In flight against Ebola
On November 24, 2014 the news spread that Fabrizio Pulvirenti, an Italian doctor of Emergency who works in Sierra Leone, is infected with the Ebola virus. The fear that a threat, hitherto distant, could also arrive in Italy begins to spread. During the night, the Italian doctor is repatriated from Sierra Leone with an Air Force aircraft specially set up for aero-medical medical transport in biocontainment. After 32 hours of mission he is transferred to the Spallanzani hospital in Rome, where the Italian doctor can be treated and saved.
Biocontent air transport falls within the broader sphere of urgent medical transport and is the ability to transport highly infectious patients, with physical containment of bacteria or viruses, in order to avoid accidental infections and the consequent infection in the surrounding community.
In emergency medical transport, the Air Force is at the service of the community, 24 hours on 24, the possibility of transferring a life-threatening patient or a medical team in a very short time, with only two hours' notice. It is a service provided in coordination with the Presidency of the Council of Ministers, the Bodies of the National Health System and the Prefectures. The research and rescue activity also falls within the emergency medical transport, tragically leaping to the news with the fire at the Norman Atlantic ferry of 28 December 2014. There are thousands of flight hours and missions carried out each year by the Air Force for this kind of activity; in the 2014 the flight hours were over 977,30 and more than 673 the sorties in the field of emergency medical transport.
The increase in intercontinental travelers who may be exposed to contagious diseases endemic in certain geographical areas, the emergence or recurrence of highly transmissible infectious diseases and the use of military contingents in areas of health risk, has determined the need to have a safe aero-medical evacuation system that can guarantee the maximum safety of the patient, crew members and health personnel. The Air Force has developed this capability from the 2005, acquiring specific systems of British production. Physicians and nurses of the Armed Forces were sent to the Institute of Infectious Diseases of the US Army for specific training, followed by numerous exercises and the certification of transport aircraft.
The AM Bio-containment team
The bio-containment unit was activated at the airport of Pratica di Mare (Pomezia). The team that ensures a medical evacuation in bio-containment consists of a Team Leader - the doctor in charge - an anesthesiologist, at least six health technicians and a logistics unit. The staff of these units, to the extent of approximately 30 elements, is periodically trained and trained through courses and exercises in which they participate, given the value and specificity of these activities, including operators of the Ministry of Health. The reference hospitals on the national territory with high specialist expertise are the Research and Treatment Institute for Infectious Diseases Lazzaro Spallanzani of Rome and the Luigi Sacco Hospital of Milan. The choice of hospitalization and destination of the patient is the responsibility of the Ministry of Health. Biocontamination transport involves the isolation of the infectious patient in specific negative pressure "isolators" and the transport on specially prepared airplanes. The following are the equipment that can be used for air transport in bio-containment.
The insulators in the broad sense consist of a frame (rigid or semi-rigid), a PVC casing that allows the observation and treatment of the patient in isolation, from a battery-powered motor that allows to maintain a negative pressure inside and high-efficiency filters that prevent the entry of potentially infected microparticles into and out of the unit.
The isolators for aero-medical transport in bio-containment, called ATI and N36, are certified for the military aircraft C-30J, C-27J and KC-767 and the certification process for the AIRBUS A-319 CJ is in progress. N36 isolators are certified for military helicopters AB-212 and AW-139. At the moment it is technically possible to carry out long-range transport of two patients on the same aircraft with ATI systems, but this is a remote event, due to the complexity of the system and the availability of specialized personnel.
Since November, a temporary isolation camp has been activated at the Pratica di Mare airport for the management of soldiers from Ebola risk areas. The field defined as "Castrum" consists of a high-insulation tent, housing for health surveillance contacts up to 200 people and a decontamination station for men and materials. The 18 and the 19 December 2014, the first course for doctors and health workers of the National Health Service who are called to carry out short-distance transport of patients was held at the Main Infirmary of the Italian Air Force of Villafranca (Verona). high infectious risk (ebola or other diffusible diseases). In the first months of the 2015 the first course for the management and transport of highly infectious patients was held in favor of a foreign delegation, the Royal Netherlands Air Force, which expressed its intention to acquire the skills and abilities necessary to manage transport situations in high bio-containment.
Before the case of the Italian doctor of Emergency suffering from Ebola, the aero-medical transport system in bio-containment was used in at least 10 operational missions to transport highly contagious patients, all in a national context. Among these, the first case of a patient suffering from contagious cavitary tuberculosis resistant to any drug treatment dates back to January 2006. Subsequently other patients were transported, some suffering from the same type of tuberculosis, a patient suffering from suspected case of hemorrhagic fever of Congo-Crimea, a case of Dengue fever, up to the last suspected case of Monkeypox in June 2014.
Source: Aeronautica Militare