Annals of Emergency Medicine
Volume 51, Issue 4 , Pages 420-425.e5 , April 2008

Initial Test of Emergency Procedure Performance in Temporary Negative Pressure Isolation by Using Simulation Technologies

Presented at the Temporary Negative Pressure Isolation Leadership Meeting, August 2005, Arlington, VA.

  • Mark A. Davis, MD, MS

      Affiliations

    • Institute for International Emergency Medicine and Health, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
    • Corresponding Author InformationAddress for reprints: Mark A. Davis, MD, MS, Institute for International Emergency Medicine and Health Department of Emergency Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115.
  • ,
  • Roxanne Landesman, MS

      Affiliations

    • Institute for International Emergency Medicine and Health, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
  • ,
  • Boaz Tadmor, MD

      Affiliations

    • Cerberus, Inc.A
  • ,
  • Michael Hopmeier, MSME

      Affiliations

    • Cerberus, Inc.A
    • Unconventional Concepts, Inc.
  • ,
  • Gili Shenhar, MBA

      Affiliations

    • Cerberus, Inc.A
  • ,
  • Tobias Barker, MD

      Affiliations

    • STRATUS Center for Medical Simulation, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
  • ,
  • Charles N. Pozner, MD

      Affiliations

    • STRATUS Center for Medical Simulation, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
  • ,
  • Emily S. Binstadt, MD

      Affiliations

    • STRATUS Center for Medical Simulation, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
  • ,
  • Stephen Nelson, CCEMTP

      Affiliations

    • STRATUS Center for Medical Simulation, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
  • ,
  • Rodney Look, MD

      Affiliations

    • Emergency Medicine Residency Training Program, Brigham and Women’s Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Maria Shubina, ScD

      Affiliations

    • Brigham and Women’s Hospital Center for Clinical Investigation, Boston, MA.
  • ,
  • Ron M. Walls, MD

      Affiliations

    • Institute for International Emergency Medicine and Health, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
    • STRATUS Center for Medical Simulation, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
    • Emergency Medicine Residency Training Program, Brigham and Women’s Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA

Received 31 August 2006 ,Revised 5 April 2007 ,Accepted 18 April 2007.

References 

  1. Kellerman A. Still not ready in the ER. Washington Post. 2005;A15;August 5
  2. Chow CB. Post-SARS infection control in the hospital and clinic. Paediatr Resp Rev. 2004;5:289–295
  3. Schull MJ, Mamdani MM, Fang J. Community influenza outbreaks and emergency department ambulance diversion. Ann Emerg Med. 2004;44:61–67
  4. Heinrich J. Infectious disease outbreaks: bioterrorism preparedness efforts have improved public health response capacity, but gaps remain. Testimony before the Committee on Government Reform, House of Representatives, United States General Accounting Office, 2003.
  5. Marier RL, Nelson T. A ventilation-filtration unit for respiratory isolation. Infect Control Hosp Epidemiol. 1993;14:700–705
  6. Rosenbaum RA, Benyo JS, O’Connor RE, et al. Use of a portable forced air system to convert existing hospital space into a mass casualty isolation area. Ann Emerg Med. 2004;44:628–634
  7. Mead K, Johnson DL. An evaluation of portable high-efficiency particulate air filtration for expedient patient isolation in epidemic and emergency response. Ann Emerg Med. 2004;44:635–645
  8. Garner JS Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals [Centers for Disease Control and Prevention Web site]. Infect Control Hosp Epidemiol. 1996;17:53–80http://www.cdc.gov/ncidod/hip/ISOLAT/isopart2.htmAm J Infect Control. 1996;24:24-52, Accessed June 4, 2006
  9. Sprunt K, Redmon W, Leidy G. Antibacterial effectiveness of routine handwashing. Pediatrics. 1973;52:264–271
  10. Steere AC, Mallison GF. Handwashing practices for the prevention of nosocomial infections. Ann Intern Med. 1975;83:683–690
  11. Lowbury EJL, Lilly HA, Bull JP. Disinfection of hands: removal of transient organisms. BMJ. 1964;2:230–233
  12. US Food and Drug Administration. The tentative final monograph for over-the-counter topical antimicrobial products. Fed Reg. 1978;43:1210–1249
  13. Garner JS, Favero MS. Guideline for Handwashing and Hospital Environmental Control. Atlanta, GA: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention; 1985;
  14. Larson E. APIC guideline for use of topical antimicrobial products. Am J Infect Control. 1988;16:253–266
  15. Ehrenkranz NJ. Bland soap handwash or hand antisepsis? (the pressing need for clarity). Infect Control Hosp Epidemiol. 1992;13:299–301
  16. Larson E. Skin cleansing. In:  Wenzel RP editors. Prevention and Control of Nosocomial Infections. 2nd ed.. Baltimore, MD: Williams & Wilkins; 1993;p. 450–459
  17. Larson EL 1992, 1993, and 1994 Association for Professionals in Infection Control and Epidemiology Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control. 1995;23:251–269

 Supervising editor: Gregory J. Moran, MD

 Author contributions: MAD was the principal coordinator and the individual with overall responsible for study design, implementation, and article preparation. R Landesman organized the progress of the study within the simulation laboratory and was the primary person responsible for data collection for statistical review. BT, MH, and GS provided expertise in bioagent threats, protocols for bioisolation implementation, and technical support in tent construction and modification. TB, CMP, ESB, SN, and RL Look participated in the design and execution of simulation laboratory-based critical care scenarios. They also assisted with article preparation. MS was responsible for statistical analysis and article review. RMW participated in simulation design, experiment implementation, and article preparation and review. MD takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This study was partially funded by Unconventional Concepts, Inc. and Collective Protection Engineering companies, with technical assistance from Cerberus, Inc. Cerberus, Inc. is now dissolved, and its former members serve as strategic consultants in emergency and disaster response planning.

 Publication dates: Available online August 24, 2007.

PII: S0196-0644(07)00544-6

doi: 10.1016/j.annemergmed.2007.04.017

Annals of Emergency Medicine
Volume 51, Issue 4 , Pages 420-425.e5 , April 2008