new Ebola patient

Nurses COVID

Published

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."

So, if you are doing a procedure that the patient is liable to "hock up some sputum" then you should wear PAPR's.

Additional explanation provided by CDC:

"Recommended Personal Protective Equipment

- "PAPR or N95 Respirator . . .

o
"PAPR
: A PAPR with a full face shield, helmet, or headpiece. Any reusable helmet or headpiece must be covered with a single-use (disposable) hood that extends to the shoulders and fully covers the neck and is compatible with the selected PAPR. The facility should follow manufacturer's instructions for decontamination of all reusable components and, based upon those instructions, develop facility protocols that include the designation of responsible personnel who assure that the equipment is appropriately reprocessed and that batteries are fully charged before reuse.

"A PAPR with a self-contained filter and blower unit integrated inside the helmet is preferred.

"A PAPR with external belt-mounted blower unit requires adjustment of the sequence for donning and doffing, as described below.

o
"N95 Respirator
: Single-use (disposable) N95 respirator in combination with single-use (disposable) surgical hood extending to shoulders and single-use (disposable) full face shield.** If N95 respirators are used instead of PAPRs, careful observation is required to ensure healthcare workers are not inadvertently touching their faces under the face shield during patient care."

http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html

CDC Video: Respiratory Protection for Ebola:

It is kinda of interesting when things aren't taken out of context how the story often has different meaning.

Not sure what you mean by this. Could you kindly clarify?

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As I understand it Dr Salia was first symptomatic on November 6 and arrived to Nebraska Medical Center on Saturday November 16. At that time he was critically ill,

in kidney and respiratory failure. He received the experimental drug ZMapp and convalescent plasma on Saturday evening.

I'm not surprised that the experimental treatments didn't work. I'm not an expert,

but it seems to me that at that point in time the problem for the patient is primarily multiple organ failure, not the virus itself.

There have been cases where patients who were critically ill from the complications of EVD have survived and recovered completely, but at such an advanced stage of the disease it's a real challenge.

https://allnurses.com/disasters-preparing-responding/ebola-research-955557.html

The premature ending of a human life due to disease is always a tragedy. It saddens me that it wasn't possible to save this physician who has dedicated his time and skill to helping people in need, in a part of the world that has a shortage of healthcare professionals and medical care facilities.

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Specializes in Anesthesia.
Additional explanation provided by CDC:

“Recommended Personal Protective Equipment

- “PAPR or N95 Respirator . . .

o
“PAPR
: A PAPR with a full face shield, helmet, or headpiece. Any reusable helmet or headpiece must be covered with a single-use (disposable) hood that extends to the shoulders and fully covers the neck and is compatible with the selected PAPR. The facility should follow manufacturer’s instructions for decontamination of all reusable components and, based upon those instructions, develop facility protocols that include the designation of responsible personnel who assure that the equipment is appropriately reprocessed and that batteries are fully charged before reuse.

“A PAPR with a self-contained filter and blower unit integrated inside the helmet is preferred.

“A PAPR with external belt-mounted blower unit requires adjustment of the sequence for donning and doffing, as described below.

o
“N95 Respirator
: Single-use (disposable) N95 respirator in combination with single-use (disposable) surgical hood extending to shoulders and single-use (disposable) full face shield.** If N95 respirators are used instead of PAPRs, careful observation is required to ensure healthcare workers are not inadvertently touching their faces under the face shield during patient care.”

Procedures for Personal Protective Equipment | Ebola Hemorrhagic Fever | CDCInformation for Health Care Workers | Ebola Hemorrhagic Fever | CDC

CDC Video: Respiratory Protection for Ebola:

Not sure what you mean by this. Could you kindly clarify?

I mean that the CDC still states that EBV is not airborne, and that taking things out of context to try to prove that EBV might be airborne shows nothing.

The CDC measure for PAPR is an overly conservative measure. It is designed to appease even the most unlikely fears about ebola.

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Specializes in Emergency/Trauma/Critical Care Nursing.
The book, Hot Zone, and the cited film adaptation, thereof (Outbreak; 1995) was about an airborne virus.

The Cal-OSHA rationale for specifying PAPR's is linked with the likely event of HCWs, here, in the U.S. performing high-risk aerosol-generating procedures, which are not performed in field hospitals in Africa. Please also refer to current CDC guidelines in re droplet precautions.

Thank you, this is what I was referring to. I was not trying to "take things out of context" as others have said, I for one am not concerned that Ebola will become airborne, and I disagree with the media's fear-mongering relating to the subject. However, I was curious about the Ebola Reston virus because in The Hot Zone they discussed how monkeys in different rooms that were connected by air ducts had become infected, leading them to say that it was airborne. My question was if anyone knew whether they believe the Reston virus was ALWAYS airborne, or if something changed/virus mutated along the way?

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Specializes in Anesthesia.

The Reston Virus was not proven to be airborne. It was thought to be airborne, but it could have been spread through the cleaning with high pressure hoses spreading fecal matter from one room to another. This goes back to those Ebola virus experiments. EBV of any kind has not been shown to be airborne. Animals with ebola when placed right next to noninfected animals did not transmit EBV when a plastic shield prevented any bodily fluid contamination even though they were still sharing the same air and were only 1 foot apart.

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Specializes in Emergency/Trauma/Critical Care Nursing.

Okay, thank you for answering my question :)

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I mean that the CDC still states that EBV is not airborne, and that taking things out of context to try to prove that EBV might be airborne shows nothing.

I don't understand what the source of the confusion is, here. However, to clarify, I never intended, by my statements, to assert that Ebola is airborne--quite the contrary.

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Article:

COMMENTARY: Ebola virus transmission via contact and aerosol — a new paradigm. R. M. Jones & L. M. Brosseau. November 18, 21014. CIDRAP.

http://www.cidrap.umn.edu/news-perspective/2014/11/commentary-ebola-virus-transmission-contact-and-aerosol-new-paradigm

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10:32 pm by wtbcrna, MSN, DNP, CRNA Guide

Quote from Bengal cat

Article:

COMMENTARY: Ebola virus transmission via contact and aerosol — a new paradigm. R. M. Jones & L. M. Brosseau. November 18, 21014. CIDRAP.

http://www.cidrap.umn.edu/news-persp...l-new-paradigm

I just read the article, and the authors discuss evidence.

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Specializes in Adult Internal Medicine.

Even the authors admit:

"Available data do not indicate that aerosol transmission at a distance from an infected person is an important route of Ebola virus transmission."

Sent from my iPhone.

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Specializes in Anesthesia.

10:32 pm by wtbcrna, MSN, DNP, CRNA Guide

Quote from Bengal cat

Article:

COMMENTARY: Ebola virus transmission via contact and aerosol — a new paradigm. R. M. Jones & L. M. Brosseau. November 18, 21014. CIDRAP.

http://www.cidrap.umn.edu/news-persp...l-new-paradigm

I just read the article, and the authors discuss evidence.

I read it too, and what they are discussing is theoretical speculation.

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