Ebola... What'cha Gonna Do When It Comes to You

Nurses COVID

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Specializes in being a Credible Source.

I presume that most urban hospitals are beginning to form contingency plans for how to react when a possible or suspected Ebola case arrives in triage... though these plans may reveal the Emporer to be stark naked.

Our hospital sent out an e-mail that seeks to assure us that a plan is in place to safely handle this situation but it's long on platitudes and short on details...

It fails to address the simplest of considerations like the fact that we have no toilets in our rooms and only a few restrooms throughout the entire department... for patients who typically produce large amounts of infectious diarrhea.

It fails to consider that the gloves we have tear on a fairly regular basis... perhaps 7% or so.

It fails to offer a detailed plan to for donning and doffing PPE in a decon zone to prevent cross contamination.

It fails to address how potential contacts will be monitored nor the options for quarantine.

It doesn't consider the issue of visitors nor what will happen if the patient decides to leave for some reason.

It's almost as though we're told, "Not to worry... we have a master plan that will be enacted as needed" when said plan is actually just a single page listing the name and number of the infectious disease fellow.

The probability of such a patient is pretty low but the potential severity is very high.

Just curious... Does your ED have a robust and realistic plan for how to cope with the arrival of a possible Ebola patient?

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Specializes in LTC,Hospice/palliative care,acute care.

Now I have that STUCK IN MY HEAD!! Thank you very much. I am going to do "The safety Dance" all the way home when it hits this area.

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Specializes in Emergency & Trauma/Adult ICU.

Good info here from the CDC:

Information for Health Care Workers | Ebola Hemorrhagic Fever | CDC

I am in no way trying to be flip about the risks ... but the nature of the ED is: by the time I have enough of a story to know that the person coughing in front of me meets the threshold for r/o TB ... or that my patient running to the bathroom with diarrhea has recently been on abx and has likely contracted c. diff. ... I've already been exposed.

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Specializes in ER.

continue strict hand washing techniques...good and often. Promoting this to parents, children, elderly, etc. I'm always irked by the elderly people who's idea of washing their hands is running water over them for a few seconds, turning off the faucet with their hand and grabbing a paper towel. They've been doing this how long? :facepalm:

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Gee, we're just hours from the CDC ... transfer! haha.

Seriously, no. No plans. I did just take my first call about Enterovirus D68 the night before last as well, so that's on the radar as well. Sigh.

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Specializes in Vents, Telemetry, Home Care, Home infusion.
Want to Fight Ebola? CDC to Train Health Workers
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Specializes in Emergency, Critical Care (CEN, CCRN).

We do have a quite robust plan for viral hemorrhagic fevers in place in my department, covering identification at Triage, a chain of notification, rooming requirements and visitor policies. If anything, it might err on the side of overkill (it calls for airborne isolation to be instituted and staff to wear Level C suits with PAPRs when treating known or suspected Ebola patients). Then again, given the eternal battle we all face to get people to wash their hands, they might just be using the Level C requirement as a forcing function...

I'm far more worried about enterovirus D68, frankly. The respiratory season here is already ramping up big time, and these kids are sick. In years past, pediatric respiratory complaints usually followed an 80/20 rule (80% well kids with worried parents vs. 20% legitimately sick kids). This year, it's more like 60% sick kids, and far more of them than one would typically expect for mid-September, even accounting for the usual back-to-school spate of URI and gastro. Nobody's confirmed any actual cases of D68 in this state yet, but I don't think we have all that long to wait - and that's one bug for which we don't yet have a plan in place. Implications... unpleasant.:wideyed:

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Specializes in Emergency Nursing.

Now that it is in the US... we all have a responsibility to get answers to this question!

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Specializes in Emergency, Trauma, Critical Care.

You jinxed us ;)

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My facility (large, urban academic medical center) recently updated its existing policy for Ebola and other hemorrhagic viruses, and circulated it to all staff. It is not "long on platitudes and short on details" -- it's specific, detailed, and concrete. The equipment, staff, and procedures are in place and ready to go if needed.

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Our policy is. At our entrance it states if you have recently visited Nigeria Liberia etc please notify the front desk reception prior to triage. Yup that's a good method! ( insert sarcasm right here ) we have shared bathrooms and only two airborne ISO rooms. Mind you this is one of the best hospitals in central nj. We got a mass email that a policy has been put in place but no info of this policy! I'd love to see more then two ebola pts come in. Funny how the top notch hospital such as Emory or Texas has only 3 proper ISO rooms as stated in their press report. By the time the test would come back positive the nurses doctors techs transport people would have all been in contact. I'm sorry but I did not sign up to "die due to my exposures at my job." Since flu season is upon us many nurses have been calling out sick due to getting the flu thanks to our patients. What does management do? They sit and complain about the call outs! Maybe the managers and charge r n will be left to take care of the ebola pts should this really get out of control :)

Id be interested to see how many nurses start refusing care of an Ed pt who has traveled to the areas of the ebola crisis.

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well, well, well ...

Presbyterian officials initially suggested that a nurse may have been at fault for failing to tell the emergency room doctor that Duncan had recently been in Liberia. Then hospital officials late Thursday blamed the miscommunication on a “flaw” in the hospital’s electronic records system.

Friday, the hospital backtracked, saying that “there was no flaw” in its electronic health records system and that the ER doctor did have access to Duncan’s travel history.

Hospital spokesman Wendell Watson said Saturday that the hospital was “looking into the entire chain of events,” but he declined to elaborate.

quoted from article:

Dallas hospital under fire as accounts of Ebola patient’s initial release change

http://www.dallasnews.com/news/metro/20141004-dallas-hospital-under-fire-as-accounts-of-ebola-patients-initial-release-change.ece

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