Staff who treated a possible Ebola patient at Maine Medical Center earlier this month burned through 25 protective suits a day.
Hospital epidemiologist Dr. August Valenti shared that tidbit at a press event MMC hosted this morning to demonstrate the hospital’s Ebola preparedness efforts. The suits are just one component of the safety gear health care workers at the Portland hospital wore, along with two sets of gloves, booties, a respirator and a hood.
The possible Ebola patient was considered low risk and ultimately tested negative for the virus. Maine has had no confirmed cases of Ebola.
But worries persist about how well hospitals are prepared to handle the virus, after two nurses who treated an Ebola patient in Texas became infected. Much of the attention has focused on the protective equipment the nurses wore and whether the protocols for putting it on and removing it were adequate.
MMC sought to allay such fears by inviting a handful of journalists to observe the process and (as we’re known to do) ask questions. Hospital officials stressed that MMC’s precautions against Ebola surpass the recommendations of the U.S. Centers for Disease Control and Prevention.
Brian Dougher, emergency management coordinator for MMC, demonstrated the process Tuesday with John Swiger, the hospital’s occupational safety industrial hygienist, and Gwen Rogers, director of epidemiology and infection control. They walked through the buddy system staff used, with Dougher suiting up as Swiger assisted and checked for any possible oversights.
- Dougher first donned the bright yellow impermeable suit, then added cotton socks with gripped bottoms (the kind patients typically wear), for better traction over the suit’s built-in booties.
- Next came the exam gloves, which the men tucked under the elasticized wrists of the suit, then covered with a second pair of Neoprene gloves.
- Even that wasn’t sufficient. Swiger wrapped duct tape around both of Doughers’ wrists for further protection. They also added a strip along the suit’s front zipper. (While duct tape doesn’t hold up against acids — hazmat responders wouldn’t use it when responding to a chemical spill, for example — it works just fine to keep out bodily fluids, Swiger said.)
- Dougher also donned a battery-powered respirator that filters out particulates. Other hospitals have opted to use “N95 respirators,” which filter out 95 percent of airborne particles, with goggles. But health workers elsewhere found the goggles fog up, which can lead to contamination as wearers try to adjust them, Rogers said. (Health experts widely agree that Ebola can’t be transmitted through the air. But some medical procedures, such as intubation, could potentially aerosolize the virus.)
- Dougher completed the getup with a hood and final patch of duct tape to close the gap between the hood and his suit.
He looked warm in there. MMC nurses have suggested that the hospital supply camel-back hydration packs and cooling vests to ease the discomfort, Valenti said.
Hospital staff followed an even stricter protocol when removing the gear, one of the riskiest parts of the process for health care workers, Rogers said. After leaving the patient’s room, the nurse or doctor would enter an anteroom with their “buddy,” who’s also suited up. They’d then get wiped down with an alcohol-based cleaner to decontaminate the gloves and suit before carefully removing each item.
The hospital already had most of the needed equipment on hand, and aimed to use gear that staff were already familiar with, Swiger said.
Doctors and nurses went through the “donning and doffing” process multiple times with the MMC patient, using fresh gear for each entry into his room, Valenti said. Hospitals across the country are rushing to stock up on the equipment.
“We’re concerned there’s going to be scramble nationally for this equipment, so we have tried to plan,” he said. “Right now we do have adequate supplies.”
Valenti said it takes about five minutes to don the equipment, and five to 10 minutes to remove it. He remains concerned about how to ensure staff suit up properly if a potential Ebola patient “codes” and needs urgent attention. Doctors and nurses can’t just run into the room like they normally would, and must balance their own safety against the patient’s, he said. MMC will assign at least three people to handle such patients, so the third individual can suit up if both the original entrant and his or her buddy are needed at the bedside, he said.
MMC could potentially handle four Ebola patients at once after the hospital finishes ongoing work to convert a unit for isolation, Valenti said.
While MMC staff have experienced some anxiety about Ebola, “after they see the training that our safety department is doing, they really feel much better,” he said.