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Do the latest restrictions in England go far enough to protect our health and social care service?


Advice from STRS

20 March 2020 - Updated advice & guidance from South Thames Retrieval Service

From what we have heard from other countries and we know:

  1.  Children are likely to be colonised/ infected with Corona virus 19 at the same rate as adults, and up to 60% of the population before this is finished.
  2. Children do not seem to have the same acuity of illness or mortality as adults, but some children may become very unwell, even critically ill from this virus:
    1. The younger children seem to get sicker (ARDS, gastro intestinal symptoms, encephalopathy and cardiomyopathy/ shock). From onset to very sick about 5-7 days.
    2. The mortality in children who are managed appropriately is less significantly than adults.
  3. They will also continue to get sick with their usual illnesses as well and may at the same time be Covid colonised & asymptomatic/ infected & symptomatic.
  4. Sick children should continue to receive the same high standard of care, and staff should not be distracted by concerns over Covid, but should ensure they are protected with necessary PPE and deliver the care the child needs.
  5. This is droplet spread so hand washing is the biggest public and staff health safety mechanism.

 STRS practice and advice:

  1.  When children need intubating during this time, take the recommended PPE precautions (useful link https://icmanaesthesiacovid-19.org/) to ensure the team stay safe with regard to aerosol generating procedures.
  2. The children with respiratory conditions suspected as Covid-19 (pneumonia) should be intubated with cuffed ETT (which is normal practice for this group of children anyway) to reduce escaping droplets.
  3. Only those necessary for the care of the child should be around the bed space. Others who are not directly involved in the child’s care should move away from the bed space and continue with their other work.
  4. Where possible closed suctioning devices should be used in children with respiratory symptoms who are intubated
    1. Evelina PICU ECH technicians can be contacted provide info re procurement via NHS supply chain. Candice.taylor@gstt.nhs.uk

 STRS service provision:

  1. STRS will continue to deliver critical care advice and transfer of critically ill children 24/7.
  2. STRS outreach teaching will be suspended from 17 March to 30 June in order to avoid crowds of essential healthcare workers are in the same space. In June we will review the situation with regard to date of recommencement of teaching.
  3. STRS and PICU delivered external teaching courses (including retrieval nurse practitioner course, and PANCC course) will be suspended from 17 march onwards. We will look at how we can deliver these course starting later in the year.
  4. STRS will continue to allow a parent to accompany their critically ill child in the ambulance as long as the parent is well with no concerns regarding symptomatic respiratory/Covid infection.
  5. Where parents are unwell (particularly if known Covid positive or have suspicious symptoms) they will not be permitted in the ambulance.
  6. ALL the national Ronald McDonald House facilities have closed. Unfortunately this will mean that none of the PICUs will be able to guarantee accommodation for parents although we will all endeavour to source alternative accommodation. They should make provision to stay elsewhere or return home daily.

 If there are any specific concerns regarding STRS please make contact with the STRS consultant on call via the STRS dedicated line 020 7188 5000. 

Keep in touch and keep yourselves well,

STRS team