Joint Royal Colleges Ambulance Liaison Committee [JRCALC] clinical guidelines 2019.Bridgwater: Class Professional Publishing; 2019

Banasik J, Copstead LE. Pathophysiology, 5th edn. St Louis (MI): Elsevier; 2013

Boniotti MB, Papetti A, Lavazza A Porcine epidemic diarrhea virus and discovery of a recombinant swine enteric coronavirus, Italy. Emerg Infect Dis. 2016; 22:(1)83-87

British Thoracic Society. Annotated BTS CAP Guideline Summary of Recommendations. 2015. https// (accessed 22 April 2020)

Features, evaluation and treatment coronavirus (COVID-19). 2020. https// (accessed 18 April 2020)

Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019; 17:(3)181-192

Curtis K, Ramsden C. Emergency and trauma care, 2nd edn. Chatswood (NSW): Elsevier; 2016

Chung M, Bernheim A, Mei X CT imaging features of 2019 novel coronavirus (2019-nCoV). Radiology. 2020; 295:(1)202-207

Creed F, Spiers C. Care of the acutely ill adult: an essential guide for nurses.Oxford: Oxford University Press, Oxford; 2010

Dahl M, Nordestgaard BG. Markers of early disease and prognosis in COPD. Int J Chron Obstruct Pulmon Dis. 2009; 4:157-167

Gregory P, Ward A. Sanders' paramedic textbook.Bridgewater: Jones & Bartlett Publishing; 2013

Guan WJ, Ni ZY, Hu Y Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;

Hall JE, Guyton AC. Guyton and Hall textbook of medical physiology, 12th edn. Philadelphia (PA): Saunders Elsevier; 2011

Innes AJ, Dover AR, Fairhurst K. Macleod's clinical examination, 14th edn. London: Elsevier; 2018

Johnson M, Boyd L, Grantham H, Eastwood K. Paramedic principles and practice ANZ. A clinical reasoning approach.Chatswood (NSW): Elsevier; 2015

Lee EYP, Ng MY, Khong PL. COVID-19 pneumonia: what has CT taught us?. Lancet Infect Dis; 20:(4)384-385

Lipsitch M, Swerdlow DL, Finelli L. Defining the epidemiology of Covid-19—studies needed. N Engl J Med. 2020; 382:(13)1194-1196

Lumb AB. Nunn's applied respiratory physiology, 7th edn. Edinburgh: Churchill Livingstone Elsevier; 2011

McCance KL, Huether SE. Pathophysiology: the biological basis of disease in adults and children, 7th edn. St Louis (MI): Mosby Elsevier; 2014

NHS. Advice for everyone. Coronavirus (COVID-19). 2020. https// (accessed 18 April 2020)

Patton KT, Thibodeau GA. Anatomy and physiology, 8th edn. St Louis (MI): Mosby Elsevier; 2013

Peate I. Pulse oximetry in the pre-hospital setting. J Paramedic Pract. 2014; 6:(6)290-294

Pilbery R, Lethbridge K. Ambulance care practice, 2nd edn. Bridgewater: Class Publishing; 2019

Qian Z, Travanty EA, Oko L Innate immune response of human alveolar type II cells infected with severe acute respiratory syndrome-coronavirus. Am J Respir Cell Mol Biol. 2013; 48:(6)742-748

Resuscitation Council (UK). Resuscitation guidelines. 2015. https// (accessed 18 April 2020)

Royal College of Physicians. National Early Warning Score (NEWS) 2. 2017. https// (accessed 18 April 2020)

Ruthven AKB. Essential examination, 3rd edn. Banbury: Scion Publishing; 2016

Saif LJ, Wang Q, Vlasova AN, Jung K, Xiao S. Coronaviruses. Chapter 13. In: Zimmerman JJ, Karriker LA, Ramirez A, Schwartz JK, Stevenson GW, Zhang J. Hoboken (NJ): John Wiley and Sons; 2019

Tian S, Hu W, Niu L, Liu H, Xu H, Xiao SY. Pulmonary pathology of early-phase 2019 novel coronavirus (covid-19) pneumonia in two patients with lung cancer. J Thorac Oncol. 2020;

Torok ME, Moran E, Cooke F. Oxford handbook of infectious diseases and microbiology.Oxford: Oxford University Press; 2016

Tortora GJ, Derrickson B. Principles of anatomy and physiology, 13th edn. New Jersey (NJ): John Wiley and Sons; 2011

World Health Organization. Coronavirus. 2020a. https// (accessed 18 April 2020)

World Health Organisation. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). 2020b. https// (accessed 18 April 2020)

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases rrom the Chinese Center for Disease Control and Prevention. JAMA. 2020;

Paramedics and pneumonia associated with COVID-19

02 May 2020
Volume 12 · Issue 5


Paramedics are at the frontline of healthcare delivery and this includes during the current coronavirus pandemic. This pandemic poses specific problems for paramedics, which include not only treating and transporting infected patients, but also issues around decontamination and disinfection of ambulances and medical equipment. Of particular concern is the pneumonia associated with the 2019 novel coronavirus. Data on COVID-19 pneumonia are developing. Ongoing research demonstrates that almost all serious consequences of COVID-19 feature pneumonia, especially in older people and those with comorbidities. Paramedics can have a profound effect on the care of patients with pneumonia. Effective management of COVID-19 pneumonia by the paramedic should centre around prompt recognition, early administration of oxygen and intravenous fluids and transfer to hospital. In some situations, paramedics may need to be involved in the delivery and maintenance of airway adjuncts in patients with COVID-19 pneumonia.

Pneumonia is an episode of acute inflammation involving lung tissue and can be of bacterial or viral origin. In the UK, the most common cause of community-acquired pneumonia (CAP) is Streptococcus pneumoniae (Strep. pneumoniae). Strep. pneumonia infections can lead to impaired gaseous exchange, global hypoxaemia, cardiovascular complications, sepsis and death.

The epidemic of 2019 novel coronavirus (officially called SARS-CoV-2) has expanded from its place of origin, Wuhan in China, to countries around the world. Some of these countries have seen onward transmission (Lipsitch et al, 2020). SARS-CoV-2 is a virus in the zoonotic coronavirus family. This virus, previously unknown in humans, is now causing the disease commonly referred to as COVID-19. Zoonotic diseases are infectious diseases that have spread from non-human animals to humans (Torok, 2016).

Coronaviruses cause respiratory and intestinal infections in animals and humans (Cui et al, 2019) but were not thought to be highly pathogenic to humans until the outbreak of severe acute respiratory syndrome (SARS) in 2002 and 2003 in Guangdong province in China (Cui et al, 2019). Like other coronaviruses, SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) as a receptor to gain entry into cells, and subsequently infects bronchial epithelial cells and lung cells called type II pneumocytes (Qian et al, 2013; Boniotti et al, 2016; Saif et al, 2019).

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