new Ebola patient

[Mulan]

http://edition.cnn.com/2014/11/13/health/nebraska-ebola-patient/index.html?eref=edition

"(CNN) -- A surgeon infected with Ebola will be transported from Sierra Leone to The Nebraska Medical Center for treatment, a U.S. government official familiar with the situation said."

"The doctor, a Sierra Leone national and legal permanent resident of the United States, is expected to arrive this weekend, most likely Saturday, the official said."

"The official said it's not known whether the doctor was working in an Ebola treatment unit or some other type of hospital. The surgeon is married to a U.S. citizen and has children, the official said."

http://apnews.myway.com/article/20141114/us--ebola-omaha_patient-ca9ee14176.html

"Salia is a general surgeon who had been working at Kissy United Methodist Hospital in the Sierra Leone capital of Freetown. Patients, including mothers who hours earlier had given birth, fled from the 60-bed hospital after news of the Ebola case emerged, United Methodist News reported."

"The hospital was closed on Tuesday after Salia tested positive and he was taken to the Hastings Ebola Treatment Center near Freetown, the church news service said. Kissy hospital staffers will be quarantined for 21 days."

[imintrouble, BSN, RN]

It's foreseeable that we will treat other HCWs, who served in the hot zone and who are not either U.S. citizens/residents or from Europe--and rightly so, in my view--based on transportation or geographical considerations.

I'm no longer opposed to transporting Ebola pts from Africa, to one of our specialized facilities. My question is, who gets to come? An ethical quandary as far as I'm concerned.

So far Americans. Then yesterday, an MD married to an American, with permanent US residency. An accomplished man who is a doctor.

Who decides who gets the treatment that might save a life?

There are still thousands who are contracting and dying from Ebola in Africa. Obviously there are plenty of candidates to fill our 10 available beds. Should we fill them all?

[lee1]

http://www.kevinmd.com/blog/2014/08/ethical-dilemma-saving-american-ebola-patients.html

Interesting article above written by a physcian on this particular ethical issue.

Now with all of the money/people being sent over to build better facilities by our government why can't this person be treated there. What special treatment did the others get here that they cannot get there???? Serum made from ebola survivors?? Others there did get it. Advanced supportive care like intubation/ventilation or CVVHD??? Which doctor sent here required that? Only Duncan I believe

[Mulan]

The ethical dilemma of saving the American Ebola patients

Interesting article above written by a physcian on this particular ethical issue.

Now with all of the money/people being sent over to build better facilities by our government why can't this person be treated there. What special treatment did the others get here that they cannot get there???? Serum made from ebola survivors?? Others there did get it. Advanced supportive care like intubation/ventilation or CVVHD??? Which doctor sent here required that? Only Duncan I believe

This is from the same article:

"But it appears to me that lost in this conversation are myriad others who need help but never get it. Right now, humanitarian work is being done all over the world, and in very dangerous places. These people knowingly put their life on the line for others. Yet tragically, some of them are injured or sickened in the service of others. But for them, the call from the CDC offering to medevac them out never came. There was a girl, who died of malaria while in Kenya. Or the young man who was serving in Egypt. Or a myriad other aid workers who die while serving their fellow human beings."

The girl was a Brit, why expect the CDC to get involved?

The young man in Egypt was stabbed to death, how would a CDC medevac be involved?

[NRSKarenRN, BSN, RN]

Philadelphia Inquirer

Nov 16th, 2014

Margery Beck and Jessica Gresko, AP

Surgeon with Ebola arrives in US for treatment

...The U.S. State Department said it was helping facilitate the transfer of Salia; the U.S. Embassy in Freetown said he was paying for the expensive evacuation. The travel costs and care of other Ebola patients flown to the U.S. were covered by the groups they worked for in West Africa. ...

Washington Post

October 28,2014

by Josh Hicks

The whole world relies on this one U.S. company to fly Ebola patients

Phoenix Air, a jet-charter service based in Cartersville, Ga., has flown 15 infected patients, including Europeans who worked in West Africa and five individuals who were treated in the United States — doctor Kent Brantly, photojournalist Ashoka Mukpo, missionary Nancy Writebol, and nurses Nina Pham and Amber Vinson.

Now the Defense Department is stepping up. The Pentagon this week said it is developing portable isolation units for use on its military aircraft, as thousands of U.S. troops head to West Africa to help combat the outbreak. The modules are expected to be tested next month and deployed in C-17 and C-130 transport planes by January.

..The tent-like isolation chambers mainly consist of a metal frame, a plastic liner and an air-filtration system. For the Phoenix Air flights, one doctor and two nurses attend to each patient.

After each patient is transported, the company sprays toxic disinfectant inside the module for 24 hours and sends the contents — including the plastic, the stretchers and even the walkie talkies — off for incineration by a federally licensed hazardous-materials disposal team.

Phoenix Air created three isolation units in 2011 with help from the Centers for Disease Control and Prevention and the Defense Department. Those agencies provided scientific expertise and advice on how to manufacture special materials, respectively....

Both trips, which cost about $200,000 each, including the decontamination process, were paid for by Samaritan’s Purse, a Christian humanitarian organization that the patients worked with in Liberia.

After those missions, Phoenix Air decided that the U.S. government should manage future transport efforts, because of the “real-world complexities of what it takes to make a mission like this work,” Thompson said. The challenges include dealing with U.S. customs officials, gaining permission to use foreign airspace and deciding which medical centers should treat the Ebola victims....

[nurse2033, MSN, RN]

The more patients we care for in the US successfully, the more it will hopefully build the public's confidence and reduce hysteria. It also allows us to try new treatments and improve the care for the disease.

[lee1]

as long as those nurses that take care of these patients in THIS country are volunteers and NOT mandated by their employers

[nurse2033, MSN, RN]

as long as those nurses that take care of these patients in THIS country are volunteers and NOT mandated by their employers

Are you implying that nurses should choose the patients they take care of? So anyone who has TB, HIV, cholera, plague, C-dif, or Ebola should only be taken care of by volunteers? (We are all volunteers BTW. No one forced us into nursing.) Please forgive me if I've taken your comments the wrong way, but the ethics of nursing mandate we take care of anyone who needs it. If you won't do your job, you should find another field.

[lee1]

Are Nurses Prepared to Work With Ebola Patients?

[BostonFNP, APRN]

Ebola was so last week.

The new terrordemic is comet flu.

Sent from my iPhone.

[wtbcrna, MSN, DNP, CRNA]

Ebola was so last week.

The new terrordemic is comet flu.

Sent from my iPhone.

Night of the Comet (1984) - IMDb

[lee1]

well so much for last week, this poor patient just died here and hopefully noone else gets infected from taking care of him

[BostonFNP, APRN]

well so much for last week, this poor patient just died here and hopefully noone else gets infected from taking care of him

Unfortunately, he was in MODS before he arrived here for treatment.

Sent from my iPhone.