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Ebola Transfer

Posted Dec 02 2008 9:27pm

Just before Christmas I had a very interesting task to undertake. We were happily plodding along on the desk, not too busy but steady enough to avoid the day dragging when we got a call from a Doctor. It was a transfer from a home address to the Royal Free Hospital. I only glanced at it to begin with and then looked again at where it was going - "Infectious Diseases Unit". Ooo exciting - and then I looked at the diagnosis. In big bold letters across the middle of the screen it said
?Ebola Virus
Oh my I thought!! That's a proper call! This is one of the few diseases that we call a Category 3 - the group of illnesses that come under the hemorrhagic fever banner. The most contagious and dangerous of the infectious illnesses. These types of transfers have a huge, very specific protocol that must be followed to the letter. It was time for me to get my organised hat on.

Hat in place, I phoned the DSO (Duty Station Officer) and explained what call we had. In order to run these types of transfers you need not only a crew but an Officer as well. The DSO listened patiently as I gave him the details and then headed back to station to start getting a vehicle sorted. We then had to find a crew. Luckily there was one who were going to be greening up at hospital very shortly so I sent them a message asking them to call the West Desk when they were done. Crews cannot refuse a Cat 3 transfer unless a crew member is pregnant (or, I believe, if they have a partner who is but don't quote me on that) Luckily the crew we had picked were all males and after confirming that neither of them was with child, I explained what I was lumbering them with. I don't know if they were annoyed at getting something like this or excited - I know one crew member was Bank staff and I bet he wasn't expecting something like that during his shift!! Then the full protocol kicked into place.

First things first, the crew has to be stood down for a break - once the transfer starts they have to see it through to the end and that can be a long time. After that they have to strip down their vehicle to the bare essentials. In this case the DSO had actually found a "shell" that could be equipped specifically for the transfer as opposed to completely trashing the crews vehicle and them being off the road for hours putting it all back together (very smart thinking on the DSO's part). They then make sure the vehicle works, do a radio check and make sure they have a mobile phone that is charged and works. They then strip themselves down and put on special suits (including paper pants which I think must look hilarious although may chafe a little!). The Officer takes all their clean stuff in the car and then together they go to the patient. The DSO stays in the car, the crew get the patient and take them to the Royal Free (here on in known as RFNW 3 which is our pneumonic for the hospital). At the RFNW 3, they are met by a team from the Infectious Unit and the patient is taken off their hands. They then get directed around the side of the building where they shower and fully clean and disinfect the ambulance according to yet more protocols.

Once the crew had been stood down, I was able to just leave them to it for a bit. While they were doing that, it was time for me to make contact with the RFNW 3. Now I've only had to contact them once before after a ?smallpox incident (I wrote about it on my blog - the original one - but can't seem to find it to link it up!) On that occasion they were the most unhelpful, unprofessional people I have ever spoken to considering the potential severity of the situation. I had to fight them for every speck of information they could give me and I almost had a full on row with a nurse who said she'd "call me back later" when she's found a Doctor who could help. As you can imagine, I wasn't really looking forward to trying to force information out of them again. Oh how wrong could I be. I spoke to the most helpful, informed, polite Nurse (I believe he was the Junior Charge Nurse) in possibly the whole of the NHS!! I explained who I was and that I wanted to confirm that they knew they were receiving this patient. He already knew all about it and was even able to give me the back story on how the diagnosis had come about. He explained the whole procedure for when the crew arrived and I felt safe in the knowledge that this would be an uneventful transfer. I gave him the crews names and the DSO's mobile number. All he asked was that the crew gave him a call once they had an ETA. 20 minutes and everything was sorted and arranged.

I rang the DSO back and gave him all the extra info and he seemed genuinely pleased that I had done all the leg work for him. I explained what would happen when they got there (it's not a usual occurrence to do one of these transfers and it's better to teach someone how to suck eggs than not give them vital info and get blamed for it later on!) The DSO thanked me for all my efforts which was very nice of him and that was it. It was perfect timing as my shift had just ended and my relief had turned up so I did a handover to them and that was that!

Today I spoke to the DSO who had dealt with it to find out what had happened. Apparently it had all gone smoothly except for the fact that the patient had not been informed she was going to hospital let alone that 2 burly men in paper suits would be arriving with an ambulance looking like something out of ET!! She hadn't been very co-operative but other than that the transfer went like clockwork. I asked if it actually was Ebola - the answer ...

... it appears that the patient simply had a PUO ( Pyrexia of Unknown Origin - a high temperature to you and me) but because she had recently been in a third world country the Dr had aired of the side of caution - and wow is that airing!!!! Lucky for her though as I can't imagine it's very pleasant having Ebola and always better to be safe than sorry!! I wonder if it will be followed up with the GP and Hospital who arranged the transfer in the first place!!

All's well that ends well!
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