title: Preparation of an intensive care unit in France for the reception of a confirmed case of Ebola virus infection.
abstract: The current Ebola Virus Disease (EVD) outbreak in West Africa is a major challenge for the worldwide medical community. On April 29th 2015, the World Health Organization (WHO) declared 26,277 infected cases; among them, 10,884 have deceased. The epidemic is still ongoing, particularly in Sierra Leone. It is now clear that northern countries will be implicated in the care of EVD patients, both in the field and back at home. Because of the severity of EVD, a fair amount of patients may require intensive care. It is highly probable that intensive care would be able to significantly reduce the mortality linked with EVD. The preparation of a modern Intensive Care Unit (ICU) to treat an EVD patient in good conditions requires time and specific equipment. The cornerstone of this preparation includes two main goals: treating the patient and protecting healthcare providers. Staff training is time consuming and must be performed far in advance of patient arrival. To be efficient, preparation should be planned at a national level with help from public authorities, as was the case in France during the summer of 2014. Due to the severity of the disease, the high risk of transmission and scarce knowledge on EVD treatment, our propositions are necessarily original and innovative. Our review includes four topics: a brief report on the actual outbreak, where to receive and hospitalize the patients, the specific organization of the ICU and finally ethical aspects.
authors.affiliation: Anaesthesiology and intensive care medicine, Begin Military Hospital, 69, avenue de Paris, 94163 Saint-Mande, France. Electronic address: clement.dubost@hotmail.fr.
authors.forename: Clément
authors.initials: C
authors.lastname: Dubost
authors.affiliation: Anaesthesiology and intensive care medicine, Begin Military Hospital, 69, avenue de Paris, 94163 Saint-Mande, France. Electronic address: pasquier9606@me.com.
authors.forename: Pierre
authors.initials: P
authors.lastname: Pasquier
authors.affiliation: Anaesthesiology and intensive care medicine, Begin Military Hospital, 69, avenue de Paris, 94163 Saint-Mande, France. Electronic address: kearnskp@gmail.com.
authors.forename: Kévin
authors.initials: K
authors.lastname: Kearns
authors.affiliation: Anaesthesiology and intensive care medicine, Begin Military Hospital, 69, avenue de Paris, 94163 Saint-Mande, France. Electronic address: cecile.ficko@yahoo.fr.
authors.forename: Cécile
authors.initials: C
authors.lastname: Ficko
authors.affiliation: Infectious disease, Begin Military Hospital, 69, avenue de Paris, 94163 Saint-Mande, France. Electronic address: rappchristophe5@gmail.com.
authors.forename: Christophe
authors.initials: C
authors.lastname: Rapp
authors.affiliation: Intensive care medicine, Bichat University Hospital Bichat, 46, rue Henri-Huchard, 75877 Paris, France. Electronic address: michel.wolff@bch.aphp.fr.
authors.forename: Michel
authors.initials: M
authors.lastname: Wolff
authors.affiliation: Intensive care medicine, hôpital de la Croix-Rousse, 93, grande rue de la Croix-Rousse, 69317 Lyon, France. Electronic address: j-christophe.richard@chu-lyon.fr.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Richard
authors.affiliation: Intensive care medicine, European Hospital Georges-Pompidou, 20, rue Leblanc, 75908 Paris, France. Electronic address: jean-luc.diehl@egp.aphp.fr.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Diehl
authors.affiliation: Intensive care medicine, University Hospital of Rennes Pointchaillou, 33053 Rennes, France. Electronic address: yves.le.tulzo@chu-rennes.fr.
authors.forename: Yves
authors.initials: Y
authors.lastname: Le Tulzo
authors.affiliation: Anaesthesiology and intensive care medicine, Begin Military Hospital, 69, avenue de Paris, 94163 Saint-Mande, France. Electronic address: merat.stephane@wanadoo.fr.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Mérat
mesh_terms: D003422:Critical Care; D005602:France; D019142:Hemorrhagic Fever, Ebola / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D010356:Patient Isolation
keywords: Biothreat; Ebola virus disease; Highly contagious patient; Intensive care unit; Isolation; Shock