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Transportation of Patients in a Bioemergency

  • Lekshmi Kumar
  • Alexander P. Isakov
Chapter

Abstract

Serious recurrent and emerging communicable diseases, such as novel influenza strains, highly pathogenic viral hemorrhagic fevers, and novel coronaviruses in an era of increased globalization and travel, necessitate heightened vigilance and preparedness. Last year over four billion persons traveled by air. Systems and processes need to be in place to not just recognize and treat individuals, who harbor a serious pathogen, but also to manage and transport them safely while minimizing the risk of transmission to healthcare workers and others in the community. In this chapter, environmental and administrative controls, work practices, and personal protective equipment necessary to prevent transmission are described for the management and transportation of patients in both the out-of-hospital and hospital settings.

Keywords

EMS Patient transport Biosafety transport Interfacility transport Intra-facility transport Hierarchy of controls 

References

  1. 1.
    Isakov A, Jamison A, Miles W, Ribner B. Safe management of patients with serious communicable diseases: recent experience with Ebola virus. Ann Intern Med. 2014;161:829–30.CrossRefGoogle Scholar
  2. 2.
    Centers for Disease Control and Prevention. Hierarchy of controls. Available at https://www.cdc.gov/niosh/topics/hierarchy/. Accessed 1 Mar 2017.
  3. 3.
    Assistant Secretary for Preparedness and Response, Technical Resources, Assistance Center, and Information Exchange. EMS infectious disease playbook. Available at https://asprtracie.hhs.gov/documents/aspr-tracie-transport-playbook-508.pdf. Accessed 30 June 2017.
  4. 4.
    Centers for Disease Control and Prevention. IV. Infection control for prehospital emergency medical services (EMS). Available at http://www.cdc.gov/sars/guidance/i-infection/prehospital.html. Accessed 1 Feb 2017.
  5. 5.
    Isakov A, Miles W, Gibbs S, Lowe J, Jamison A, Swansiger R. Transport and management of patients with confirmed or suspected Ebola virus disease. Ann Emerg Med. 2015;66(3):297–305.CrossRefGoogle Scholar
  6. 6.
    Lowe JJ, Jelden KC, Schenarts PJ, Rupp LE, Hawes KJ, Tysor BM, Swansiger RG, Schwedhelm SS, Smith PW, Gibbs SG. Considerations for safe EMS transport of patients infected with Ebola virus. Prehosp Emerg Care. 2015 Apr–Jun;19(2):179–83.CrossRefGoogle Scholar
  7. 7.
    Centers for Disease Control and Prevention. Guidance for developing a plan for interfacility transport of persons under investigation or confirmed patients with ebola virus disease in the united states. Available at https://www.cdc.gov/vhf/ebola/healthcare-us/emergency-services/interfacility-transport.html. Accessed 1 Feb 2017.
  8. 8.
    Centers for Disease Control and Prevention. Healthcare Infection Control Practices Advisory Committee (HICPAC). Available at https://www.cdc.gov/infectioncontrol/guidelines/isolation/index.html. Accessed 1 Feb 2017.
  9. 9.
    Occupational Safety and Health Administration. Respiratory protection. Available at https://www.osha.gov/Publications/osha3079.pdf. Accessed 1 Feb 2017.
  10. 10.
    Centers for Disease Control and Prevention. Guidance on personal protective equipment (PPE) to be used by healthcare workers during management of patients with confirmed ebola or persons under investigation (PUIs) for ebola who are clinically unstable of have bleeding, vomiting, or diarrhea in U.S. hospitals, including procedures for donning and doffing PPE. Available at https://www.cdc.gov/vhf/ebola/healthcare-us/ppe/guidance.html. Accessed 1 Feb 2017.
  11. 11.
    Centers for Disease Control and Prevention. Ebola: personal protective equipment (PPE) donning and doffing procedures. Available at https://www.cdc.gov/vhf/ebola/hcp/ppe-training/index.html. Accessed 1 Feb 2017.
  12. 12.
    Occupational Safety and Health Administration. Respiratory protection standard 29 CFR 1910.134. Available at https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=12716. Accessed 1 Feb 2017.
  13. 13.
    Halpern SD, Emanuel EJ. Ethical guidance on the use of life-sustaining therapies for patients with Ebola in developed countries. Ann Intern Med. 2015;162:304–5.CrossRefGoogle Scholar
  14. 14.
    Centers for Disease Control and Prevention. Transport of pediatric patients. Available at https://www.cdc.gov/vhf/ebola/healthcare-us/emergency-services/transporting-pediatric-patients.html. Accessed 1 Feb 2017.
  15. 15.
    American College of Emergency Physicians. Policy statement: medical direction of emergency medical services. Available at http://www.acep.org/Content.aspx?id=29570. Accessed 1 Feb 2017.
  16. 16.
    Assistant Secretary for Preparedness and Response. Planning considerations when developing standard operating procedures for the transfer of an ebola (or other highly infectious disease) patient from/to an air transport provider to/from a ground transport provider. Available at https://www.phe.gov/Preparedness/responders/ebola/Pages/air-transport-factsheet.aspx. Accessed 1 Feb 2017.
  17. 17.
    Fischer WA II, Hynes NA, Perl TM. Protecting health care workers from Ebola: personal protective equipment is critical but is not enough. Ann Intern Med. 2014 Nov 18;161(10):753–4.CrossRefGoogle Scholar
  18. 18.
    Hewlett AL, Varkey JB, Smith PW, Ribner BS. Ebola virus disease: preparedness and infection control lessons learned from two biocontainment units. Curr Opin Infect Dis. 2015 Aug;28(4):343–8.CrossRefGoogle Scholar
  19. 19.
    Schultz CH, Koenig KL, Alassaf W. Preparing an Academic Medical Center to Manage Patients Infected With Ebola: Experiences of a University Hospital. Disaster Med Public Health Prep. 2015 Oct;9(5):558–67.CrossRefGoogle Scholar
  20. 20.
    National Ebola Education and Training Center. Bellevue hospital center incident response guide. Available at https://netec.org/wp-content/uploads/2017/03/Bellevue-EVD-IRG.pdf. Accessed 1 June 2017.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Section of Prehospital and Disaster Medicine, Department of Emergency MedicineEmory University School of MedicineAtlantaUSA

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