Anthrax in the ED

LerRN95 · Oct 17, 2001

We have just started gathering information to set up policies and procedures. Haven't started getting calls yet, but our EMS did bring a patient in last week that had just left Florida, passed out at the Subway. Patient told the EMS that he had "Flu-like symptoms". He was a transient with a very large heavy bag that was "dusty".

EMS was concerned.....

So we are including them in our plan and will provide them with the same information.

debbyed · Oct 17, 2001

We have received several fax's from our state health department regarding proper steps to take for reported possible exposures. You might want to check with your Dept. of health and human resources.

The only people we actually test are people who are sent in by the teams responding to potential exposures when it is deemed that there was exposure. Those tests are actually sent by special messanger to the State Lab.

Anyone showing up requesting the test that was not sent in by the appropriate department is referred to the DHHR. In the event an occurance occurs that the physicians feel needs to be investigated immediately we have to call 911, DHHR and the FBI to respond. Thankfully that has not happened at this point.

Zee_RN, BSN, RN · Oct 17, 2001

My ICU patient was tested for Anthrax this week. She has been in the unit for 2 weeks. She had been in florida a few weeks ago. She is intubated (now trached) for respiratory failure. Family felt maybe she was exposed to anthrax, hence her failure to wean. Certainly it had nothing to do with her 95 pack-year smoking history:eek: . Anthrax was, um, negative.

JJFROG · Oct 17, 2001

We had 3 separate incidences yesterday where we decontaminated 12 people. They were postal workers who found a package and 2 letters with "a white powdery substance". HAZMAT went to the facility, contained the substance, medics brought the victims in, all clothes went into biohazard bags, pts were showered and given paper scrubs, all were set in chirs in our isolation room, talked to the DR and sent home. As I was leaving work today we were waiting on the results of the last package, but the first 2 were not anthrax. The biohazard bags with their clothes were kept in the decon room until we received the results of the powdery substance. We did not do the nasal swabs and did not give cipro rxs. It all went fairly smoothly considering we had no policy in effect!

kaycee · Oct 17, 2001

We do get daily faxes from the health dept and info from CDC. Basically we are doing the same things you all have said.

No nasal swabs or Rx unless it is deemed significant exposure from the analysis of substance found.

We just wanted a written procedure that is consistently followed and apparently they are working on it.

Thanks for the info!

Lynne

LerRN95 · Oct 17, 2001

We have also received updated information from the CDC. Very informative...I have even sent the information to my non-medical friends......

newgirl · Oct 19, 2001

Oh man the life of an ER nurse..when you aren't dealing with people calling in or coming in you gotta deal with attendings...we already had two attendings come down to be checked...no particular reason, they just wanted an anthrax test..(they are attendings for the love of God) ...also we have had people come in and want to be tested...the triage went like this:

triagenurse : what's going on today?

Patient: i need an anthrax test and some cipro

nurse: have you been exposed in any way to the bacteria?

patient: NO but i saw it on the news and i want Cipro

The news is our worst enemy!!!!!!

we have had two cases of suspicious anthrax and have had to hose the people down with bleach water in our haz mat room...who even knew my hospital had this room before that??? the stuff you learn when you have to!!!