MOUNTAIN RESCUE ENGLAND AND WALES SCOTTISH MOUNTAIN RESCUE: COVID-19 GUIDELINE 2 CHANGES TO CASUALTY CARE ABCDE MANAGEMENT
UPDATED
You MUST have done your risk assessment and have appropriate PPE for this rescue.
A
Make a risk assessment – use MREW Airway and Breathing Risk Assessment
• Turn a casualty with an ‘airway at risk’ into lateral position • Avoid use of suction — use positional drainage if possible • Use manual airway opening manoeuvres only after risk assessment • Only use airway adjuncts — OPA/NPA after risk assessment.
B
Cardiac arrest: • Use level 2 PPE (minimal requirement) • Check for signs of life but do not listen for breathing or get close to mouth or face • Cover casualty’s mouth and nose with a face covering/mask • If AED is immediately available apply before chest compressions • Apply AED and follow instructions • Perform chest compression-only CPR as instructed by the AED • Do not ventilate or perform airway interventions (see MREW Airway and Breathing Risk Assessment) • Consider use of mechanical chest compression devices if available. • Do not use a pocket mask or face shield • Only use a BVM with good fitting mask and filter after risk assessment • Use oxygen with a face mask according to clinical need. Avoid nasal delivery • Use pulse oximeter to guide oxygen use if possible • Use inhaler and spacer as first line (single use/dispose after use) • If required, use nebuliser — lowest functional flow (approx 6l/min), do not use in enclosed space, rescuers to remain upwind. Make a risk assessment – use MREW Airway and Breathing Risk Assessment
C
• No change — record conscious level D
E
• Avoid use of bivi shelter unless environmental or clinical need. Keep warm using alternative methods of insulation if possible.
MREW Covid-19 Guideline 2: Mike Greene Medical Director Updated October 2020. V4.0
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