Planning for remote site medical support

If you are responsible for an overseas operation, specifically one remote from mainstream medical care, the following considerations will be key to your medical planning.

Planning assumptions
Most authorities are calculating on the basis of a clinical attack rate of 25%, but experience shows the likelihood of higher infection rates for remote site operations, working in what could be defined as a 'closed community', such as an oil or gas project. If you have this type of operation, plan for an increased clinical attack rate of 50%.

Diagnosis
Procedures need to be in place for accurate diagnosis¹ and clear identification of the onset of complications². Medical supply workers need to be appraised of the risks of contagion, usually lasting from one day before onset of illness to five days following.

Evacuation
Once a pandemic is upon us, it may prove difficult to hospitalise or move infectious patients. Plans should be agreed in advance with the relevant parties, preferably in writing and regularly reviewed and updated.

Treatments
Oseltamivir or Tamiflu is currently recommended and has a low incidence of side effects. If you are able to source this product, be aware that shelf life may only be a few months. Subsequent stocks may have a longer shelf life. See our medical supplies page for a full list of treatments.

Accommodation
Identify and source buildings for screening and isolating patients, with beds, clinical and other waste disposal, communications and rest areas. Consider soft-skin temporary buildings that can be stored and erected when necessary. Mortuary capacity including refrigeration should be prepared in advance and local cultural and religious requirements catered for.

Workforce planning
Past pandemic experience indicates that between 10 and 35% of the workforce may be absent from work. Consider plans for flexible working, with extended work periods and the minimum workforce possible. There will be extra demands on the medical team and personnel needed for feeding patients, cleaning and maintaining the sick bay.

Minimizing the impact
Ensure employees who may be susceptible to complications are kept off site³, with appropriate screening for anyone arriving on location for work. Consider travel restrictions to known areas of infection.

Infection control
The UK Government has issued guidance on basic measures for individuals to lower the risk of infection. Other essentials include isolation of anyone suspected of having the disease and hand hygiene, the single most important practice to reduce the transmission of infectious agents in health care settings. Ensure supplies of emollients that do not require the use of water. Provide masks for coughing or sneezing patients in common waiting areas or during transportation.

For comprehensive advice on contingency planning or remote site medical support, contact us.

More information is available from Frontier Medical on these topics: ¹ More information in the Clinical Guidelines for Patients available through Frontier Medical ² A management tool for assessing the severity of influenza-related pneumonia ³ Patients at high risk of influenza-related complications