Tripler exercises comprehensive emergency response for emerging respiratory pathogen

By Natalie KintzJanuary 30, 2020

Tripler exercises emergency response for emerging respiratory pathogen
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Tripler exercises emergency response for emerging respiratory pathogen
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HONOLULU- Tripler Army Medical Center's highly infectious disease of significance team held an exercise last week at Tripler to test communication and utilization of personal protective equipment for respiratory pathogens such as the Middle East Respiratory Syndrome coronavirus.

"It was an opportunity for us to implement a rapid triage, starting at the entry point where the patient comes in, to the time the person is actually discharged from the hospital," said Iwalani Sato, Hawaii Military Health System's medical disaster planning working group liaison.

The highly infectious disease of significance, HIDoS, drill prepares the facility and all essential communications for a medical surge or possible pandemic according to Sato. The drill was executed positively because the operations plan created by Kevin Guerrero, TAMC's Provost Marshal, and unites the public health executive officer and emergency management personnel to expedite actions and decisions on the ground level. Other central activation members involved were the Hawaii MHS, and Tripler's intensive care unit, emergency department, lab, infection control, Provost Marshal Office, and preventative medicine, as well as Hawaii's Department of Health.

"What makes this drill so incredibly relevant is that we had this scenario where the patient was a Middle East Respiratory Syndrome, MERS, patient which is a coronavirus," said Mary Ono, Assistant PHEO and Army family physician.

According to the Centers for Disease Control and Prevention, MERS-CoV is a respiratory virus with an unidentified source that is currently being investigated. The virus spreads from person-to-person, similarly to MERS that arose in 2012

"We were validating the quick identification and isolation of a HIDoS patient and the proper donning and doffing of the personal protective equipment throughout the staff," said Ono.

"Even the receptionist was aware that this patient was quite ill and coughing with fever and immediately gave them a mask, which is the appropriate thing to do. The charge nurse put the patient in a negative pressure room, which is exactly what we would like to see," said Ono.

Army Capt. Joshua Callaway, the emergency department's charge nurse coordinated the communication and directed the appropriate staff to where they needed to be according to Army Capt. Aaron Matthews, emergency department clinical nurse specialist, .

"It was a good test of communication and the response from the system," said Matthews.

During the exercise, the patient was moved from the emergency department to the intensive care unit. "The ICU was fantastic receiving the patient. Everyone donning and doffing appropriately," said Ono.

"The exercise was a success," said Ono. "Both units, despite all the equipment in-between, they were very calm and reassuring to the patient that it was going to be OK and they were going to take good care of them and that was nice to watch."

Recommendations from the CDC to minimize risk of infection are suggested for those traveling to practice safe hand hygiene and stay away from sick individuals.