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Air Quality Monitoring During High-Level Biocontainment Ground Transport: Observations From Two Operational Exercises

Published online by Cambridge University Press:  28 June 2021

Audrey Dang ,
Brent Williams ,
William D. Warsing ,
Michael Noone Open the ORCID record for Michael Noone [Opens in a new window] ,
Alexander P. Isakov ,
David K. Tan  and
Stephen Y. Liang Open the ORCID record for Stephen Y. Liang [Opens in a new window]
Audrey Dang
Affiliation:
Center for Aerosol Science and Engineering, Department of Energy, Environmental, and Chemical Engineering, Washington University in St. Louis, MO, USA
Brent Williams
Affiliation:
Center for Aerosol Science and Engineering, Department of Energy, Environmental, and Chemical Engineering, Washington University in St. Louis, MO, USA
William D. Warsing
Affiliation:
Abbott Emergency Medical Services, American Medical Response, St. Louis, MO, USA
Michael Noone
Affiliation:
Los Angeles County Emergency Medical Services, Los Angeles, CA, USA
Alexander P. Isakov
Affiliation:
Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
David K. Tan
Affiliation:
Abbott Emergency Medical Services, American Medical Response, St. Louis, MO, USA Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
Stephen Y. Liang*
Affiliation:
Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
*
Corresponding author: Stephen Y. Liang, Email: syliang@wustl.edu.
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Abstract

Objective:

Stretcher transport isolators provide mobile, high-level biocontainment outside the hospital for patients with highly infectious diseases, such as Ebola virus disease. Air quality within this confined space may pose human health risks.

Methods:

Ambient air temperature, relative humidity, and CO2 concentration were monitored within an isolator during 2 operational exercises with healthy volunteers, including a ground transport exercise of approximately 257 miles. In addition, failure of the blower unit providing ambient air to the isolator was simulated. A simple compartmental model was developed to predict CO2 and H2O concentrations within the isolator.

Results:

In both exercises, CO2 and H2O concentrations were elevated inside the isolator, reaching steady-state values of 4434 ± 1013 ppm CO2 and 22 ± 2 mbar H2O in the first exercise and 3038 ± 269 ppm CO2 and 20 ± 1 mbar H2O in the second exercise. When blower failure was simulated, CO2 concentration exceeded 10 000 ppm within 8 minutes. A simple compartmental model predicted CO2 and H2O concentrations by accounting for human emissions and blower air exchange.

Conclusions:

Attention to air quality within stretcher transport isolators (including adequate ventilation to prevent accumulation of CO2 and other bioeffluents) is needed to optimize patient safety.

Keywords

air qualitybiocontainmentEbola virus diseaseemergency medical servicestransport isolator
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 16 , Issue 4 , August 2022 , pp. 1482 - 1489
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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