Epishuttle
[True or False] HART operatives conveying a patient inside the epishuttle must be wearing HCID PPE at all times.
False.
Name and define the two transmission types of a HCID.
Contact – spread by direct contact with an infected patient or infected liquids. tissues or other materials, OR by indirect contact with contaminated materials
Airborne – spread by respiratory droplets or aerosol transmission in addition to contact routes of transmission
Within the ambulance service, who can manage a confirmed low consequence infectious disease patient?
Able to be managed by a DCA crew with universal precautions and PPE (hand hygiene, gloves, plastic apron).
Within NBOC where are the primary locations (two) you would obtain your HCID PPE?
1 - garage racking by briefing room
2 - EPRR store for wellies
Please list three items that a patient would be prohibited from bringing with them into the epishuttle.
The letter(s) following each item indicates the general reason for prohibiting it, the coding is shown below.
• C - possibility of damaging the fabric of the chamber
• D - contamination of the environment
• E - explosion risk
• F - fire source (including static charges) or a combustible substance
• L - could be broken or damaged by pressure
• M - will possibly cause a mess
• P - affects ability of diver
LISTING (in alphabetical order):
• Adhesives (F)
• Aerosols (D, E, F)
• Aftershave (D, F)
• Alcohol (D, F, P)
• Batteries with unprotected leads (F)
• Chemical cleaners, eg; trichlorethylene, 'Freon', etc (D)
• Cigarettes, cigars, tobacco of all kinds (F, M)
• Cleansing powder (C, F, P)
• Clothing, bedding included blankets, sheets, pillows, mattresses, etc. (F)
• Drugs, non-prescribed (P)
• Electrical equipment including tape recorders, radios, etc (F)
• Explosives (F)
• Glass thermometers, including batteries containing mercury (C, D, P)
• Ink pens (M)
• Lighters, matches (F)
• Newspaper (F)
• Non-diving watches (L, M)
• Petroleum based lubricants, grease, fluids (F)
• Sugar and fine powders
Describe common symptoms associated with HCID
Headache, Fever, Fatigue, Diarrhoea, Vomiting
What is the closest hospital to NBOC for an airborne HCID? For a contact?
Airborne - Southmead (Adult) // John Radcliffe - Oxford (Paed)
Contact - Royal Free London HLIU (adult) // St. Marys Hospital in London (Paed)
Who is responsible for cleaning gross contamination from the ambulance interior following transfer of an HCID patient?
Attending clinicans still in their HCID PPE
You are conveying a patient in the epishuttle who needs to be on oxygen. What is the maximum amount, in L/min, that they can have via a nasal cannula or standard oxygen mask?
4 L/min
How many hazard groups are there, and which one do most HCIDs fall into?
- HCIDs are group 4
Who would the team leader speak with to receive specialist clinical advice?
NILO/TacAd who can contact that High Level Isolation Unit specialist or UKHSA
How many clinical waste bins are there in the sup
Four
What is the minimum number of DCAs required to undertake an epishuttle transfer. (not including other HART vehicles)
Two.
For the respective transmission types - list two HCIDs for each.
Contact
Junin Virus
Machupo Virus
Crimean Congo Haemorrhagic Fever
Ebola
Lassa Fever
Lujo Virus
Marburg Virus
Severe Fever with thrombocytopaenia syndrome
Airborne
Hantavirus
Avian influenza A (H7N9 and H5N1)
Middle East Respiratory Syndrome (MERS)
Nipah Virus
Yersinia Pestis (Plague)
Severe Acute Respiratory Syndrome (SARS)
When determining the risk possibility of a VHF, how many risk categories are there and what are they? [partial points possible]
Three.
VHF unlikely
Low possibility of VHF
High Possibility of VHF
How many people are needed to run the SUP, an what are their titles?
Three.
SUP Lead
SUPOp
Clinical Waste Lead
Who is responsible for dealing with decontamination of the epishuttle?
Epishuttle technician (Istvan)
Define an HCID [partial credit available per point named]
An acute infectious disease. that:
- has a high case-fatality rate
- may not have effective prophylaxis treatment
- often difficult to detect and recognise rapidly
- has the ability to spread in the community and within healthcare settings
- requires an enhanced individual, population and systemic response to ensure it is managed effectively
Using the ACPD VHF Risk Assessment (10.2024 version) and determine the patients VHF Risk and appropriate ambulance response + conveyance option.
32M contacted 111 with 5/7 history of fever, cough, and recently some bloody sputum and unexplained rectal bleeding.
He returned from Sierra Leone 3/7 ago after spending two weeks visiting unwell family in a rural community.
At Risk of VHF
HART to respond in full HCID PPE
NILO/TacAd to coordinate with UKHSA, HILU to determine receiving hospital.
List the required PPE to be worn for an HCID confirmed or suspected patient not in the epishuttle.
Wellies, Disposable Scrubs, Tyvek Suit, Inner Gloves, Outer Gauntlets, Heavy Apron, Scrub Cap, FFP3 mask, visor.