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Transport of patients/users during COVID-19
This article describes the basic measures that are recommended to reduce the risk of transmission, as well as enhanced measures that are relevant in the event of an increased risk of transmission. The purpose is to protect passengers / users and employees against infection, and to limit the spread of infection. The recommendations given in the guidelines for public transport also apply to the transport of patients / users.
Each company is responsible for assessing whether the transport satisfies basic requirements for infection control, and therefore can be offered. Each company must consider how the measures are to be adapted to their business and local conditions.
The company must ensure that all employees are familiar with the infection control measures that apply to the company and ensure that these can be followed.
The company or its employer should map and make a risk assessment of the risks and problems that may arise as a result of coronavirus. Reference is also made to information on the Norwegian Labour Inspection Authority's website.
If transport is requested by the healthcare service, the person making the request must state whether enhanced infection control measures must be implemented before transport. The information shall not contain patient information.
The transport company shall establish routines for how transport will take place. They must also ensure that all employees are familiar with these routines and have received training in current routines. The transport company shall arrange for the infection control advice to be followed by both the driver and the patient / user before, during and after transport.
Each driver must be familiar with the current routines for transporting patients / users during the COVID-19 pandemic. The driver must assist passengers so that they can comply with the infection control advice.
The individual driver must strive to follow the infection control advice;
- Stay at home with symptoms of illness
- Keep a distance of 1 metre to the patient / user during transport
- Perform hand hygiene before and after contact with patient / user
- Maintain cough etiquette
- Avoid shaking hands
Patient / user
The patient / user has a responsibility to follow the current infection control advice specified by the transport company during the entire transport.
Transport of patients / users without suspected or confirmed COVID-19
The advice is based on the guidelines for public transport, with separate assessments for patient transport.
The probability of transmission increases with the time spent together. For longer transport stages (for example more than one hour), the need for enhanced infection control measures should be considered, for example, that both the patient and the driver use a face mask.
Preferably use means of transport that maintain distance between driver and patient / user and any fellow passengers.
Consider establishing cohorts of drivers who have been trained in enhanced infection control routines, including the use of protective equipment.
Consider having plexiglass screens between driver and passengers.
Especially for taxis: Passengers should sit in the back seat. The distance between the driver and passengers in the back seat is considered sufficient as they do not sit face to face.
Depending on the type of means of transport / car, a distance of 1 metre must be arranged between passengers during transport.
Ordinary routines are followed for cleaning the car.
Enhanced infection control measures (assessed on the basis of the risk of transmission in society):
Passengers and employees should wear face masks during the journey when distance cannot be maintained.
Companies should enhance their cleaning and waste management routines.
Especially for taxis:
- It is recommended not to have passengers in the front seat to maintain distance
- It is recommended that passengers in the back seat wear a face mask if there are several passengers and they do not belong to the same household / cohort
- It is recommended that the driver wears a face mask
When the patient needs assistance
The need for assistance and the need for mobility aids such as a walking frame or wheelchair shall be clarified when ordering transport.
Where possible, any need for assistance should be handled by the companion.
If the companion cannot provide assistance, the driver shall ensure that the patient is wearing a face mask and performs hand hygiene with soap and water or disinfectant before giving assistance.
Transport of passengers with suspected or confirmed COVID-19
In situations where the infection status is unclear, enhanced infection control measures must be ensured. The number of passengers should be reduced. The patient will wear a face mask during the entire transport stage.
It is not recommended to transport passengers / users who are isolated at home with a confirmed COVID-19 without having clarified this with the health and care service in the municipality in advance.
If transport cannot be postponed, transport and necessary precautions should be agreed in consultation with the health and care service in the municipality. Alternative transport in the form of an ambulance can be considered.
A patient with confirmed COVID-19 should be transported alone, except for necessary companions.
Always prepare the following equipment before transport:
- hand disinfectant gel and disinfectant wipes
- face masks
- eye protection (visor or glasses)
- paper towels
- rubbish bags
Ensure that the driver and passengers can perform hand hygiene before and after transport. Hand hygiene can be performed with hand disinfectants.
Transmission by hands with gloves happens in the same way as for hands without gloves. Using gloves does not replace the need to perform hand hygiene. Therefore, routine use of disposable gloves is not recommended.
Passengers and companion should put on a face mask before entering the vehicle. Face masks can be removed after the passenger and companion leave the vehicle.
The driver should open and close the vehicle doors so that the patient can avoid touching contact surfaces as much as possible when entering and leaving the vehicle, and during the journey.
When transporting a passenger with confirmed COVID-19, the driver should use a visor.
Where possible, do not use ordinary cars (5-7 seats). This is based on an assessment that the distance between the driver and passengers will be too small to prevent transmission.
Use a bus, minibus or other vehicle where the distance between driver and passenger is more than 2 metres. As a general rule, no more than one passenger should be transported at a time, in addition to a companion (if required).
Keep a distance of 2 metres between the driver and passengers when entering and leaving the vehicle.
During transport, set the vehicle's ventilation / air conditioning system so that the air does not circulate inside the car, ventilation with open windows is also possible.
The transport company must establish routines for cleaning of vehicles.
Cleaning includes areas that passengers have been in direct contact with and surfaces near to where the passengers were sitting (approximately 1 metre).
With low risk of transmission follow ordinary cleaning routines.
With increased risk of transmission, enhanced routines should be considered. Enhanced routines include use of targeted cleaning with disinfectant alcohol 70 % alcohol) of all common touch points (on all the smooth surfaces that the passenger may have touched, such as door handles, the seat and seat belt).
If bodily fluids such as saliva, urine, or vomit are spilt in the vehicle follow this advice:
- For all contact with spills: Wear a face mask, eye protection and gloves
- Wipe up spills using paper towels that is disposed of immediately
- Wipe the area with disposable disinfectant wipes
- Dispose of rubbish with general household waste
- Perform hand hygiene after taking off 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, but perform hand hygiene after handling these items.