Transporting an Ebola patient takes practice, adherence to protocols

As a regional approach to treating Ebola patients develops, the role of the nation’s emergency medical service and transport fleet will take on more significance.

“We're going to be moving more and more of the patients from Point A to Point B, either by ground or by air,” said Dr. Edward Racht, chief medical officer at Greenwood Village, Colo.-based American Medical Response, which transports more than 3 million patients a year in 4,200 vehicles operating in 40 states. “This has changed the landscape very quickly and intensely, and everyone is trying to figure out how to manage this emerging threat.”

An AMR ambulance transported one Ebola patient from Texas Health Presbyterian Hospital Dallas to the airport on Oct. 15 and another the next day. Racht said the process took nearly 10 hours per vehicle. Preparing each vehicle took four hours, the trip took one and a half hours, and it took another three to four hours to decontaminate and sterilize the vehicle after transport.

“The process is very checklist oriented and specific, so you don't miss any steps,” he said.

A first step involves installing an impermeable plastic lining that covers the patient compartment.

“The inside of the ambulance is separated from the driver's compartment and separated from the outside world,” Racht said. “After transport, there is a methodical process to remove the lining and put it in a hazardous materials container.”

Staff have been trained in “donning and doffing” protective equipment, have practiced doing so, and done so under observation so they would be stopped if they were doing something incorrectly, he said.

We know the science, we know how to protect ourselves,” Racht said.

As of Friday, Racht said AMR had no more Ebola-patient transports pending.

Ebola preparedness takes on the equivalence of a “medical Ground Hog Day,” Racht said, referencing the movie in which actor Bill Murray's character experiences the same day over and over again. There is regular communication on any new information and reminders of basic principles, he said.

The communication often includes the latest information from the Centers for Disease Control and Prevention.

Many 911 telephone centers are being trained to ask callers if they've traveled to West Africa, Racht said, and if they are experiencing Ebola symptoms. If those answers are “yes,” then AMR drivers know they need to put on protective gear.

Follow Andis Robeznieks on Twitter: @MHARobeznieks