When the Ebola virus emerged in the United States in 2014, two of the four confirmed cases were nurses at a Dallas hospital who treated the first patient: Thomas Eric Duncan, who had contracted the virus in Liberia and later died.
Those cases underscored how quick and effective response to a number of emerging diseases means protecting caregivers from first responders to hospital staff from dangerous pathogens.
This month at its training facilities in Anniston, Ala., FEMA’s Center for Domestic Preparedness brought two dozen emergency response and healthcare professionals together for a four-day course on barrier precautions and controls to protect staff from highly infectious diseases. In addition to instruction on best practices from patient intake to final outcomes, students watched demonstrations and practiced putting on protective equipment. Exercises simulated receiving infected patients in an emergency room and treating them in an isolation ward.
CDP’s Noble Training Facility includes 12 intensive care patient rooms, a fully automated nurse’s station, multiple supply and storage rooms, and a waiting room, in addition to classrooms and training rooms.
Charles Reneau, a Leidos contractor overseeing the nation’s only emergency preparedness training hospital as training facility manager, told HSToday after the most recent class that students were challenged by practicing protective measures in the treatment of an obese patient, a patient with dementia and a pregnant woman. Two ambulance simulators helped students understand necessary precautions in transporting patients with highly infectious diseases, including hemorrhagic fevers.
The training incorporates “all of the different healthcare sectors — clinical providers, paramedics doing the transportation,” Reneau said. CDP’s nationwide reach is critical because this is the “type of training that a local jurisdiction would not be able to do on their own due to either budgetary constraints or skills.”
Pointing to a “greater need within the EMS community and the hospital community” for such training, he stressed that challenges to barrier protection protocols at some facilities include staffing and equipment needs and issues such as how hospitals discard contaminated waste or handle persons who have died from an infectious disease in the mortuary.
“It will become more important as more diseases emerge globally,” Reneau said.
Kent Latimer, FEMA’s chief of the CDP Training Management Branch, told HSToday that demand for courses is high and students arrive “very keen on learning.” The barrier precautions program was expanded from three days to four to incorporate training for pre-hospital encounters with highly infectious patients.
And what the Dallas nurses suffered in 2014 is helping protect medical professionals in the event of future encounters with potentially deadly pathogens.
“We developed some training in response to Ebola,” Latimer said. “This course was born out of what we learned with that.”
This week, China confirmed two cases of the pneumonic plague, which can be transmitted person-to-person via airborne droplets, and put police guard on the quarantined Beijing emergency room where the couple from Inner Mongolia first sought treatment.
Latimer noted that these types of reports will continue to emerge, and the emergency community wants to be ready. “Hospitals are more interested in finding ways to protect patients and staff from these diseases,” he said.
The CDP trains about 50,000 emergency responders each year. In October, CDP overall conducted 45 courses for 1,559 students in Anniston as well as 201 courses for 3,315 students at other sites across the United States and territories. CDP also offered four online classes to train 1,264 students. Courses included healthcare leadership and emergency response training for mass casualty incidents, bombing prevention awareness, field operations training in preparation for the 2020 political conventions, and honing emergency response to chemical, biological, radiological, nuclear, and explosive incidents.
In 2020, CDP will be offering six opportunities to take the Barrier Precautions and Controls for Highly Infectious Disease course.
CDP’s goal is to train first responders and healthcare professionals with a complementary slate of courses that help jurisdictions handle incidents in a manner that protects caregivers while providing the best care to patients. The healthcare leadership course, for instance, covers utilizing a control center to manage incidents and media relations to ensure the public is properly informed.
“You can just imagine the chaos that would happen in a small community if they found they had a life-threatening disease that could threaten the whole community,” Reneau said.
“We teach them how to manage resources because mass casualty incidents gobble up resources quickly,” Latimer said, adding that the goal is taking “fewer and fewer resources to achieve same results.”