De-escalation of isolation and patient transport

De-escalation of isolation

If the diagnostic VHF blood test is negative, additional VHF IPC measures can be ceased. However:

• to prevent false negatives, results obtained in the first 48 hours of illness should be confirmed by a second specimen obtained after this time when a high degree of clinical suspicion exists
• consideration to other infectious diseases should continue as clinically indicated, which may require other transmission-based precautions. This will need to be assessed on a case-by-case basis.

Patients with confirmed VHF will remain in isolation until deemed to be non-infectious by the facility’s infectious diseases service, in consultation with the Chief Human Biosecurity Officer (contact the department on 1300 651 160).

Urgently contact the LPHU and the department (on 1300 651 160) and seek their advice if the patient would like to discharge themselves against medical advice.

Documentation and communication

Management of documentation and communication includes:

• documenting the rationale and timing for de-escalation
• notifying all relevant departments (for example, cleaning services, transport and the lab)
• updating signage and removing isolation notices only after final clearance.

Patient transport

When transporting a patient with suspected or confirmed VHF, remember:

• Transfers of patients should be limited to essential moves only.
• Identify the most direct path that will encounter the least number of people.
• All staff involved in the transport must wear the appropriate level of PPE (1 or 2), according to the clinical situation and setting (see Selection of PPE on Personal protective equipment) and their role during transportation.
• Consider using a transport hood (for example, the Medihood personal ventilation hood) on the patient where available. Where transport hoods are not available, the patient should wear a face mask if tolerated.
• A spill kit, with a solidifying product and vomit bag should accompany the patient.
• Before leaving the room:
  • notify the receiving team to ensure they are ready to receive the patient
  • confirm staff involved in the transport are aware of the route
  • lock down hallways and call for elevators that will be accessed
  • allocate staff to clear traffic from designated pathway.