Norway SAR units rush incubators into operation for coronavirus patient transport

As the novel coronavirus began to spread throughout Norway in recent weeks, the country’s Air Force search-and-rescue (SAR) squadrons began purchasing airtight incubators to safely move an expected influx of infected patients with its SH-3 Sea King and Bell 412 helicopters.

For the last two weeks, the Norwegian Air Force has worked overtime to acquire EpiShuttle incubators, now in operational use at two of the country’s five SAR bases. The remaining bases will implement incubators by the end of next week, according to LCol Svein Tore Pettersen, commander of 330 Squadron, the first to deploy the incubators.

A Royal Norwegian Air Force SH-3 Sea King search-and-rescue helicopter and an EpiShuttle incubator now in use to transport COVID-19 patients. 330 Squadron photo
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“When we realized the severity of the COVID-19 situation, we needed to make sure we had the proper equipment for safe transportation of patients. We knew about EpiShuttle from earlier, but now it became very applicable. The incubator provides an air-sealed environment for the patient, who still receives all necessary treatment without spread of infection,” Pettersen told Vertical in an email.

“If we have suspicion or if it’s known that someone is COVID-19 infected, the use of this incubator will eliminate risk of exposure to our crew members. After each use, the helicopter will remain clean and safe for new operations. This way we can maintain our normal readiness state.”

The 330 Squadron of the Royal Norwegian Airforce is a 24/7 search-and-rescue helicopter unit that operates from five permanent search-and-rescue bases across the country. It flew 1,461 missions in 2019.

The squadron currently has 10 Sikorsky SH-3 Sea King helicopters, but two were recently retired. Those aircraft are scheduled for replacement with the Leonardo AW101 SAR helicopter beginning in 2020, according to 330 Squadron pilot Lt. Eric Lein. The unit flies with an aircrew of six: a pilot, co-pilot, flight engineer, system operator/navigator, rescue swimmer and an anaesthesiologist.

The 339 Squadron flies Bell 412 helicopters and has supported Health Region North (Helse Nord) with ambulance helicopter capacity in Northern Norway since 2018.

The Norwegian Air Force’s 330 and 339 squadrons and Norwegian Armed Forces Medical Services (FSAN) have, for a long time, had a close collaboration with the University Hospital of Northern Norway (UNN).

Since the beginning of March, Norway has had a strong increase in COVID-19 infections and it has been the highest priority to strengthen medical readiness both pre- and intra-hospital. Until recently, Northern Norway lacked the capacity to transport infected patients by helicopter.

The 330 Squadron was concerned about using its Sea Kings to move suspected or confirmed COVID-19 patients because it is difficult to protect the crew against the spread of viral infection inside the cabin, said LCol Håkon Asak, FSAN chief of airborne medevac.

Then, on March 12, a request came from Bård Rannestad, medical director at the helicopter ambulance base in Tromsø, regarding the possibility for the Air Force to assist in transport of infected patients in Northern Norway.

The same day a 339 Squadron Bell 412 flew to UNN hospital to test whether or not an EpiShuttle would fit in the cabin, said Lt. Bjørn Eidissen, the unit’s chief paramedic. The unit then began a race against the spreading virus to get the incubator operational with its helicopters.

On March 17, a final test was carried out with the incubator to ensure flight worthiness and medical compatibility. The Bell 412 helicopter became EpiShuttle operational the same evening.

For strategic and logistical reasons, the EpiShuttle incubator and medical response team is located at UNN hospital in the city of Tromsø. The concept is that a Bell 412 with a pilot, a system operator and a paramedic from FSAN will assist with these transports.

A 330 Squadron Sea King helicopter during exercise Flotex 2016. 330 Squadron photo

Two days later, a request came from UNN to assist with the transport of a COVID-19 infected patient from Gravdal Hospital in Lofoten. The Bell 412 flew to UNN and picked up the medical response team together with the EpiShuttle incubator. The plan was for the patient to be flown directly from Gravdal Hospital to Nordland Regional Hospital in Bodø. Upon arrival in the Lofoten Islands, snowy weather conditions had worsened, forcing the helicopter to land at Svolvær airport. The medical team was then transported with the ambulance to the patient.

The dense snow showers continued all evening. During the night a Sea King rescue helicopter from Bodø with radar capability was scrambled. The 330 Squadron was at this time not formally EpiShuttle operational, but chose to execute the mission because the patient was in critical need of transport.

That was the first Norwegian airborne application of the EpiShuttle device in relation to a COVID-19 infected patient, according to Fridtjof Heyerdal, a spokesman for the EpiGuard company that makes the EpiShuttle incubator.

Both 339 Squadron and 330 Squadron are now capable of safely executing air ambulance and SAR missions without the risk of exposing aircraft crew members.

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