On that date, the positivity to Ebola's disease of a Sister of the Order of San Juan is confirmed, this time in Freetown, that's why the government president called the Air Force 20
In this case, the aircraft is of the paletizable type, i.e. regardless of its baseline configuration, it is possible to insert them, through a wire rod, the attachments directly to health configuration can be installed.
The load, therefore, is much simpler and faster than in the case of Airbus A-310, in this case the aircraft adapts to the care needs, and the interior is wider to perform the care work.
On the other hand, Hercules C-130 are slower than cold, darker and noisy.
At 22h, when the aircraft landing from its base had the equipment on top, the team that prepared it was the health staff activated for the flight and the staff on the ground that the Unit alerted.
Once placed on the aircraft, the members of the care team, together with the flight crew components of Ala 31, ended up carrying out the task in approximately 2 hours.
The three zones were once again set out in the aforementioned mission:
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- The clean area, which was also the anteriormost of the aircraft and therefore the most affected area of the patient.
- the intermediate zone situated in the centre of the intermediary zone where all the material needed for the laying and removal of the PPE line was found and separated by plastics in the form of a double curtain as follows:
- the Swiss or Assistant Zone, which was the posterior zone, the most common type of insurance affecting the isolation camera and all the equipment.
Due to the characteristics of the aircraft, this provision made the indoor temperature during the flight, particularly at the glue post, to be very cold for health personnel and especially for the patient.
However, all this could be resolved with the will to carry out the mission and training of all designated personnel.
The team was formed by the Cte.
Doctor D. Ignacio Martinez, Cap.
© 2012 Sociedad Colombiana de Anestesiología y Reanimación.
Cristina González, la Cabo 1o Technician specialist Da.
Verónica Manzaneda and the Soldado Técnico specialist D. Jesús Mora, reinforced by the Tcol.
D. Justino Rodríguez Velayos (Intensivista) was sent as a reinforcement of care from the Central Hospital of Defense.
As in the previous case, the exit took place while waiting for confirmation of international permits and surfings, deviating from zero at 07:15 o'clock in direct flight without climbing down to Sierra Leown.
Upon landing, it was confirmed that the patient was going to be admitted to the airport from his place of hospitalization.
It was only possible to wait, a situation that lasted 4 hours, during which protocols were reviewed, equipment, fixation systems were checked...waited, trying to pass this time controlling the tension that sees.
The patient arrived in an ambulance with two members of the hospital where he was admitted, he was lying on his back, alone.
Everybody came with the IPE dress.
Once at the airport and after changing the image about the mode of performing the IPE camera, they found the IPE sealant afterward, where the members of the UMAER were already equipped.
When approaching the patient, it was found that the peripheral vascular access that he carried was outside the vein, flowing blood and leaving the chamber in both the cabin of the ambulance and the entire path until reaching the bedside.
For this reason, while the medical care team undertook the monitoring and placement protocols, the staff who had indicated that they were not aware of the affected areas.
The transfer of the patient was carried out by a Spanish physician who performed the specialty of infectious diseases in Sierra Leone, to whom we must thank her for her magnificent collaboration and availability to help us and I'm not sure anymore.
The accommodation protocol within the camera, monitoring, closure of the camera and transfer to the interior of the aircraft was the same as that performed in the previous mission, but with the lessons learned and counting on several advantages:
- It was daylight, taking advantage of daylight, which greatly facilitated movements.
- Although the airport installation did not put at our disposal any facility, so the transfer was also at the foot of the aircraft, this time it was next to the posterior aircraft, protected by the tail-action solitude.
- Two care teams were set up, which directly cared for the patient, consisting of a physician, nurse and technician, considered to be a dirty team and one of the same composition, whose task was to monitor the healthcare team on one hand.
- All waste generated was collected in specific containers and left on land under the custody of the hospital equipment.
