Anesthetic implications of Ebola patient management
Citation: Missair A, Marino MJ, Vu CN, Gutierrez J, Missair A, Osman B, Gebhard RE. Anesthetic implications of Ebola patient management: a review of the literature and policies. Anesthesia & Analgesia. 2015 Sep 1;121(3):810-21.
Summary: A comprehensive literature review was undertaken to identify key areas of anesthetic care affected by this disease, particular relating to “high risk exposure” and “direct contact” for anesthetists. Twenty articles met search criteria relating to inpatient Ebola patient management or animal virology studies, and 9 more articles were published guidelines. Sources used include controlled animal experiments and tuberculosis patient research.
The use of personal protective equipment (PPE) and differences in published guidance are covered, and the importance of protocols for removing PPE stressed. The use and decontamination of surfaces, ventilators and portable equipment are covered, including a suggestion that peripheral nerve block techniques may be beneficial rather than general anaesthetics. Risks posed by undiagnosed Ebola Virus Disease (EVD) patients to hospital staff, needle risks, aerosol-generating procedures, and the challenges of patient transport and transfer, together with the danger of intraoperative death, lead the authors to suggest that potential surgery in patients with EVD may not be warranted, and also to state that anesthesia personnel worldwide need to be educated, trained and prepared for such encounters.
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