high risk infectious disease response team patrick auger bhsc, memgt, med(c) ccp
TRANSCRIPT
High Risk Infectious Disease Response Team
Patrick Auger BHSc, MEmgt, MEd(c) CCP
Introduction & Background
2
Population & Call Volume
• 13,678,740
• 38.5% of Canada’s Population
• Approximately 21 000 calls for service per year
page 3
Introduction & Background
page 4
Scope of Practice
Adult/Pediatric and Obstetrical Critical Care Transport.
Example of skill set•Rapid Sequence Intubation•Difficult & Advanced Airway Management & Tools (Air-traq, Bougie, Needle Cric etc.)•Mechanical Ventilation•Needle thoracostomy•Intravenous, Intraosseous, umbilical vein catheterization•Gastric tubes and foley catheters•Gastroesphageal balloon monitoring•Chest Drainage Systems•X-ray, Lab, 12 interpretation•Arterial/central line maintenance & monitoring•Transcutaneous & Transvenous pacing•Blood product administration
page 6
Emergency Medical Assistance Team & Paramedics
CBRN Trained Paramedics
page 7
EVD outbreak in West Africa
• 1st cases notified in march 2014
• August 8th WHO declared a Public Health Emergency of International concern.
page 8
Ebola Virus Disease (EVD)
• A severe, often fatal illness
• Transmitted to people from wild animals and spreads through human to human transmission
• Average EVD case fatality rate is around 50%. Varied from 25% to 90% in past outbreaks
page 9
What were we asked to do….
• Transport confirmed EVD cases that required advanced or critical care.
page 10
PPE Training
Donning Requirements• Fit Tested N95• Goggles• Face shield• Hood• Full body barrier protection• Double Gloves
Challenges of fit
page 11
PPE Training
Doffing Requirements• Prevention of cross
contamination
• Step by step process to remove PPE under the direction of a safety Officer
Safety Officer with Checklist
page 12
Validating Training
page 13
Challenges of PPE for Paramedics
Heat Stress• Inside the suit is a
microenvironment • Inside Temperature• Humidity• Air currents
• Increased metabolic work
• Reduction in speed, thought and alertness
Work Rest Cycles
page 14
Modification of PPE for High Risk Infectious Disease Team
page 15
Powered Air Purifying Respirator (PAPR)
page 16
Positive Pressure System•APF 1000Flow Pattern – Hood – Suit – outside
Cooling effect
Checklists
Issues
1. Donning
2. Doffing
3. Engineering Controls
4. Safety Officer
5. Patient Preparation & Packaging
6. Biocontainment
7. Work Rest Cycles
Visual Guides
page 18
Visual Guide – Bio-Bag
page 19
Personal Kit List
Team FrameworkModular & Scalable
page 21
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Call Organization – Major Issues
page 28
Donning Principles
Safety Officer Check Time Documented
page 29
Patient Preparation & Packaging
Tubes & Lines PreparedAll potential Infusion Medications anticipated
page 30
Patient Preparation & Packaging
Ingress & Egress Access
page 31
Patient Preparation & Packaging
page 32
Patient Transport
Egress issues Patient Loading
page 33
Two AmbulancesMitigate Logistical Challenges
Primary AmbulanceSupport Vehicle/Secondary Ambulance
page 34
Doffing Principles
Checklists & Safety Officer Designated Marked Area
page 35
Doffing Principles
Rolling outer layer
page 36
Doffing Priniciples
Colour Coded GlovesRed Biohazard Bags &
Container(s)
page 37
Doffing Principles
Reusable Equipment
page 38
Doffing Principles
Suit Size very important
page 39
Bio-containment
Everything Wiped Down Sealed Drums
page 40
Recovery Phase
After Action Report• Lessons Learned
• Corrective Action Plan
Decontamination• Vehicle Decontamination
• Equipment Decontamination
• Supply Replacement
page 41
Questions?
page 42