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  • Transport of patients/users

Article in manual

Transport of patients/users

Here you will find advice and information about transporting patients/users in Norway during the COVID-19 pandemic.

Here you will find advice and information about transporting patients/users in Norway during the COVID-19 pandemic.


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Under revision

This page is being updated. Meanwhile you will get the latest update from Feb. 12, 2022 on National recommendations and rules (government.no)

On 9.12.2021, the Government introduced national recommendations to hold 1 metre distance from others than household members and the requirement to use a face mask in public transport and taxis if it is difficult to keep a distance. 

Companies that provide transport of patients / users should have a special focus on  high compliance with infection control advice. We do not yet know enough about the risk of infection and disease burden of the omicron variant, and the advice will be adjusted on an ongoing basis.

Companies should ensure that employees, patients/users and companions are aware of the general infection control advice. This includes staying home when you are ill and having good cough etiquette and hand hygiene.

Companies should facilitate vaccination of employees against COVID-19 and influenza and for testing for respiratory tract symptoms or suspected COVID-19 infection.

The risk of infection will vary geographically and municipalities can implement measures based on local risk of transmission. Companies must adapt to infection control measures based on local risk of transmission and current national and local infection control measures. 

Responsibility

Requester

The requester must follow ordinary routines for ordering patient transport, and state which infection control measures must be implemented before and during transport and whether COVID-19 is suspected or confirmed. The information shall not contain patient information.

  • The need for assistance and the need for aids such as a walker, wheelchair or similar must be clarified when ordering transport.
  • Where possible, the need for assistance should be taken care of by a companion / relative.

Transport company

The transport company follows ordinary routines for transporting users based on information from the requester.

Each company is responsible for assessing whether the transport satisfies basic requirements for infection control, and thus can be offered

The company has a responsibility to assess whether the transport heeds general infection control advice and is adapted to local conditions. In addition, it is important to carry out a risk assessment to identify the risk of infection and other conditions that may arise as a result of SARS-CoV-2 (coronavirus).

The transport company shall follow local, regional and/or national infection control advice and establish routines for how transport is carried out:

  • Ensure that there are routines for employees to stay at home with newly arisen symptoms of respiratory tract infection.
  • Establish routines for follow-up of employees who test positive for COVID-19 and collaborate with the municipality about notification of close contacts.
  • Assess preparedness for high sickness absence among employees.
  • Ensure that all employees are familiar with these routines and have received training in current routines and facilitate the implementation of these.
  • Arrange for the infection control measures to be followed by both the driver and the patient/user before, during and after transport.
  • Provide information about current infection control advice in effect to patient/user.
  • Ensure that drivers receive training in use of personal protective equipment when transporting patients / users with suspected COVID-19.
  • Develop routines for cleaning vehicles.

Driver

Each driver has an individual responsibility to familiarise themselves with the current routines for transporting patients/users.

The driver should assist patients/users so that they can follow current infection control advice.

In addition, the driver shall: 

  • Stay at home for newly arisen respiratory tract symptoms and test for suspected SARS-CoV-2.
  • Drivers who have been in close contact to a COVID-19 case must follow the advice for close contact, and not go to work until the duty to quarantine and be  tested has been clarified and possibly completed.
  • Maintain good hand hygiene and cough etiquette.
  • Try to keep a distance of 1 metre to the patient / user during transport.
  • Avoid shaking hands with the patient / user or companion.
  • Perform hand hygiene before and after assisting the patient / user where necessary.

Patient/users and companions

In the event of newly arisen respiratory tract symptoms, regardless of vaccination status, the patient / user should consider the need for transport and whether to postpone the journey, if possible.

The patient/user should receive information so that they will be able to follow the current infection control advice specified by the transport company during the entire journey.

Transport of patients/users without suspected or confirmed COVID-19

The probability of transmission increases with the time people are together. For longer transport stages (for example more than an hour), the need for reinforced infection control measures should be considered, in that, for example, both the patient / user and the driver use a face mask.

  • Depending on the type of transport / car, a distance of 1 metre must be arranged between the patient / user and the driver during transport. Preferably use a means of transport that allows passengers to keep a distance.
  • For car / taxi: Patient / user / companion should sit in the back seat. The distance between the driver and the patient / user / companion in the back seat is considered sufficient in that you do not sit face to face. Two passengers can sit in the back seat at the same time.
  • The patient / user, companion and driver should wear a face mask throughout the journey.
  • If the driver must assist the patient / user and after the journey, and where physical contact is expected, the driver can consider the need for protective clothing and possibly gloves.
  • Cleaning after transport of patients / users without suspected or confirmed COVID-19 should follow the company's ordinary cleaning routines.

