Ebola virus disease: the UK critical care perspective.
The recent outbreak of Ebola virus disease (EVD) has required the treatment of affected patients in the NHS system within the UK. Managing patients with a confirmed viral haemorrhagic fever requires a thorough understanding of treatment options within the confines of an effective biocontainment setting. The Royal Free Hospital High Level Isolation Unit (HLIU) in London, is a purpose built facility that allows healthcare workers to safely treat patients with highly contagious diseases. This HLIU uses Trexler isolator tents to prevent the spread of infection from patients to healthcare workers. Provision of invasive organ support can be provided in this environment, if considered appropriate, and is achievable without posing additional risk to staff. We report our recent experiences of managing patients with EVD, with particular focus on those aspects of care pertinent to anaesthesia and critical care medicine.
Critical Care Unit Division of Surgery and Interventional Science, University College London University College London Centre for Altitude Space and Extreme Environment Medicine, UCLH NIHR Biomedical Research Centre, Institute of Sport and Exercise Health, London W1 T 7HA, UK daniel.martin@ucl.ac.uk.
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Martin
Critical Care Unit.
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Howard
Critical Care Unit.
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B
Agarwal
Critical Care Unit.
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Rajalingam
Infectious Diseases Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
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Athan
Infectious Diseases Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
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Bhagani
Infectious Diseases Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
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I
Cropley
Infectious Diseases Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
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Hopkins
Infectious Diseases Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
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Mepham
Infectious Diseases Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK Research Department of Infection, University College London, Royal Free Campus, Pond Street, London NW3 2QG, UK.
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Rodger
Infectious Diseases Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
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Warren
Infectious Diseases Department, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
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Jacobs
D000698:Analgesia / Q000379:methods; D016292:Procedural Sedation / Q000379:methods; D003422:Critical Care / Q000379:methods*; D006282:Health Personnel; D019142:Hemorrhagic Fever, Ebola / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D017053:Infection Control / Q000379:methods; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D010356:Patient Isolation / Q000379:methods; D010357:Patient Isolators; D012121:Respiration, Artificial / Q000379:methods; D006113:United Kingdom
Anaesthesia; Ebola haemorrhagic fever; Ebola virus; critical care; multiple organ failure; viral haemorrhagic fever