A few people have been asking about what actually happens on
the unit, so in an attempt to describe it, here’s a condensed guide to what you
might expect, if you came into our unit.
In Connaught, KSLP run an isolation unit, as opposed to a
Ebola treatment unit (ETU). This is essentially a screening and testing point
for Ebola. Anyone that comes through the doors of the hospital passes a guy
with a screening sheet and temperature gun. If you score enough symptoms you
get put in a tent outside, if you are a contact or from a “hot spot” you’re
streamed with a much higher index of suspicion. In general however, suspicion
is high as at the moment things are concentrated on finding every single last
case…
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| You get screened on the left and then wait in the tent on the right |
If you’ve screened positive you’re now in the tent and one
of us will then come out in “half PPE”
(personal protective equipment) – face mask, visor, apron, gloves – to take a
bit more of history, to help streamline treatment inside. No touching at this
stage. You’re then admitted to the isolation unit. This is when you’d meet
their first space man, “full PPE”.
From the top down this is… mask +visor, full body suit, inside gloves, forearm
length gloves, outside gloves and apron. We’d take you inside and if you’re
vomiting or have diarrhoea place you in the “Wet” area. If not you’d go to the
“Dry” area. We have started putting drips in people, so if you are unwell or
can’t hold anything down then one of our Ebola Survivors (or sometimes one of
the rest of us) would put a drip in you. At this point, you’d get the same
treatment as every other admission – a buttock injection (intramuscular) of
Ceftriaxone (antibiotic), an antimalarial, a 1.5 L bottle of rehydration
solution and some paracetamol. We can give a few other things; anti-sickness,
heartburn medication and sometimes if people are very confused and potentially
a danger to themselves of others, some calming medication. This is a really
trick one but you can imagine that its is more of a risk than in a normal ward,
as you or anyone you touch may have Ebola, so we try to keep things calm and
separate if we can.
As you’re being taken into the unit, we try and explain a
few things. Firstly, try not to be scared by all the suits and by all the other
people in the unit, some of whom may be quite unwell. The suits are just for
our protection. We will keep you separated from other patients and won’t be
re-using any of the same equipment. Once you are in, we’ll give you some
medication (as listed above), try to drink as much as possible. If you want to
use the toilet, there are two small buckets next to your bed, sorry that its
not so private but I’m sure you can appreciate, we can’t have everyone using
the same toilet. We will bring you breakfast, lunch and dinner. Your family can
bring you food as well, but any containers they bring will have to be thrown
away. On that note, all your clothes will also be thrown away at the end, we’ll
give you some new ones to go home with. We can decontaminate your money,
jewelry and phone. Someone will be coming in to take a blood test shortly. If
it comes back positive, we will treat you for Ebola and you will be sent to one
of our Ebola Treatment Centres where all the other positive patients go (ETU),
if not you will be discharged either home if you’re better or into the hospital
if not. Unfortunately if you’re symptoms have been around for less than 48 hrs,
we’ll need to keep you to repeat your test, as early test may be negative.
Finally, I’m really sorry but if none of us are here inside the unit we will
need to lock the doors to your rooms. Just to warn you, the main door is quite stiff so makes a bang when we close it. We’ve had some people try to escape and I’m afraid this
is potentially very dangerous for the hospital and the local area. Its a really difficult time
for the whole country so please bear with us for this. If you really need
something, people will be passing through frequently during the day, or
otherwise please shout loudly.
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| Door to "Orange zone" for dressing and then "Red zone" |
After this initial interaction we’ll largely leave you be,
unless you are unwell when we can do whatever we are able to do, although we
are slightly limited – we can’t take blood tests, or test your blood sugars, a
this is too much of an infection risk. We will also come and change you if are
incontinent. We’ll bring you medications (a daily bum injection of antibiotic,
anti-malarials and some paracetamol), food and change your toilet buckets. All
of this until you finally get the good news: Your test is negative! We (still
in our space suits) take you to our shower room, and you have a final shower
before being given new clothes and being picked up by another of the staff at
the clean entrance. As a negative patient you get your “Negative” certificate and 10,000 (1.50) for transport home.
There is lots of stuff that goes on behind the scenes,
obviously we CANNOT run out of chlorine, water or PPE, and there is a team of
people dedicated to this and other logistics. On a busy 6 hr shift each person
uses approximately 40 pairs of gloves and washes their hands at least 50 times
per day; the decontamination process alone includes washing your hands 10
times.
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| Ebola isolation units, not a place for people with OCD |
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