Critical Care |

Establishing a New Biocontainment and Treatment Unit FREE TO VIEW

Brian Garibaldi, MD; Neysa Ernst, MSN; Mallory Reimers, RN; Ronald Langlotz, RN; Anatoly Gimburg; Michael Iati; Gregory Bova; Polly Trexler, MS; William Clarke, PhD; Elizabeth Daugherty, MD; Howard Gwon; Lauren Sauer, MS; Margaret Garrett, JD; Brian Gragnolati, MBA; Roy Brower, MD; Redonda Miller, MD; Trish Perl, MD; Gabor Kelen, MD; Lisa Maragakis, MD
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Johns Hopkins Hospital, Baltimore, MD

Chest. 2015;148(4_MeetingAbstracts):248A. doi:10.1378/chest.2268190
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SESSION TITLE: Critical Care Posters III

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: In response to the Ebola Virus Disease (EVD) crisis in West Africa, Johns Hopkins Medicine (JHM) created a new biocontainment and treatment unit (BCU) to safely care for patients with EVD and to serve as a site for innovation, education and research for highly infectious diseases.

METHODS: In September 2014, we identified a de-activated clinical unit as the site of the new BCU. The BCU leadership team examined published literature, visited two existing biocontainment units and contacted experts to inform the design of the physical structure and care activities of the unit. Architects and engineers collaborated with clinicians to redesign the unit to safely accommodate patients with highly infectious diseases transmitted via contact, droplet, airborne or mixed transmission methods. Colleagues throughout the Johns Hopkins Health System contributed to the development of the BCU and its education, research and patient care protocols.

RESULTS: The BCU is a 3-bed biocontainment unit at Johns Hopkins Hospital, capable of caring for adult and pediatric patients with highly infectious pathogens. The unit has dedicated donning and doffing areas, a negative pressure differential across patient rooms and greater than 12 air changes per hour with a dedicated HEPA filtration exhaust system. There is an onsite Biosafety Level 2 (BSL-2) laboratory with critical care capabilities as well as an autoclave-based waste management system to handle highly infectious medical waste. The BCU is staffed by clinicians, nurses and technicians with experience in infectious diseases and critical care. Other care providers as well as family members will interact with patients and staff through an advanced telemedicine system. Training and education can be adjusted for specific diseases. As a result of these efforts, Johns Hopkins was selected by the CDC to be a designated national Ebola Treatment Center.

CONCLUSIONS: The Johns Hopkins BCU represents the highest level of multi-disciplinary collaboration and will serve as a leader in safe patient care, education, innovation, and research for EVD and other highly infectious diseases.

CLINICAL IMPLICATIONS: Prior to the current Ebola virus disease (EVD) outbreak in West Africa, the capacity to handle patients with highly infectious diseases was limited to a small number of nationally funded biocontainment units and military facilities. The new Johns Hopkins BCU will add to that national capacity and contribute to the growing clinical, research and training efforts in highly infectious diseases.

DISCLOSURE: The following authors have nothing to disclose: Brian Garibaldi, Neysa Ernst, Mallory Reimers, Ronald Langlotz, Anatoly Gimburg, Michael Iati, Gregory Bova, Polly Trexler, William Clarke, Elizabeth Daugherty, Howard Gwon, Lauren Sauer, Margaret Garrett, Brian Gragnolati, Roy Brower, Redonda Miller, Trish Perl, Gabor Kelen, Lisa Maragakis

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