Are American hospitals ready for Ebola?

[texarkana 551]

I retired from a major trauma hospital in 2009 and even then I knew they weren't going to be able to handle a large epidemic of any kind. Most ICU's only have 1 or 2 negativepressure isolation units.I also don't trust the CDC especially after their most recent mishaps of sending out supposedly deactivated anthrax and "finding" still live samples of smallpox forgotten in a storage room. I also find it disturbing that after the reports coming out now about the 1st US case of ebola I am finding little discussion on other nursing boards about this. We should be scared, we all know how administrators water down things,that's their job.Also patients lie,the CDC doesn't really know how many people this man came in contact with,also I believe he knew he was infected and fled Liberia before he couldn't hide his symptoms anymore.We all knew we were only one air flight from a pandemic ,well the plane has landed and from one reply on this board apparently Houston has a large population of Nigerian immigrants. This man will not be the last one, there are clouds on the horizon.In a lot of hospitals infection control is a joke, put that with understaffing and cost cutting. We need to start communicating with each other. Start looking at your own hospitals infection control policies, are they being followed.Start asking questions that could save your life,look at the numbers of health care workers in Africa that have already died doing their job.This is a health care emergency, you might say don't panic, well if panic involves having hospitals actually doing and enforcing their own infections control policies well then let the PANIC begin.Emergency rooms are going to start being overwhelmed by anybody that has a temp or upset stomach. I guess we will all know in about 21 DAYS.(mark your calendar)

[Pepper The Cat, BSN, RN]

Hmm - my first post disappeared. Guess the cat ate it.

Anyway - here we go again.

I am Canadian and I think my hospital is prepared for Ebola. We were a SARS hospital back during the SARS epidemic and we learned A LOT from that time.

ER and ICU staff have been educated about the PPE needed for Ebola, including how to triple glove. Supplies are in place. Plans are in place about how to minimize pts with Ebola moving about the hospital, including limiting blood work, tests etc. They have plans to limit the amt of people coming in contact with any pt with Ebola to a minimum.

All hospitals in Ontario already use a screening tool right at triage that includes questions about travel outside the country and if you have been to another health institute in the past 6 months. Isolation techniques start right then depending on the answer to the question. - For example, if while working at my hospital that had SARS pts, I had gone to another hospital's ER they would have immediately handing me an N95 mask.

To me, SARS was a lot scarier than Ebola. We didn't know what we were dealing with with SARS. We know what Ebola is, how it is transmitted and how to treat it. We didn't know any of that at the start of SARS. Ebola is scary, but SARS was scarier. We made it through SARS, we will make it through this.

[Christy1019, ASN, RN]

I keep thinking to myself, how the heck would I start an IV on an Ebola patient? I sometimes have a hard enough time palpating a vein with one layer of nitrile gloves on a normally hydrated pt, but add in triple gloving, severely dehydrated pts with flat veins, trying to see through the face shield I'm likely to fog up or get sweat on, and the fact that I would be so afraid of a needlestick that I'd probably be a little shaky, and I have no idea how I would accomplish this! Maybe I'd have to stand across the room and throw the angiocath like a dart and hope for a bullseye lol!

[sistrmoon, BSN, RN]

I guess there is some talk that healthcare workers are infecting themselves by removing PPE incorrectly. I could totally see that.

[Rose_Queen, BSN, MSN, RN]

I keep thinking to myself, how the heck would I start an IV on an Ebola patient? I sometimes have a hard enough time palpating a vein with one layer of nitrile gloves on a normally hydrated pt, but add in triple gloving, severely dehydrated pts with flat veins, trying to see through the face shield I'm likely to fog up or get sweat on, and the fact that I would be so afraid of a needlestick that I'd probably be a little shaky, and I have no idea how I would accomplish this! Maybe I'd have to stand across the room and throw the angiocath like a dart and hope for a bullseye lol!

My guess would be that with the support required of most of these patients, they're getting central lines at some point.

As for whether hospitals are ready, I'm going to go with mine isn't. Have not seen one single solitary bit of education other than an emailed link to the CDC. I don't work in ER, so I don't know if they've gotten additional information, but my unit certainly hasn't.

[gcupid]

we can handle taking care of an ebola patient but we can not handle an outbreak. The hospitals are short staffed all ready on purpose. Sometimes I'm amazed that I make it up out of the hospital alive and I am the nurse.

[dudette10, MSN, RN]

I have to say it is a little fishy that the guy was sent home from the hospital and when he was still sick and becoming sicker 2 days later that his nephew called the CDC.

I have had family members sent home, and appear the same or worse 2 days later and I take them back, I don't call the CDC.

He knew for a fact he was exposed. I think at least in the back of his mind he must have been thinking he had better get over here before the incubation period got to the point that symptoms would be expected to set-in, just to be safe.

Wow. You're right. I totally missed that his nephew called the CDC when he felt his uncle wasn't getting the proper treatment, which is a very, very odd thing to do.

[Laurie52]

You honestly believe this individual knew he was infected with Ebola ... for certain Ebola. And lied to leave Liberia. And then allowed himself to be discharged with a diagnosis of a viral illness. And then went back? ...

If he were really seeking medical treatment in the US for a better survival rate, don't you think he would have essentially told health care personnel he had Ebola?

Yes, I honestly believe this. It is a fact that he lied to get out of Liberia and his nephew called the CDC when he was not admitted to a hospital the first time. Do you really believe he didn't know?

[dudette10, MSN, RN]

I think he knew there was a very good chance he was infected, but was hoping against hope that he wasn't. He knew if he answered the Liberian exit questions honestly that there was a chance that he would not be allowed to get to the States. When he went to the hospital the first time, he may have been relieved that the doctors didn't think he had Ebola, because he did tell them he had been in Africa. At that time, he did not know that critical piece of information did not play into his diagnosis and treatment. When he got sicker, it became clear to his family that he did indeed have Ebola, which was why his nephew called the CDC.

Only his family had all the pieces of information that led to the correct diagnosis. I don't think Duncan is necessarily a bad person; he was just a person deep in denial of his chances of being infected.

[joanna73, BSN, RN]

Guaranteed we will see ebola and various other life threatening diseases spread. Very challenging for health officials to track given the rates of travel.

This is precisely why adequate staffing is essential, but of course that's not happening.

[TheGooch]

He fled Libera because he knew he had Ebola? You're not serious, right? That sounds like a conspiracy theory.

well the dude helped a pregnant woman who had the disease and later died from it, he lied on the questionnaire that he had to fill out before he exited the country(which he will now be prosecuted for in Liberia if he lives).

So, yes, those two things DO send up a red flag saying that he knew he had a pretty good chance of being infected when he left.

[TheGooch]

Only his family had all the pieces of information that led to the correct diagnosis. I don't think Duncan is necessarily a bad person; he was just a person deep in denial of his chances of being infected.

I don't think he is a bad person at all. He risked his own life to help a pregnant woman with the disease-most people wouldn't have done that. Frightened over the potential of having contracted the disease comes to mind, not bad.

[TheGooch]

If this man dies what will they do with the body? I don't see too many funeral homes jumping at the bit to take it. And since he is in critical condition and deteriorating rapidly I see this as more than a possibility.