Awareness and First Aid
When an ambulance arrives, most people notice the sirens and urgency.
What they don’t see is the infection-control process already in motion – beginning before a paramedic even reaches the patient.
From respiratory illnesses like COVID-19 and RSV to blood-borne infections such as HIV, emergency crews must act quickly while protecting themselves, hospital staff and the public from exposure. In fact, says Heinrich Africa, Clinical Performance Specialist at ER24, preparation starts long before the ambulance doors open.
“Paramedics don’t simply arrive and react,” he explains. “We receive information from dispatch and begin risk assessment before we reach the patient. That determines how we approach the scene and what protective measures we put in place.”
Assessing risk before arrival
ER24’s Contact Centre plays a key role in infection prevention. When callers report symptoms such as fever, persistent coughing, breathing difficulty or known exposure to illness, crews are alerted while still en route.
This allows paramedics to prepare appropriate personal protective equipment (PPE) and plan patient contact.
“If we suspect an infectious disease, we adjust immediately,” Africa explains. “We may limit the number of crew members making contact with the patient and ensure the correct protective equipment is ready before we even step out of the ambulance.”
Protective gear: more than gloves and masks
The level of protection depends on how a disease spreads. Respiratory infections such as COVID-19 and RSV require respiratory protection. For blood-borne illnesses, such as viral hemorrhagic fevers (VHFs), protection focuses on avoiding contact with blood or other body fluids.
PPE can include:
- Medical gloves
- Eye protection or face shields
- Surgical masks or N95 respirators
- Fluid-resistant gowns or coveralls.
“The type of PPE we use depends on the transmission route,” says Africa. “For respiratory illnesses we prioritise masks and breathing protection, while for blood-borne conditions we need strict protection against exposure to bodily fluids.”
Properly removing PPE is just as important as wearing it.
“Incorrect removal is one of the highest risk moments,” Africa explains. “The outside of the equipment may be contaminated, so if you touch the wrong surface or remove it in the wrong order, you can transfer pathogens onto your hands, clothing or face. We follow strict procedures when taking equipment off to avoid contaminating ourselves.”
Managing the patient on scene
On arrival, paramedics balance the need for urgent treatment with infection control. They may place a surgical mask on the patient, open windows or doors to improve airflow, and keep bystanders at a safe distance while they provide essential care.
“We try to control the environment as much as possible,” Africa says. “Simple steps like improving ventilation and limiting the number of people nearby help reduce the risk of transmission while we treat the patient.”
Safe transport to hospital
An ambulance functions as a small mobile treatment space, so precautions continue during transport. Only essential crew members are allowed in the patient compartment, and the receiving hospital is notified in advance.
“We notify the hospital ahead of arrival so they can prepare,” Africa explains. “That helps prevent unnecessary exposure and allows them to receive the patient safely.”
The hospital can then put its infection-control measures in place before the patient arrives.
After the handover
The process continues after the patient is transferred to hospital staff.
Post-call procedures include:
- Thorough cleaning and disinfection of the ambulance
- Safe disposal of contaminated materials
- Documentation and incident reporting
- Monitoring for possible exposure.
“Every surface inside the ambulance is disinfected,” Africa says. “The vehicle can only return to service once it’s declared safe.”
Crew members will also monitor themselves for symptoms if exposure is suspected.
SOPs and preparedness
Regular updates of standard operating procedures (SOPs) ensure crews are ready for high-risk scenarios. “We prepare for these situations by assuring the policies and SOPs align with the current best practice for handling the specific case,” explains Africa.
He adds that infection-control procedures have improved a lot over time, boosting both patient care and responder safety – although some rare conditions may still fall outside standard training.
The unseen layer of emergency care
For patients, an ambulance call is frightening and urgent. At the same time, paramedics are managing both treatment and infection prevention to protect everyone involved.
“Our goal is always to help the patient while protecting ourselves and the community,” Africa says. “If we stay safe, we can keep helping others.”
Behind every emergency response is not only medical skill, but a structured system of preparation, training and infection control working quietly to prevent further spread of disease.