positive beliefs, and had compassionate attitude regarding lawful organ transplantation.