Transfer to a designated health service

All transfers of a suspected or confirmed case will need to be discussed with the department. Refer to Patient transport for IPC measures relating to transfer of VHF patients.

Patients who should be transferred from a non-designated to a designated health service include:

• patients with a confirmed VHF diagnosis
• patients who are highly suspected to have VHF (those with consistent clinical picture and/or higher risk exposures/epidemiology)
• patients with ‘wet’ symptoms (for example, vomiting, diarrhoea and bleeding)
• critically unwell patients requiring urgent pathology and/or invasive or aerosol-generating procedures (for example, intubation, suctioning, active resuscitation)
• patients at a non-designated health service without the capacity to hold on to a suspected case before confirmation of diagnosis. These health services usually do not have suitable infrastructure to isolate a VHF case, or do not have infectious diseases or IPC expertise and capability.

Ambulance transfer arrangements

AV is equipped to transfer suspected or confirmed cases of VHF in Victoria:

• AV responders will follow AV’s established IPC precaution guidelines when managing suspected or confirmed VHF patients.
• Adequate quantities of PPE (as outlined in Infection prevention control) must be available to manage the case to completion at the receiving health service.
• Where the clinical condition of the patient allows, the department will coordinate the transfer of a suspected case with AV via established pathways and contacts.
• Health services should avoid direct transfer of a patient with suspected or confirmed VHF prior to receiving specific instruction from the department, unless necessitated due to the patient’s clinical condition or if the health service has been unable to contact the department.
• Cases involving paediatric patients requiring specialised retrieval will be coordinated by RCH through the Paediatric Infant Perinatal Emergency Retrieval (PIPER) service.
• Cases involving adult critical care patients requiring specialised retrieval will be coordinated through the Adult Retrieval Victoria (ARV) service.

Transfer of accompanying parents or carers

Parents or carers may request to accompany a patient (for example, a minor, an adult requiring a carer or a patient requiring an interpreter) during the transfer to the receiving health service.

This decision requires a risk assessment considering:

• the level of suspicion for the patient to have VHF
• potential infectivity of the patient
• potential for the parent/carer to have VHF
• AV’s ability to safely accommodate a parent/carer escort.

General principles include:

• for ‘dry’ symptoms only (for example, fever, myalgia and headache):
  • at the discretion of the department and AV, one parent or carer may accompany the patient
  • that the carer will be required to wear appropriate PPE and remain at least one metre away from the patient (if possible), avoiding physical contact
• for ‘wet’ symptoms (for example, vomiting, diarrhoea and bleeding)
  • a parent or carer cannot accompany the patient during transfer
  • alternative transport arrangements to the receiving health service must be made for the parent or carer.