Ebola VI - What It Means for Me

As a critical care fellow, I'm likely to be one of the physicians taking care of patients with suspected or proven Ebola. It's a fascinating and crazy process. One of our first training sessions involved learning to put on and take off our personal protective equipment. It's a real process; the guide has 38 steps for donning the equipment and 27 steps for doffing it (which, by the way, is now one of my favorite words). We wear helmets with built-in fans normally sported by orthopedic surgeons to ventilate our suits while we work. We have three pairs of gloves, three layers of footwear. Walking feels strange, and placing an IV is a challenge. With three layers of gloves, I can barely palpate veins. Our body is protected by an impermeable suit and impervious surgical gown. I spent half an hour in the get-up, practicing intubating mannequins, placing IVs, and manipulating equipment, and by the end, under all those layers, I had worked up a sweat.

The real danger is taking off the equipment because that's when things are contaminated. There is a strict protocol and order in which everything is done including when we step out of the patient's room to the antechamber and when we're allowed to leave the antechamber. Currently, the way things are set up, there will always be a health care practitioner in the room, one in the antechamber to help, and two outside the room as well as a safety officer overseeing compliance with all of this.

Even though the diagnosis and treatment of Ebola virus disease is not necessarily complicated, as we plan for this potential threat, I'm learning how even for a relatively straightforward disease, we will have to implement new and complex protocols for physicians and other health care workers.

Image of an air-transportable isolation module is in the public domain, from Wikipedia.