Frontline ambulance: Advanced paramedic on collecting samples for Covid-19 tests


THE decision to use the ambulance service to collect samples from households around the country in a bid to combat the spread of Covid-19 is unprecedented, according to advanced paramedic Richard Quinlan, chief ambulance officer for the North Leinster region, who has paid tribute to the outstanding work being undertaken by frontline health service staff in the battle to contain the coronavirus outbreak.
“Everyone involved has stepped up and put their shoulder to the wheel,” he tells Feelgood, as he explains how the testing works.
“The concept of using the ambulance service to collect samples was quickly identified as the best option for carrying out Covid-19 testing.
“It was decided that we had the vehicles and the clinically trained staff who can do clinical assessments in the home. We also have the personal protective equipment in place, so the only extra is the test itself.
“We built a training module for each staff member who volunteered. All of the people doing the testing have volunteered to do this outside their normal clinical duties.”
Yes.
“We started testing for Covid-19 across the country on Wednesday, March 4, at 8am. The first test was carried out at a private residence in the North East area of the country.”
“As of Tuesday, March 10, we have carried out 500 tests all over the country.”

“A call goes into the National Emergency Operations Centre, from a GP or the Public Health Office.
“A request is sent to the national ambulance service for a home test to be carried out. The nearest appropriate Rapid Response Vehicle, which is part of the national ambulance fleet, is then given the relevant information about the call, and a sole responder travels to the house.
“Before entering the premises, the sole responder telephones the patient to explain the process which will take place, to alleviate any concerns and gather information for the documentation of the test sample. By the time the sole responder arrives, the patient will, in compliance with the sole responder’s request, be waiting in a different room to the rest of the inhabitants.
“The sole responder dons the necessary protective equipment — goggles, masks apron and gloves — and begins the assessment process.
“First, the patient is given a mask to wear while a clinical assessment — checking the heart rate, breathing, temperature and blood pressure — is carried out.
“If it is decided that the patient needs to be moved to an appropriate healthcare facility, arrangements will be made for them to be transported by ambulance.
“If the person is deemed suitable to stay at home in self-isolation — that is, in a different room and using a different bathroom to the other inhabitants of the house — samples are taken.”
“The patient is asked to remove his or her mask to allow two swabs to be taken, one from the back of the throat and another from the nasal cavity.
“The swabs are placed in a biohazard container.”

“The patient’s mask is replaced and a series of questions are asked in relation to the patient’s environment and living situation, to ensure he or she can self-isolate and will have access to essentials such as food, water and medical supplies over the 14 days of their self-isolation.
“A special pack is provided. This contains information explaining what to do should the patient’s condition deteriorate, along with contact information, and advice about both the correct washing of hands and etiquette for coughing and sneezing.
“A waste bag is provided for tissues and masks. Before leaving, the sole responder ensures that the patient is happy, comfortable and reassured.”
“The samples are delivered to the nearest acute hospital with a microbiology department, from which samples are collected on a daily basis and sent to the National Virus Reference Laboratory.”
“Be patient. Listen carefully to what the person on the phone is asking you, and to what they are telling you.
“Provide clear, accurate information about your condition and your living conditions.
“Know your Eircode, as this helps the sole responder locate your home quickly.”