Hospital readiness for Ebola

[aspiration]

I am wondering, with all the news on Ebola and the CDC saying it is going to come to U.S on a plane without isolation, what are your hospitals doing to prepare? Has your hospital set up where the patients will go? Will the nurse caring for that patient have that patient only? Where will body fluids be disposed? If the patient recovers will they go to a new isolation area until they are no longer infectious? Will your hospital offer incentive to work with these patients? If there is an exposure what will be the protocol? Thanks for input.

[icuRNmaggie, BSN, RN]

My employer (large, urban academic medical center) included a piece in this week's employee newsletter that it has updated its existing Ebola policy.

What level of isolation is required for a suspected Ebola hemorrhagic virus pt at your institution?

[icuRNmaggie, BSN, RN]

contact isolation procedures and universal protocol may be all we need to do. I remember when people with AIDS were frist being treated - same fears. Fear can lead to bad decisions.

I am wondering if the Ebola hemorrhagic viral illness is more prevalent or virulent in HIV positive patients. Is there any correlation.

[icuRNmaggie, BSN, RN]

Keep in mind, Ebola has been brought under control time and again in central Africa, particularly by Uganda, in the absence of first world biohazard facilities (outside the lab in Entebbe). Bog standard barrier nursing has been shown over and over to be essentially 100% effective with Ebola.

The current outbreak reflects the absolutely awful state of west-African healthcare - even the DR Congo (!) have been able to control their outbreaks, under some pretty terrible conditions out east. Unfortunately, a big part of the problem in this new region is a lack of education or experience. Even in Uganda we see people leaving or avoiding hospital in favour of traditional medicine (read: witchdoctors), and they're GOOD at this, with a lot of experience. They should know better - and mostly do.

But now in west Africa we get the combination of people who don't know anything about Ebola, who are extremely distrustful of the government (for good reason) and outside organisations (for less good, but still justifiable, reasons), and who only have access to absolutely bare-bones medical care. It's perfect for Ebola.

But in a first world country, I can say with certainty, it would be absolutely gob-smacking to see it get past a second generation, and frontline healthcare workers (who follow proper barrier nursing protocols) should be fine.

And yes, I'd bet my life on it.

:)

Thank you for sharing your experience. What is bog standard barrier nursing? Does it include airborne precautions?

I have read that this is an RNA virus and capable of mutating to an airborne respiratory illness. The CDC advisory says no aerosol generating procedures.

[elkpark]

What level of isolation is required for a suspected Ebola hemorrhagic virus pt at your institution?

Isolation in a negative-pressure room. Somewhat beefed up contact and droplet precautions (double gloves, impermeable gowns, shoe covers, N-95 mask or respirators, eye protection (goggles or full face shield). Minimal number of people coming and going in room. No lab specimens sent to our lab -- only point of care testing done in the room by specially trained lab staff, or samples sent to CDC for testing there.