{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T10:20:53Z","timestamp":1780395653795,"version":"3.54.1"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X20014166_as1\"><jats:title>Objective:<\/jats:title><jats:p>In response to the 2013\u20132016 Ebola virus disease outbreak, the US government designated certain healthcare institutions as Ebola treatment centers (ETCs) to better prepare for future emerging infectious disease outbreaks. This study investigated ETC experiences and critical care policies for patients with viral hemorrhagic fever (VHF).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20014166_as2\"><jats:title>Design:<\/jats:title><jats:p>A 58-item questionnaire elicited information on policies for 9 critical care interventions, factors that limited care provision, and innovations developed to deliver care.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20014166_as3\"><jats:title>Setting and participants:<\/jats:title><jats:p>The questionnaire was sent to 82 ETCs.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20014166_as4\"><jats:title>Methods:<\/jats:title><jats:p>We analyzed ordinal and categorical data pertaining to the ETC characteristics and descriptive data about their policies and perceived challenges. Statistical analyses assessed whether ETCs with experience caring for VHF patients were more likely to have critical care policies than those that did not.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20014166_as5\"><jats:title>Results:<\/jats:title><jats:p>Of the 27 ETCs who responded, 17 (63%) were included. Among them, 8 (47%) reported experience caring for persons under investigation or confirmed cases of VHF. Most felt ready to provide intubation, chest compressions, and renal replacement therapy to these patients. The factors most cited for limiting care were staff safety and clinical futility. Innovations developed to better provide care included increased simulation training and alternative technologies for procedures and communication.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20014166_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>There were broad similarities in critical care policies and limitations among institutions. There were several interventions, namely ECMO and cricothyrotomy, which few institutions felt ready to provide. Future studies could identify obstacles to providing these interventions and explore policy changes after increased experience with novel infectious diseases, such as COVID-19.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2020.1416","type":"journal-article","created":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T07:16:01Z","timestamp":1613373361000},"page":"1307-1312","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":6,"title":["Institutional policies and readiness in management of critical illness among patients with viral hemorrhagic fever"],"prefix":"10.1017","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1284-6428","authenticated-orcid":false,"given":"Madeline A.","family":"DiLorenzo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph A.","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn J.","family":"Herstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Lowe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn G.","family":"Gibbs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahid","family":"Bhadelia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,2,15]]},"reference":[{"key":"S0899823X20014166_ref4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504874"},{"key":"S0899823X20014166_ref2","unstructured":"2. Viral hemorrhagic fevers (VHFs). Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/vhf\/index.html. Accessed June 6, 2020."},{"key":"S0899823X20014166_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60712-7"},{"key":"S0899823X20014166_ref11","unstructured":"11. NETEC webinar series: COVID-19 education and training. National Ebola Training and Education Center website. https:\/\/netec.org\/education-and-training\/. Accessed June 5, 2020."},{"key":"S0899823X20014166_ref16","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2014111057"},{"key":"S0899823X20014166_ref15","first-page":"5","article-title":"Bioethics in practice\u2014a quarterly column about medical ethics. Ebola and medical ethics: ethical challenges in the management of contagious infectious diseases","volume":"15","author":"Blais","year":"2015","journal-title":"Ochsner J"},{"key":"S0899823X20014166_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2017.07.001"},{"key":"S0899823X20014166_ref9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2010758"},{"key":"S0899823X20014166_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2019.12.005"},{"key":"S0899823X20014166_ref6","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.su6503a2"},{"key":"S0899823X20014166_ref21","doi-asserted-by":"publisher","DOI":"10.1177\/1129729820923935"},{"key":"S0899823X20014166_ref1","unstructured":"1. Ebola situation report. World Health Organization website. https:\/\/apps.who.int\/ebola\/sites\/default\/files\/atoms\/files\/who_ebola_situation_report_30-12-2015.pdf?ua=1&ua=1. Accessed July 28, 2020."},{"key":"S0899823X20014166_ref19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1910993"},{"key":"S0899823X20014166_ref7","unstructured":"7. Ebola virus disease for clinicians. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/vhf\/ebola\/clinicians\/index.html. Accessed May 25, 2020."},{"key":"S0899823X20014166_ref10","unstructured":"10. 2018 annual report. National Ebola Training and Education Center website. https:\/\/netec.org\/wp-content\/uploads\/2019\/01\/NETEC-Annual-Report-FY2018.pdf. Published 2019. Accessed May 8, 2020."},{"key":"S0899823X20014166_ref23","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202003-261IP"},{"key":"S0899823X20014166_ref3","volume-title":"Laboratory Safety Biomanual,","year":"2004"},{"key":"S0899823X20014166_ref12","doi-asserted-by":"publisher","DOI":"10.3201\/eid2605.191245"},{"key":"S0899823X20014166_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2017.05.008"},{"key":"S0899823X20014166_ref20","first-page":"129","article-title":"Early multiorgan point-of-care ultrasound evaluation of respiratory distress during SARS-CoV-2 outbreak: case report","volume":"4","author":"Farrow","year":"2020","journal-title":"Clin Pract Cases Emerg Med"},{"key":"S0899823X20014166_ref17","doi-asserted-by":"publisher","DOI":"10.1378\/chest.15-0278"},{"key":"S0899823X20014166_ref8","unstructured":"8. Edelson, PJ. Don\u2019t categorically refuse CPR to Ebola patients. The Hastings Center website. https:\/\/www.thehastingscenter.org\/dont-categorically-refuse-cpr-to-ebola-patients. Accessed May 25, 2020."},{"key":"S0899823X20014166_ref5","unstructured":"5. 2014\u20132016 Ebola virus outbreak in West Africa. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/vhf\/ebola\/history\/2014-2016-outbreak\/index.html. Accessed July 27, 2020."}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X20014166","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T13:52:19Z","timestamp":1636725139000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X20014166\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,15]]},"references-count":23,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["S0899823X20014166"],"URL":"https:\/\/doi.org\/10.1017\/ice.2020.1416","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,15]]},"assertion":[{"value":"\u00a9 The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}