Skip to contents
In This Issue:
Fred Wang (at right) assists medical technicians Nicole Ciofolo and Eric Hubbard as they don PPE during an Ebola preparedness drill.
With dozens of years of combined clinical laboratory training and experience, Andy Onderdonk, PhD, Clinical Microbiology director, and Fred Wang, MD, medical director of the Clinical Virology Laboratory, know what it takes to develop a rigorous laboratory protocol and ensure that teams undergo the appropriate training to adhere to it--especially when the stakes are high.
Performing training exercises for several months now, Onderdonk, Wang and the Clinical Laboratories team have moved full-speed ahead with their Ebola preparedness efforts.
"The more you drill, the better you are at performing a task," said Onderdonk. "Fred and I have a lot of experience training and working with dangerous microorganisms. That experience has helped us become a resource for the rest of the hospital and health facilities around the country as they focus on Ebola preparedness."
Should a suspected Ebola patient present at BWH, the Clinical Laboratories would be responsible for the handling and testing of the patient's bodily fluids. Additionally, a sample of the specimen would be sent to the state lab to test for the presence of Ebola within six hours. The state lab would also send a sample of the specimen to the Centers for Disease Control and Prevention (CDC) for confirmation.
Because Ebola is transmitted through direct contact with blood or body fluids, as well as objects like syringes or needles that have been contaminated with the virus, Clinical Laboratories staff require extensive training while wearing personal protective equipment (PPE) in order to process specimens from a suspected Ebola patient.
The BWH Clinical Laboratories have gleaned lessons from Atlanta's Emory University Hospital, which has successfully treated four Ebola patients, to strengthen its protocol and training. Now, Onderdonk said other hospitals are seeking BWH's help for tips on preparedness since the lab is so far along.
Should BWH receive a suspected Ebola patient, testing would be conducted after consultation with the BWH Infectious Disease and Infection Control staff, as well as the Boston Public Health Commission epidemiologist on-call. Infectious Diseases and the Emergency Department attending physician would determine what clinical laboratory samples need to be drawn and work with the team and Central Transport staff to ensure safe retrieval and handling of specimens.
Four teams of two people from the Clinical Laboratories have been fully trained to operate the instruments and work with the materials that would be used when testing specimens. In addition, the teams have been taught how to properly don and doff PPE. Twenty people from the labs volunteered to work on the teams. As the teams train and participate in drills, they have learned from each other, said Linda Weiser, technical director of the Clinical Microbiology Laboratory.
"Each team plays an integral role in our hospital-wide response efforts, and we will continue to train as time goes on to keep our skills sharp," Weiser said.
Training has been ongoing in a satellite lab separate from BWH's main lab. If actual testing needed to be performed, the teams would work from this space instead of the main lab to avoid concerns about contamination and slowing down daily activities.
"We are ready to provide services if the need arises," Onderdonk said. "We certainly feel confident with where we are today."
As part of its hospital-wide preparedness efforts, BWH also held a drill in the Emergency Department (ED) and on Shapiro 8 earlier this week. This drill was an opportunity for participants from several departments, including the ED, Infection Control, MICU, Emergency Medicine, Security and others, to put the training, experience and understanding of the BWH Ebola Virus Disease Control Plan into practice. In real time, staff ran through what would need to happen in the event that a suspected Ebola patient arrived in the ED.
Nicole Ciofolo and Eric Hubbard don PPE.