Methods: Patients arrived via medical evacuation flights and were transported via ambulance in isolation pods. An all-volunteer staff provided care in an isolation unit specially designed to accommodate critical care interventions. We chose a conservative isolation approach, combining contact, droplet and airborne precautions, and only relaxing precautions when clinically appropriate. A multidisciplinary team of healthcare and ancillary personnel met daily to review patient care, infection control, and facility operations. Medical waste was autoclaved and incinerated, and human waste was disinfected prior to flushing.
Results: Trained observers actively monitoring donning and doffing of personal protective equipment provided critical round-the-clock occupational safety support. Unanticipated challenges included: obstacles to maintaining effective isolation when established transportation algorithms could not be followed; anxiety about the adequacy of infection control interventions among uninvolved clinical staff; waste disposal bottlenecks; increased occupational safety vulnerability during transient periods of patient agitation; and a need for more than one trained observer during busy shifts and emergencies. We gained substantially from frequent communication with experienced colleagues, healthcare staff and public health authorities. Patient confidentiality was maintained to the maximum extent possible.
Conclusion: Care of patients with EVD was complex, involved contributions from all members of the multidisciplinary team, necessitated flexibility, reassessment and adjustment, underscored precise communications, and required meticulous attention to infection control details.
T. N. Palmore,
A. M. Ramsburg, None
A. V. Michelin, None
R. T. Odom, None
M. A. Bordner, None
D. K. Henderson, None