View
221
Download
0
Category
Preview:
Citation preview
Transport of EVD patients Medical evacuation (MEDEVAC)
Dr. Thomas Kratz
Robert Koch Institute, 15-02-25
ECDC Training Course – Ebola and Marburg Diagnostic
24th February to 27th February 2015
Robert Koch Institute, Berlin
Reasons for medical evacuation
• Suspected Ebolavirus Disease
(e.g. Symptoms + Contact)
• Confirmed Ebolavirus Disease
(by PCR)
• High Risk Exposure
(e.g. needlestick injury, splash of body liquids into mucous membranes)
MEDEVAC of EVD Patients
Field location
MEDEVAC Aircraft
International Airport GUI/SLE/LIB
Ambulance System
BSL4-Ward
European International Airport
MEDEVAC of EVD Patients
Field location
MEDEVAC Aircraft
International Airport GUI/SLE/LIB
Ambulance System
BSL4-Ward
European International Airport
… possible constraints
MEDEVAC of EVD Patients
Field location
MEDEVAC Aircraft
International Airport GUI/SLE/LIB
Ambulance System
BSL4-Ward
European International Airport
… possible constraints
Lack of … - physical accessibility (unpaved roads, rainy season) - Access to healthcare - communication means (no cell phone connection etc.)
MEDEVAC of EVD Patients
Field location
MEDEVAC Aircraft
International Airport GUI/SLE/LIB
Ambulance System
BSL4-Ward
European International Airport
- Physical accessibility - Groundhandling
… possible constraints
MEDEVAC of EVD Patients
Field location
MEDEVAC Aircraft
International Airport GUI/SLE/LIB
Ambulance System
BSL4-Ward
European International Airport
… possible constraints
Must be available Must be accessible (physically, financially …)
MEDEVAC of EVD Patients
Field location
MEDEVAC Aircraft
International Airport GUI/SLE/LIB
Ambulance System
BSL4-Ward
European International Airport
… possible constraints
Groundhandling
MEDEVAC of EVD Patients
Field location
MEDEVAC Aircraft
International Airport GUI/SLE/LIB
Ambulance System
BSL4-Ward
European International Airport
… possible constraints
Must be available Must be equipped (Barrier Nursing!)
MEDEVAC – actors in the event of evacuation of a German citizen
• GO / NGO
• Federal Foreign Office
• Robert Koch Institute
• Health Authority (local, federal, state)
• Health Insurance
• MEDEVAC facilitator (e.g. German Red Cross Assistance)
• BSL-4 equipped ward (STAKOB)
STAKOB Competence – and Treatment Centres
MEDEVAC – Airbus „Robert Koch
Public Health Preparedness in Germany
Dr. Iris Hunger
Robert Koch Institute, 15-02-25
ECDC Training Course – Ebola and Marburg Diagnostic
24th February to 27th February 2015
Robert Koch Institute, Berlin
Recognition of EVD cases
What is a “probable EVD case”?
Anamnestic interview:
Clinical picture?
Travel history?
Exposure history?
Differential diagnosis: Malaria tropica
Measures in case of probable or confirmed EVD case outside of special isolation units
PPE
Isolation
Primary care
Patient transport Disinfection Waste, waste water
Laboratory diagnostics
Contact tracing
Measures in case of probable or confirmed EVD case outside
of special isolation units
PPE
Isolation
Measures in case of probable or confirmed EVD case outside of special
isolation units
The following minimum standards are mandatory (“barrier nursing“): • The patient room has vestibule or another designated
entry area separating clean from unclean areas. • Realization of: - appropriate means for disinfection, - possibilities to safely don and doff PPE, and - options for safe collection and subsequent disposal of
used PPE. • Point of care diagnostics (small diagnostic series) for
infectious samples should be available within the isolation unit.
• Appropriate waste management procedures (waste key 180103*) needs to be in place.
Patient transport
Measures in case of probable or confirmed EVD case outside of special isolation units
Waste, waste water
Measures in case of probable or confirmed EVD case outside of special isolation units
• On-site inactivation of waste is the preferred option. • Packaging for shipment of waste to special waste
incineration plants: - Primary receptacle: plastic drum with removable head,
internal volume up to 60 liters available for this purpose, opening diameter approx. 400 mm , leak-proof, lid preferably with adhesive seal, single-use closure (not to reopen).
- Secondary packaging: PE bag with a material thickness of preferably 100 μm, but at least 75 μm.
- Outer packaging: plastic drum with removable head and clamping ring closure, external dimensions approx. 500 mm diameter, 800 mm height.
Measures in case of probable or confirmed EVD case outside of special isolation units
Thank you for your attention ;) !
Questions ? Dr. Thomas Kratz, MD Dr. Iris Hunger Federal Information Centre for Biological Threats and Special Pathogens Robert Koch Institute Nordufer 20 13353 Berlin E-Mail: KratzT@rki.de, HungerI@rki.de The Robert Koch Institute is a Federal institute within the portfolio of the Federal Ministry of Health.
Recommended