The Johns Hopkins Hospital
Biocontainment Unit
Brian T. Garibaldi, MD
Associate Medical Director, JHHBCU
Assistant Professor of Pulmonary and Critical Medicine
Johns Hopkins University School of Medicine
4/26/2016
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Financial Disclosures/
Unapproved Use
• We have no financial relationships with a
commercial entity that are relevant to the
content of this presentation.
• JHH has received funding from the Maryland
Department of Health and Mental Hygiene
(DHMH) and the Assistant Secretary for
Preparedness and Response (ASPR)
Objectives
By the conclusion of this talk, you will be
able to:
• Describe the critical elements of a
biocontainment unit
• Understand the design process of the JHH BCU
• Recognize the multidisciplinary nature of BCUs
• Describe the mission of the JHH BCU in the
broader context of national and international
preparedness
What is a Biocontainment Unit?
Key features of a BCU
• Secure entry and exit points
• Advanced air handling system
• Highly trained nurse and provider team
including adult, pediatric and obstetrics
• Laboratory
• Critical Care
• Onsite imaging
• Waste Management
• Infrastructure
Johns Hopkins
Ebola Preparedness
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Screening/Triage
Education &Training
Supplies
Transportation
Cleaning, Disinfection
Waste Management
Laboratory
Workforce
Ethics
Communications
Designated Units
Biocontainment
Why is this relevant today?
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The BCU Vision
The Johns Hopkins Hospital
Baltimore, MD
The BCU Vision
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Key Collaborations
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Emory University
University of Nebraska
NIH
CDC
Colleagues across the world
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Tackling the fear of contagion
• John G. Bartlett
– Established the AIDS clinical
service at JHH in 1983
• B. Frank Polk
– Pioneering research and
clinical care for patients with
HIV
Timeline of the BCU
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BCU Floorplan
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BCU Floorplan
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Patient Room 1
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Patient Room 1
Onsite Laboratory
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Onsite Laboratory
Available Laboratory Tests
Analyte/Panel
Instrument
Tube Type
Comprehensive Metabolic
Panel (CMP)
Abaxis Piccolo
Green Top
Electrolytes (Na, K, Cl)
Abaxis Piccolo
Green Top
Magnesium
Abaxis Piccolo
Green Top
Phosphate
Abaxis Piccolo
Green Top
Lactate
Abaxis Piccolo
Green Top
Heme-8 (CBC w/differential)
Sysmex pocH-100i
Lavender Top
Arterial Blood Gas w/Cooximetry
Radiometer ABL90
Blood Gas Syringe
Venous Blood Gas w/Cooximetry
Radiometer ABL90
Blood Gas Syringe
Ionized Calcium
Radiometer ABL90
Blood Gas Syringe
Whole Blood INR
Hemochron Signature
Blue Top
Plasma equivalent aPTT
Hemochron Signature
Blue Top
Urinalysis
Manual Dipstick
Urine Screw Cap
ABO typing
Glass Slide Test
Lavender Top
Waste Management
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Autoclave – Unit Side
Autoclaves – Clean Side
Radiology
Sonosite Xporte
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Digital
Xray
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Digital Stethoscope
Think Labs
One
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Unique Features of the JHH BCU
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Unidirectional flow of staff
Donning and doffing rooms for all patient care areas
Dual Pass-through autoclaves
Physical space for obstetrics procedures
Physical space for sterile procedures, including
limited surgery
• Main patient room with two ICU headwalls to provide
care for family
• Advanced Telecommunications System
Telecommunications
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Providers
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The Making of the JHH BCU
• https://youtu.be/oVmCBToWYqc
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Tour of the BCU
• https://youtu.be/RzsCk4lm1T8
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The JHH BCU Vision
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PATIENT CARE
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Region 3 Ebola and Other Special
Pathogen Treatment Center
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HHS Regional Centers
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Massachusetts General Hospital in Boston, Massachusetts
Bellevue Hospital Center in New York City
Johns Hopkins Hospital in Baltimore, Maryland
Emory University Hospital and Children’s Healthcare of
Atlanta/Egleston Children’s Hospital in Atlanta, Georgia
University of Minnesota Medical Center in Minneapolis,
Minnesota
University of Texas Medical Branch at Galveston in Galveston,
Texas
Nebraska Medical Center in Omaha, Nebraska
Denver Health Medical Center in Denver, Colorado
Providence Sacred Heart Medical Center and Children’s
Hospital in Spokane, Washington
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National Ebola Training and
Education Center (NETEC)
(ASPR),
(CDC) Emory University, University of Nebraska
Medical Center/Nebraska Medicine & New York Health and
Hospitals Corporation, Bellevue Hospital
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Training and Education
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Highly Infectious Disease
Training
• Quarterly activation drills
• Yearly no-notice drills
• Monthly staff meetings and activities
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Infection Control Training
• 500 EVS employees have trained on
the unit
• Compliance scores have increased
across the hospital
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Research
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Research and Innovation
PPE design and testing
CDC Epicenter Grant
FULD Fellow
Self-Selector Study
Genomics and infection
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Questions?
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