Tags: Ebola Outbreak | Ebola | Nebraska Biocontainment Patient Care Unit | bioterrorism

High Tech Hospital Unit Tailored for Ebola Victims

Friday, 10 October 2014 10:53 PM

A high-tech hospital unit designed to care for bioterrorism victims but mostly unused since its opening in 2005 is now on the front line of America's response to Ebola, The New York Times reports.

The Nebraska Biocontainment Patient Care Unit is the largest of four units in the United States specially equipped to respond to the hemorrhagic disease, and the only one designated for the general public, the Times reports.

The others are at the National Institutes of Health in Bethesda, Md., Emory University Hospital in Atlanta and St. Patrick Hospital in Missoula, Mont.

The unit can treat more than a dozen highly infectious diseases, including SARS, plague, monkeypox and multidrug-resistant tuberculosis. It has a steam sterilizer, known as an autoclave, for linens, scrubs and equipment, and a special air-handling system to keep germs from spreading beyond the patient rooms, the Times reports.

"At the time, we were worried about smallpox," Dr. Harold Maurer, the former chancellor of the University of Nebraska Medical Center, told the Times about its inception in the years after the 9/11 attacks.

"Then nothing happened. Some of the faculty called it Maurer’s Folly."

That all changed Sept. 2, when the State Department called Dr. Philip Smith, an infectious disease specialist who opened the unit in 2005, and asked if it could treat Dr. Rick Sacra, an American missionary who contracted Ebola in Liberia.

Sacra spent three weeks at the unit in September before being released.

While there, he got an experimental drug called TKM-Ebola and two blood transfusions from Dr. Kent Brantly a missionary who was treated at Emory and recovered as well as intravenous fluids and supplements to prevent electrolyte imbalance.

The unit's second patient arrived 10 days after Sacra left; Ashoka Mukpo, 33, an American freelance journalist airlifted from Liberia to Omaha on Monday, is now getting a twice-weekly pill of the experimental drug, brincidofovir. He also got a transfusion of blood plasma from Brantly, the Times reports.

"There are certainly aspects of it that are stressful," Dr. Christopher Kratochvil, the associate vice chancellor for clinical research at the University of Nebraska Medical Center, told the Times.

"But this is exactly what we’ve been training to do, and a role the unit was intended to serve."

Smith, who opened the unit with funds Congress was granting to states for disaster preparedness, told the Times it cost $1 million to retrofit a former pediatric transplant ward, creating isolation rooms with concrete-block walls, tornado-proof windows and video links to the unit’s nursing station.

Nurses on the biocontainment team have been working 12-hour shifts in the unit; they take turns spending four straight hours in Mukpo’s room in full protective gear, including full face shields and three pairs of surgical gloves duct-taped to water-resistant surgical gowns, the Times reports.

A police officer guards the entrance to the unit around the clock, and team members who work in the "dirty" section shower before leaving.

Mukpo has felt ill and hasn't wanted to talk, Hewlett said. The nurses take his vital signs once an hour, monitor his intravenous fluids and draw blood once a day from a central line so they can avoid using needles. They are also responsible for changing his sheets and cleaning his bathroom; the cleaning staff is not allowed in the unit, the Times reports.

The team also includes respiratory therapists, in case a patient needs a ventilator or expert monitoring of their breathing, nursing technicians who run the autoclave and help doctors and nurses don and doff protective gear, and doctors specializing in critical care and infectious disease, the Times reports.

In the event of an outbreak, Smith told the Times the unit would not be able to expand beyond its current 10 beds.

So much infectious waste is produced, he said, and the disease is so hazardous, that "we’re more comfortable taking care of one or two," he told The Times.

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A high-tech hospital unit designed to care for bioterrorism victims - but mostly unused since its opening in 2005 - is now on the front line of America's response to Ebola, The New York Times reports.
Ebola, Nebraska Biocontainment Patient Care Unit, bioterrorism
Friday, 10 October 2014 10:53 PM
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