KUALA LUMPUR, July 10 — As the doctors and nurses — collectively referred to as frontliners since the start of the pandemic — in our hospitals deal with the huge numbers of Covid-19 cases, another group works as tirelessly to ensure patients get adequate pre-hospital treatment and safe transport to hospitals.

These are paramedics who, like others in the healthcare sector affected by the pandemic, also had to adapt to the challenges brought about by a new invisible and deadly threat.

For Paramedic EMS Services Sdn Bhd (PEMSS) general manager and chief paramedic Faizal Nurdin, the immediate challenge posed by the Covid-19 pandemic is having to safeguard paramedics from the infectious disease.

Paramedic EMS Services Sdn Bhd general manager and chief paramedic Faizal Nurdin speaks to Malay Mail during an interview in Kuala Lumpur July 5, 2021

Since the onset of the pandemic, Faizal said as much as 50 to 60 per cent of their response calls now are Covid-19 related involving the transportation of patients-under-surveillance (PUS) or confirmed positive cases to their respective quarantine centres or hospital for treatment.

"What has happened, the difference between now and then, is that we now greatly emphasise the safety of our paramedics in terms of providing them with full Personal Protection Equipment (PPE).

"The second challenge is having to impart the necessary understanding and awareness to our staff so they can use it to educate patients as well,” he told Malay Mail when met at PEMSS’s headquarters in Pandan Indah here.

Paramedic EMS Services Sdn Bhd paramedics and staff on duty at their headquarters in Kuala Lumpur July 5, 2021.

As pandemic rages on, private ambulance services joins the fight

Faizal said private paramedic emergency services were not highly sought after prior to the pandemic in 2020 but that changed when the country’s daily recorded Covid-19 cases saw a gradual increase with existing ambulance services in the public sector unable to cope.

"We receive a lot of calls from PKRC especially, and those living in residential areas requiring patient transfer service,” he said, referring to the acronym of the Covid-19 Low Risk Quarantine and Treatment Centres.

In most cases, Faizal said PEMSS is usually involved in the transportation of patients to PKRC Malaysian Agro Exposition Park Serdang (Maeps) or major hospitals.

A stringent standard operating procedure (SOP) is followed whenever a case involves the transportation of PUS or confirmed positive patient, following prior incidents of patients withholding their medical and travel history.

Apart from donning full PPE, this includes a thorough interrogation of said patient’s history and any contacts they had prior to transportation as paramedics take steps to ensure the safety of their patients while providing the essential care they need.

Paramedics don Personal Protection Equipment as they prepare to respond to a Covid-19 related emergency at the company's headquarters in Kuala Lumpur July 5, 2021.

To further reduce the risk of contamination, an ambulance — equipped with plastic separator to avoid direct contact between patients — has also been designated exclusively for the transportation of Covid-19 related cases and is decontaminated thoroughly each time it has completed a journey. 

"If one shows any form of Covid-19 symptoms or having an unknown travel history, we will not immediately transport them. 

"We will conduct a RT-PCR or RTK Antigen test on the spot before communicating with the receiving hospital to obtain a guideline beforehand and informing them of the arrival. This is done in a very transparent manner so everybody is aware of the ongoing situation.

"We must always expect the worst case scenario,” he said, adding that such was the challenge faced by paramedics in the early stages of the pandemic and even to this day.

Paramedic EMS Services Sdn Bhd general manager and chief paramedic Faizal Nurdin explains how one of the company's ambulance is repurposed for Covid-19 related emergencies in Kuala Lumpur July 5, 2021.

A paramedic’s best friend is the ambulance

As a paramedic himself, Faizal said public misconception of a paramedic must be corrected as it is considered a certified medical profession with many imposters misusing the term.

"When we say paramedics, by definition, they are certified healthcare personnel trained to provide emergency medical care outside of a hospital setting. This means their best friend is the ambulance,” Faizal explained.

Established in 2014, he said the formation of PEMSS was motivated primarily by the necessity to provide a suitable support platform for paramedical science graduates to experience first-hand being a trained paramedic.

At that time of the company’s inception, there were only a handful of paramedics including Faizal himself with only one ambulance to start off with. 

Seven years later, PEMSS has expanded beyond the Klang Valley into Kota Kinabalu, Sabah as well while boasting a fleet of 10 ambulances of various response capabilities ranging from non-critical Basic Life Support to life-threatening Advanced Cardiac Life Support categories.

Paramedic Norsahril Abdul Razak, in full Personal Protection Equipment, demonstrates how a suspected Covid-19 case is handled in the repurposed ambulance.

The team has also now expanded to include some 30 full-time medical staff taking on the role of paramedics and nurses including a round-the-clock medical director specialised in emergency services.

Among the services PEMSS offers are patient transfers, medical evacuation (medivac), and paramedic training. They also specialise in medical and paramedical services in both construction and oil and gas industries.

When asked what he thought of the company’s sustainability moving forward, Faizal said businesses such as his will remain relevant and necessary.

"However, just because there is a high demand, we should not give our bare minimum. We must still ensure the delivery of a quality service as it involves people’s lives,” he said.