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Madigan doctors use vomiting, high-stress simulators for Ebola training

The first lesson in caring for an Ebola-infected patient: It’s hard to hear your fellow medical workers speak when you’re wearing full-body protective gear.

That point became clear to a group of Madigan Army Medical Center doctors and nurses who spent Thursday running through simulations of how they’d care for an Ebola patient at the hospital south of Tacoma.

They found they had to shout to say anything to their patient, or to each other.

“We have three pairs of gloves on. The hood has a motor in it, so I can’t hear much of anything. I can barely hear myself talk,” said Capt. Stacey Good, a Madigan doctor. “Communication on the team is extremely important.”

Good and about 50 others are preparing to be Madigan’s go-to team if an Ebola patient appears at the hospital. They’re following an Army directive to get ready for the virus that coincides with the military’s buildup of its Ebola-response headquarters in Liberia.

Up to 4,000 U.S. military service members could be sent there in the next months, mostly from the 101st Airborne Division at Fort Campbell, Kentucky. They’re deploying to help build facilities that can treat patients infected with a virus that has claimed more than 4,800 lives in West Africa.

So far, Madigan is setting aside two beds in its intensive care unit for potential Ebola patients, said Madigan Chief Medical Officer Col. Steve Yoest.

Hospital leaders say they think they’re most likely to encounter someone with Ebola if a military service member or family member travels to West Africa for personal reasons and comes home with the virus.

“I’m very confident that we are prepared,” Yoest said.

Civilian hospitals in Pierce County had Ebola-training sessions for staffers last month after two nurses who treated an Ebola patient became infected with the virus in Dallas. They were eye-opening events for medical staff who once thought of Ebola as a virus contained to a faraway continent.

Madigan’s sessions added an extra layer of stress by incorporating high-tech dummies that can simulate Ebola symptoms, such as vomiting. They’re controlled by staffers who can speak to doctors through a voice box in the dummy.

“Am I going to die?” the simulated patient asked Good during a training session. “Please tell me I’m not going to die.”

The patient’s heart rate increased and he began to vomit. Madigan staffers had to figure out how to clear his mouth and throat while wearing awkward protective gear.

At the end of the drill, the dummy’s simulated vomit left traces all over the medical staff members; it could be seen under a black light, revealing that the seemingly clean staffers were actually covered with the patient’s fluids. Ebola is transmitted through contact with bodily fluids.

“It’s the stuff we can’t see that’s really the danger,” said Lt. Col. Mohamad Haque, director of the Andersen Simulation Center at Madigan.

Joint Base Lewis-McChord’s role in the military’s Ebola-response efforts is mostly handled by airmen in the 62nd and 446th Airlift Wings who are flying missions to deliver supplies and troops to Liberia and Senegal. They spend little time on the ground, so are unlikely to encounter the disease.

A doctor and a nurse from Madigan, meanwhile, are joining a medical unit on its way to Liberia. They’ll be quarantined for 21 days when they return home, in accordance with a Pentagon order.

At Madigan, the simulated Ebola drills eased some concerns among medical staffers.

“It gives you the confidence to be able to say, ‘If we get one of these patients, I’ve done something similar. I know what to do to take care of them,’ ” Good said.

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