Minimum Requirements for High Isolation Unit in European countries EUNID Minimum Requirements for High Isolation Unit in European countries One national Unit or dispersed units? depends on size and administration in each MS Two units generally desirable One with collaboration (also international model)

Minimum Requirements for High Isolation Unit in European countries EUNID Minimum Requirements for High Isolation Unit in European countries Location and connections Alongside a tertiary (specialist referral hospital) Stand alone pavilion or integrated in a multi-storey building with proper engineering and operation protocols Close liaison in design and management with critical care Include critical care capabilities into the design Paediatric support Availability of advice by other specialties

Minimum Requirements for High Isolation Unit in European countries EUNID Minimum Requirements for High Isolation Unit in European countries Negative pressure Negative pressure agreed Pressure gradient HEPA filtration Poor evidence but generally agreed Pressure adequacy should be constantly visible Regular testing and validation (min x2/yr)

Minimum Requirements for High Isolation Unit in European countries EUNID Minimum Requirements for High Isolation Unit in European countries Patient management laboratory services Comply with biological agents EC directive Maximize point-of-care options Auto analysers with appropriate protocols and safety measures Other tests in BSL-3 or higher Operator training and quality assessment

Minimum Requirements for High Isolation Unit in European countries EUNID Minimum Requirements for High Isolation Unit in European countries Packaging and transport of samples UNECE guidance Biohazard Accident response protocol

Minimum Requirements for High Isolation Unit in European countries EUNID Minimum Requirements for High Isolation Unit in European countries Clinical waste handling Evidence available but not all applicable to small scale Several modes of waste management and national restriction/guidelines Most people will use regular tried and tested methods Treatment of liquid waste: ? necessity and efficacy

Minimum Requirements for High Isolation Unit in European countries EUNID Minimum Requirements for High Isolation Unit in European countries Decontamination of HIU Fumigation generally not supported Explore other options Dedicated or identified equipment should be chosen with decontamination in mind

Minimum Requirements for High Isolation Unit in European countries EUNID Minimum Requirements for High Isolation Unit in European countries Staff protection issues Uniforms/PPE according to other group Auscultation difficulties Undressing and showering/washing Should be part of the staff decon Fail-safe against breach of protection Part of the adverse event response protocol

Minimum Requirements for High Isolation Unit in European countries EUNID Minimum Requirements for High Isolation Unit in European countries Outstanding issues Transport of patients Ambulance choices Other transport Transport isolators Operational policy and Risk Management tools Training and exercises Audit Sharing adverse event information