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UNCONTROLLED WHEN PRINTED

This is a living document based on available Rapid Antigen Testing kits, while best endeavours will be made to inform you of changes, please check back regularly to updates to this skill based on kits available

Indications
  • Any patient > 2 years being transported from the community to a WA Health emergency facility where indicated under Clinical Response framework
    • Patient can self test if able to follow instructions clearly
    • Children may be tested by accompanying guardian if they can follow instructions clearly
  • Family member/guardian/carer escort if required to be transferred in line with current operational policy
    • Clinical and law enforcement escorts will not be tested
Contraindications
  • Patient who already has a known/confirmed COVID-19 infection from a recent rapid antigen or PCR test
  • Inter hospital transfers including RFDS
  • Patient who has time critical/urgent care needs where performing a rapid antigen test would distract from provision of appropriate levels of care
  • Patient who has only called an ambulance for purposes of a rapid antigen test
  • Patient Not Transported scenarios where patient not being transferred
Patient Factors & Considerations
  • Do not interpret the test result before 15 minutes and after 20 minutes starting the test.
  • Rapid antigen test kits should be stored below 30 degrees but brought to room temperature before use
  • Negative results do not rule out SARS-CoV-2 infection and should not be used as the sole basis for treatment or patient management decisions, including infection control decisions. Continue wearing PPE per current interim guidance irrespective of result
  • Negative results should be considered in the context of a patient’s recent exposures, history and the presence of clinical signs and symptoms consistent with COVID-19.
  • Excess blood or mucus on the swab specimen may interfere with test performance and may yield a false-positive result
  • Department of Health provided tests are not for staff/personal use
Procedure

The following is instructions for the WestLab / MP Biomedicals Rapid SARS-CoV-2 Antigen Test card product currently being supplied by the Department of Health. Further instructions may be released at a later stage due to supply of RATs to St John WA.

Instructions

  1. Test is to be conducted in stationary vehicle before departing scene for hospital/nursing post, with ambulance airflow configured per WIAMB22
  2. Ensure PPE is worn as per interim guidelines with strict adherence to hand hygiene practices
  3. Remove kit from temperature controlled storage, allow to come to room temperature and check all contents are present
  4. Place "bluey" on a clean surface and then place contents of kit onto bluey
  5. If patient (or their parent/guardian in case of children) is performing test under SJWA instruction, ensure person carrying out test completes hand hygiene
  6. From the below infographic, instruct patient or their parent/guardian on steps 4, 5 and 6 while officer completes steps 2 and 3 from the infographic. Officers may carry out the test on patient if unable to do so themselves, in this case officer carries out all steps below
  7. Hand patient or their parent/guardian the extraction tube and instruct on how to complete steps 7-9 while officer completes step 10, placing test card on bluey
  8. Patient or parent/guardian hands extraction tube back to officer who completes step 11 and starts timer for 15 minutes. At this point, you may commence the journey to hospital
  9. Once 15 minute timer has been completed, and before 20 minutes has elapsed from time test started, read result per instructions below
  10. Dispose of test card into large sharps container or alternately into clipseal bag kit provided in and disposed of in clinical waste at hospital
  11. Record result on ePCR in On Examination section or in free text of paper PCRF
MP-TestingProcedure_v2

Interpreting result

Positive

  • Two distinct coloured lines appear
  • One red-coloured line next to the "C" and one red-coloured line next to the "T" indicates a COVID-19 positive result. Note that the colour intensity will vary depending on amount of COVID-19 protein present in the sample but that any faint coloured lines in the Test ("T") region should be considered as a positive.

Negative

  • One red-coloured line only next to the "C" indicates a negative result

Invalid

  • If the red-coloured line in the control region ("C") is not visible, the result is invalid.
  • Handover the indeterminate / invalid result at hospital and follow advice of Health Service Provider staff

Once the result has been interpreted, the test cassette and vial should be treated as clinical waste and disposed of in the clinical waste bag supplied or in the large sharps container in the vehicle

MP-InterpretResultsv2
Success
  • Record result in ePCR interventions and ensure result handed over to hospital staff
Discontinue
  • Patient unable to tolerate testing procedure
  • If result invalid / indeterminate do not retest the patient on route, handover this result to hospital and follow directions of health staff
Additional Information
References
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