Surgeries to be cancelled and ICU beds closed if Ebola hits Ireland

Major surgeries will have to be cancelled, intensive care beds closed and extra staff provided if a case of Ebola occurs in an Irish hospital, according to new guidelines for the management of infected patients.

Three nurses will be required to attend to an Ebola patient, compared to the normal ratio of one nurse per patient in critical care, the guidelines state.

“This will significantly drain the numerical pool of ICU nursing staff for any institution and mandate closure of a number of ICU beds, impacting negatively on the ability of that centre to provide for other acutely ill patients,” they say. “Restrictions to major elective surgeries and redistribution of ambulance take may be required.”

The guidelines were drawn up by the Critical Care Advisory Group on Ebola, comprising ICU consultants who are members of the Intensive Care Society of Ireland.

The demands of care for a patient with the disease, the extra risks involved and the difficulties inherent in working while dressed in protective equipment will require shorter shifts and therefore greater number of doctors and nurses.

Six-hour shift would be the maximum tolerable for nursing staff in this context, the guidelines say.

Patients who test positive for Ebola will be transferred to the National Isolation Unit in the Mater Hospital in Dublin where this is possible. Capacity in the unit is appropriate, assuming a "sporadic" exposure to the disease, the document states.

However, an “exceptional cluster” or cases may arise of a patient may be deemed too unwell to transfer and so all hospitals have to plan for receiving cases, according to the report.

More than 5,000 people have died in the current Ebola outbreak in west Africa. Fourteen people have been tested for the disease in Ireland, but all were negative.