Transport of patients/users with confirmed COVID-19

A patient/user with confirmed COVID-19 should be transported alone, except for necessary companions. In situations where the infection status is unclear, infection control measures should be followed as if the patient / user has confirmed COVID-19.

If possible, transport should be postponed. If transport cannot be postponed, transport and necessary precautions should be clarified in advance and in consultation with the health and care service (hospital / municipal health services / private health provider). Alternative transport in the form of an ambulance can be considered. Healthcare professionals and drivers working with known coronavirus cases are advised to turn off tracking on the Smittestopp app during working hours.

Infection control measures:

  • If possible, a distance of 2 metres between driver and patient / user is recommended.
  • The driver, patient / user and companion must wear a medical face mask during the entire transport stage, unless use of a face mask is contraindicated for medical reasons. If the patient / user cannot use a medical face mask, the driver should use respiratory protection.
  • The driver should also wear eye protection (visor or goggles) gloves and perhaps protective clothing. 
  • Arrangements must be made for the driver and patient / user to perform hand hygiene before and after a transport. Hand hygiene can be performed with hand disinfection. The use of gloves does not replace the need to perform hand hygiene. Therefore, routine use of disposable gloves is not recommended. Hand hygiene is performed immediately after removing gloves.

The following equipment must always be prepared before transport:

  • hand disinfectant
  • gloves
  • medical face masks, possibly respiratory protection for use during longer transport stages.
  • eye protection (visor or glasses)
  • paper towels, cloths or disposable disinfectant wipes
  • collection bags for waste

Vehicle assessment:

  • Ordinary passenger cars (5–7 seats) should preferably not be used. This is based on an assessment that the distance between driver and patient / user will be too small to prevent infection.
  • Bus, minibus or other vehicles where the distance between driver and patient / user is more than 2 metres should be used if possible. As a general rule, no more than one patient / user should be transported at a time, in addition to any companion.
  • The distance of 2 metres must be maintained during boarding and disembarking as far as possible.
  • During transport, the vehicle's ventilation / air conditioning system should be set so that air does not recirculate inside the car.

Completion of transport

  • The patient / user and any companion put on a face mask before entering the vehicle. The face mask is removed after the patient / user and any companion have left the vehicle.
  • The driver opens and closes the door so that the patient / user touches the contact surfaces in the vehicle as little as possible when entering, leaving and during transport.

Vehicle cleaning after transporting patients/users with suspected or confirmed COVID-19

Cleaning includes areas that patients/users have been in direct contact with and surfaces near to where the patients/user were sitting (approximately 1 metre).

See: 

For incidents where a patient / user being transported spills body fluids (saliva, urine, vomit) in the vehicle, the following advice should be followed:

  • Before all contact with spills, the person performing the cleaning must consider the use of protective equipment (face mask, eye protection and gloves).
  • Remove spills using paper towels that are immediately thrown in a waste bag.
  • Waste is disposed of as general waste.
  • Wipe the area with a clean, damp cloth and detergent or disposable disinfectant wipes.
  • Perform hand hygiene after removing gloves.

Clothing, luggage, walking frames and other belongings are assumed to cause little contamination in a vehicle. It is therefore not necessary to clean the luggage compartments.

History

12.01.2022: Updated as per Norwegian version.

13.12.2021: Updated advice about face masks

10.12.2021: Change of text in relation to other updated advice.

08.12.2021: • Updated an earlier version of the advice in accordance with advice from the Government, the current level of infection risk and new variants • Inserted links to other articles in the corona guide

23.11.2021: Updated section: Transport of patients/users without suspected or confirmed COVID-19

16.11.2021: Update advice according to national guidelines

07.10.2021: Comprehensive revision of text, including change of heading, updating links.

02.06.2021: Inserted a point about changed advice when the patient / user is protected and for the unvaccinated. Minor adjustments in text

09.02.2021: Moved a sentence about advice from Directorate of Health to the first part of this article.

01.02.2021: Replaced "passenger" with "patient/user" throughout. Moved sentence about smittestopp 

29.01.2021: 

  • Clarified infection control measures related to the transport of patients / users without suspicion of covid-19 and the transport of patients / users with suspected or proven covid-19.
  • Clarified and shortened paragraph about responsibility with new descriptions for each actor; requester, transport company, the individual driver and patient / user.
  • Clarified enhanced infection control measures.
  • Updated measures for transport of patient / user with suspected or proven covid-19.

29.10.2020: Article is updated throughout according to the Norwegian version

05.10.2020: Under paragraph "When patient cannot wear a face mask" - changed first bullet point from "Surgical face mask (type I)" to "Medical face mask"