Ambulance service tests patients for covid-19 before transfer to hospital in pioneering study

Paramedics at South Central Ambulance Service (SCAS) are testing patients for COVID-19 at home - including those without symptoms - if they require transfer to hospital in a pioneering initiative designed to speed up handovers and release crews more quickly.

Currently, lateral flow tests, which are used to detect the virus in people with no symptoms who could be highly infectious, are only used when patients being transferred by ambulance without confirmed COVID-19 arrive at hospital in locations such as emergency departments and maternity assessment units. 

The test involves placing a swab in the nose and/or mouth which is then mixed with a solution that looks for virus fragments. Droplets are then placed onto the device and a result is delivered within 30 minutes. 

The pilot study will see lateral flow tests administered by a trained ambulance crew to patients on the decision to transfer them to hospital, with the trial involving all patients over 18 - both with or without symptoms - who are being taken to Oxford University Hospitals.  

The process will ensure a patient has test results on or very soon after arrival to inform secondary care clinicians which COVID-19 care pathway should be followed. 

“The pandemic saw hospitals quickly arrange separate pathways for receiving patients, with red/COVID-19 for patients reporting symptoms and with suspected or confirmed infection, and green/non-COVID for patients not reporting symptoms and without suspected or confirmed infection,” said Dr John Black, Medical Director at SCAS.

“When these tests are carried out on arrival at hospital, social distancing requirements and the wait for results may contribute to ambulance handover delays and a bottleneck in patient flow through the care pathways. 

“We expect the use of lateral flow tests pre-hospital to have a direct and positive impact on reducing handover delays, improving bottleneck of patients in the red/COVID care pathway queue and increase patient hospital flow.” 

He added: “This is a small study to begin with in Oxford, so it will not happen with every patient transfer across SCAS, however, further roll out to a wider area will be considered if the concept is proved through the pilot and there is sufficient access to lateral flow devices.”