UIHC trains, preps for the worst at mock Ebola treatment center

A  handful of emergency medical services providers assembled in a University of Iowa Hospitals and Clinics ambulance bay last week, each having transported and cared for thousands of patients over the years.

But this new undertaking would look different.

'We would move slowly, we would move deliberately,' Mike Hartley, UIHC emergency management coordinator, told the room EMS providers Friday. 'This isn't a trauma.'

None of the EMS providers have cared for a patient suffering — or suspected to be suffering — from the deadly Ebola virus that continues to ravage parts of West Africa. But they could after the Iowa Department of Public Health last week identified the state's EMS providers and hospitals that could play a role in the treatment of an Ebola patient, should a case emerge Iowa.

The UIHC has agreed to serve as the state's Ebola treatment facility, while Mercy Medical Center and UnityPoint Health-Iowa Methodist Medical Center — both in Des Moines — have agreed to screen potential patients for the virus, if necessary.

Cedar Rapids-based Area Ambulance, Davenport-based Medic EMS, and West Des Moines-based Iowa EMS Alliance are the only services approved to transport confirmed or suspected Ebola patients.

And the Iowa State Hygienic Lab, based in Coralville, has been certified by the Centers for Disease Control and Prevention to test for Ebola, if necessary.

Limiting the number of hospitals in Iowa that could screen or treat potential Ebola patients ups the likelihood of ambulance transport should someone begin showing symptoms.

That's why UIHC experts, with the help of state and federal officials, have fine-tuned their Ebola transport procedures and spent all Friday training about 18 EMS professionals.

Using a piece of precut plastic, crews would prepare a landing area on the ground divided by a long piece of red tape.

One side would be 'clean' and one side with be 'dirty,' and nothing from inside the ambulance — except for the patient, using a side-by-side 'bed clean transfer' — would be allowed to cross the line, Hartley said.

A patient would be cocooned in linens and plastic sheeting, and a pair of protected nurses would take him or her to an isolated room via a route that avoids other patients and staff.

From there, EMS technicians would be charged with disinfecting their equipment, Hartley said. UIHC staff will provide support, and each ambulance has an approved procedure — including use of an ultraviolet disinfection light, in some cases — for killing remnants of the virus.

Iowa has not seen any cases of Ebola, and public health officials have stressed that the 'likelihood of an Ebola case in Iowa is extremely low.' Still, the state is working with federal officials to track travelers returning from Ebola-affected West African countries.

Iowa has monitored 18 people since Sept. 1, but only one low-risk person was being monitored as of last week. All but one of the individuals who have been monitored in Iowa have been considered low risk.

UIHC administrators and experts for months have been evaluating their Ebola response, creating a core team of 70 responders — including ancillary staff such as house keepers and lab technicians.

But being designated as Iowa's Ebola treatment facility 'makes it explicit,' Herwaldt said.

'We know now for sure what our role is,' she said.

'Trained and well equipped'

If a suspected Ebola case emerges in Iowa, state officials will choose an ambulance service based on several factors, including location of the patient, risk level, hospital preference and even weather, said Rebecca Curtiss, chief of the Iowa Department of Public Health's Bureau of Emergency and Training Services.

Although the UIHC is the only Iowa hospital that can provide a full 30-day course of treatment, Curtiss noted, the other two hospitals can test, diagnose and provide some aid.

Cedar Rapids-based Area Ambulance Service was among those trained at UIHC on Friday, but Executive Director Keith Rippy said his crews began preparing long before that. A 'special response unit' of eight individuals has been trained by a response team out of Illinois and by UIHC, and an ambulance designated to handle Ebola patients has been equipped with all the necessary safeguards, Rippy said.

Some in the special response unit are members of the military and have been trained through their service in infectious disease response, Rippy said.

'We are well trained and well equipped,' Rippy said.

The state hasn't designated a territory for the Cedar Rapids-based EMS crew trained to handle an Ebola patient. But, Rippy said, his team will take any charge it's given.

'We'll go wherever we're requested,' he said.