FICM Statement: Ebola Clinical Management & Guidance

The Faculty of Intensive Care Medicine refers its members to the Ebola guidance given on the Department of Health website. It is anticipated that all cases will be transferred to a high level isolation unit (Royal Free Hospital or Newcastle).  Isolation units have also been set up in Sheffield and Liverpool.  

The FICM recommends that critical care admission should be considered only where isolation facilities can be provided.  Currently this means that referral and transfer to a high level isolation unit should precede the decision to offer critical care support (see the Public Health England guidance, linked).

Ebola is primarily a disease causing gastrointestinal disturbance and haemorrhagic fever, with associated problems of fluid balance.  It is not a primary respiratory condition, and the clinical need for respiratory support is thought to be very rare except in those patients in extremis.

The risk-benefit ratio of artificial ventilation and the associated creation of aerosols, which could pose a significant risk to other patients, relations, staff and thereby of dissemination of the condition to the wider public, should be carefully balanced against the assumed benefit to the individual, on a case-by-case basis."

https://www.gov.uk/government/collections/ebola-virus-disease-clinical-management-and-guidance

We have made some amendments to this statement (20/10/14) following advice and would be happy to modify the statement accordingly if we are contacted with suggestions.  It should be noted the intention of this news item is to provide a short statement which will in turn link ICM clinicians to other more detailed resources, for example that of Public Health England.  Email: ficm@rcoa.ac.uk

 

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