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Once the entire protocol was completed, consisting of monitoring constants, placing a new peripheral vascular access, probing and placing the devices inside the equipment, no patient needed to have a very important catheterization period, and the external operating room needed to remember that there was no
After the necessary time and with the permission of both the commander and the aircraft surcharge, the camera was ascended and located in the area empowered to do so.
At 19:30 h, the patient was discharged and the return flight was started. The treatment applied was based on hydrating the patient with serum therapy, performing a sedation that allowed the team to watch the patient for constant movements of the team.
Carlos without counter-times entered the Air Base of Torrejón, at 03:15 hours from Monday 22 September performing the transfer to the SAMUR hospital that was waiting for the patient by SAMUR.
The mission had never ceased to exist, it was necessary to spend 21 days of home control, after which we could definitely say that the mission had gone.
Waste management
Waste management was carried out in a significantly different way between the first and second evaluation.
In the second evacuation, precise changes were applied, after analyzing the lessons learned from the first evacuation.
For waste management, the existing indications in the literature were followed1-5.
During the first evacuation, waste generated by monitoring maneuvers and clinical care of patients was not left at the airport, because local authorities forced them to withdraw to grant permission to dispose of material.
The "double bag" procedure was followed, resulting in greater storage six packages of "double bag 4/full-trolley" bags provided by the Iberia airline as part of the pouch.
The bags were filled in 80% of their capacity and closed with flanges, after which they were placed in the "Swedish area" of the aircraft, secured, to prevent them from spreading.
Among the wastes, apart from those that were in direct contact with patients, we also included the clothes worn, gloves and everything that was used during the flight that, despite being used outside the biochamber, was also included.
Upon landing in Madrid, the waste was placed outside the plane in an isolated and signaled area, which also maintained permanent surveillance to prevent nobody from coming closer to them.
Residues placed in the bags were placed in rigid container with a paste of 60, which were filled up to 80% of their capacity without crushing the content.
They were then closed and made available to the company responsible for their administration.
In one of the rigid black containers, a 4-degree yellow polypropylene container was available, where biominated material was found.
This container is placed in a pouch and then in a rigid container with 60, and was considered the "first container".
This task was carried out by two people from the UMAER who were protected with EPI type 3B clothes. In addition, during this task, the medical staff of the Torregiosa Air Base revised bibliography indicated that they were infected.
In conclusion, during the first evacuation a total of 17 containers were used, which were marked with labels with UN code 3291 biomedical waste.
In the second evacuation, during the initial patient care, local staff from the NGO Medicals without Borders participated.
Many of the waste generated in the initial care of the patient was left in Freet; they were arranged in rigid containers of 60 waste capacity and it was the local of that NGO according to their management protocol.
The cube with sodium hypochlorite solution was also left in Freetown, which was used for hand washing and footwear by the healthcare staff.
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During the flight, the generated waste was placed in red bags using the double bag procedure.
Once used, these bags were closed with bridles and introduced in rigid containers of 60 markings with labels with UN code 3291 of biomedical waste.
Again, a single black container was used to insert the yellow container of polypropylene 4 units where the biominated puncture material was placed.
It was also considered as "first container".
Containers were placed in the "Sweden Area" of the aircraft and secured to the aircraft with a mail system with aeronautical certification.
Once the aircraft arrived in Madrid, containers with the waste material remained inside the aircraft during the disinfection period.
When it was concluded, the containers were placed in an isolated and monitored area of the air platform, where the company responsible for waste management took over.
In this second aero-evaluation, a total of 13 containers were used.
Plastic materials used to cover both aircraft were considered biominated material.
Once the patient is charged in Madrid, plastics remained inside the unit during the process of decontamination, which introduced rigid waste EPI type was converted into a personal waste disposal unit B, after which the patient was placed in the vehicle.
For decontamination of the aircraft, a spraying of the inside of the aircraft was performed with Rely+On Virkon® 1% solution, after which a 10 ml NDP Total Boot was opened.
