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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
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.

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.

Type
Original Research
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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