Dear Editor,

Following the coronavirus disease 2019 (COVID-19) pandemic since December 2019, unforeseen challenges have arisen in the world that threaten the traditional health care delivery processes. One of these challenges is providing emergency services to the patients who are transported by indoor air ambulance services.^{Reference Albrecht, Knapp, Theiler, Eder and Pietsch1,Reference Tien, Sawadsky, Lewell, Peddle and Durham2} Due to the lack of information about these patients’ infectious conditions and the limited space of the emergency helicopters, the risk of disease transmission is higher for the members of the air emergency medical crew compared to other providers in hospitals or other medical departments. The risk of virus transmission also increases due to the nature of the services provided in the prehospital environment, the acute condition of most patients in this phase, and many medical procedures such as airway management and ventilation associated with aerosol production.^{Reference Hilbert-Carius, Braun and Abu-Zidan3,Reference Spoelder, Tacken, van Geffen and Slagt4}

Following the outbreak of COVID-19 in many countries, standard operating procedures for infection prevention measures tailored to specific circumstances have been proposed based on the current recommendations of associations and national medical authorities. One of these methods is the wide-spread use of isolated patient compartments in many countries providing helicopter Emergency Medical Services (EMS) to effectively protect the medical crew, which eliminates the need for disinfection of patient cabins and increases the time to access critical helicopter EMS. In Switzerland, simulation training was used as another strategy to prevent the transmission of infection in a recent pandemic and other possible future pandemics in air rescue settings.^{Reference Albrecht, Knapp, Theiler, Eder and Pietsch1,Reference Hilbert-Carius, Braun and Abu-Zidan3}

Other strategies, such as keeping a distance of at least two meters from the patient, reducing the number of health care providers in the patient cabin, and using standard personal protective equipment (PPE), are operational on the agenda of these centers. Furthermore, some European air emergency service providers have taken a major step towards maintaining the health of air emergency staff by allocating designated air relief centers equipped with an isolated infectious disease ward to transport COVID-19-approved patients.^{Reference Hilbert-Carius, Braun and Abu-Zidan3}