"Houston we have a problem" This just got very real

Published

And so it begins....

A health care worker who treated Thomas Eric Duncan, the first person in the U.S. diagnosed with Ebola who later died, has preliminarily tested positive for the deadly virus, the Texas Department of State Health Services said in a statement today.

The health care worker at Texas Health Presbyterian Hospital has been isolated since reporting a low-grade fever Friday, the department said. The Centers for Disease Control and Prevention will conduct further testing to confirm the diagnosis.

"We knew a second case could be a reality, and we've been preparing for this possibility," Dr. David Lakey, commissioner of the Texas Department of State Health Services said in the statement. "We are broadening our team in Dallas and working with extreme diligence to prevent further spread."

http://abcnews.go.com/Health/texas-health-care-worker-tests-positive-ebola/story?id=26135108
Specializes in Critical Care.

How dare they blame the nurse when they give her inadequate equipment, a flimsy gown, mask. No respirator, no safety suit, her whole body wasn't even covered and then dealing with intubation and dialysis, and profuse body fluids. Too bad she can't sue them for putting her in this dangerous situation. As others have stated Ebola is a level 4 biohazard and should be met with a positive pressure hazmat body suit and respirator, even decontamination showers to make sure their is no virus on the suit before taking it off! They should be using the 4 hospitals in the country that have the necessary safety equipment. Also they were drilled and instructed before caring for the Ebola patients complete with a buddy system, unlike the rest of us. Even in Africa workers are sprayed down with bleach before taking off their safety equipment. A flimsy gown and mask just doesn't cut it! Also ending air travel to and from West Africa till this is contained is long overdue! What is this someone's idea of an experiment to see how Ebola would react in America. Why are we being put needlessly at risk! Also I don't want to worry about my pet being euthanised and my house being invaded to decontaminate it!

The govt should be paying hospitals to buy the hazmat suits and respirators for their staff and providing adequate training to protect us and the borders should be closed already so more people aren't needlessly exposed to Ebola in America! Honestly if I could afford to quit I would do so rather than be put in this position of risking my life with inadequate equipment and training. As long as the borders are open we will be at risk. I'm not worried about millions dying, I am worried about how many health care workers are going to die from this and how many others exposed between the Ebola patients and their healthcare workers. Now we have thousands of Americans in the military being exposed to Ebola and I wonder how many of them are going to need to be medivaced back to the states for treatment. It is only a matter of when and how many that remains to be seen!

I hope the National Nurses United are strong enough to get action throughout the countries hospitals since the govt and CDC haven't been of much use. The CDC telling people a simple mask and gown is enough! What a big fat lie! I would like to see the head of the CDC gowning up in a simple mask and gown taking care of these patients and see if he gets it? He knows damn well it is not safe and a gown and mask are not enough to protect us!

26 y/o female RN, BSN, CCRN. TX Christian University grad.

Lifting the lid on toilet plume aerosol:... [Am J Infect Control. 2013] - PubMed - NCBI Article re aerosolization from toilet flushing in hospital facilities.

Seems to me the toilet problem should have been fixed by now. The contaminant monitored in the studies was c. diff but seems like it is part of the reason for rampant spread of resistant bacteria. It doesn't seem like a huge leap to assume ebola would travel the same way, since it can reportedly be aerosolized by other methods.

It looks like CDC is not recommending the hazmat type suits for US hospitals, since they claim it is only necessary in the primitive conditions of some African clinics. When hospital acquired infections are such a concern in US hospitals, what makes us believe we can contain Ebola? Please forgive my ignorance, I'm a new nurse still trying to grasp seeming discrepancies in theory and practice.

This article on PICS, below, seems like a possible way to isolate potential ebola patients for triage prior to admission to a facility:

Portable Infection Control System: Mobile Medical Shelters for Surge Capabilities and Other Medical EmergenciesAkers∗, C. et al.

American Journal of Infection Control , Volume 32 , Issue 3 , E30

Specializes in psych. rehab nursing, float pool.
How dare they blame the nurse when they give her inadequate equipment, a flimsy gown, mask. No respirator, no safety suit, her whole body wasn't even covered and then dealing with intubation and dialysis, and profuse body fluids. Too bad she can't sue them for putting her in this dangerous situation. As others have stated Ebola is a level 4 biohazard and should be met with a positive pressure hazmat body suit and respirator, even decontamination showers to make sure their is no virus on the suit before taking it off! They should be using the 4 hospitals in the country that have the necessary safety equipment. Also they were drilled and instructed before caring for the Ebola patients complete with a buddy system, unlike the rest of us. Even in Africa workers are sprayed down with bleach before taking off their safety equipment. A flimsy gown and mask just doesn't cut it! Also ending air travel to and from West Africa till this is contained is long overdue! What is this someone's idea of an experiment to see how Ebola would react in America. Why are we being put needlessly at risk! Also I don't want to worry about my pet being euthanised and my house being invaded to decontaminate it!

The govt should be paying hospitals to buy the hazmat suits and respirators for their staff and providing adequate training to protect us and the borders should be closed already so more people aren't needlessly exposed to Ebola in America! Honestly if I could afford to quit I would do so rather than be put in this position of risking my life with inadequate equipment and training. As long as the borders are open we will be at risk. I'm not worried about millions dying, I am worried about how many health care workers are going to die from this and how many others exposed between the Ebola patients and their healthcare workers. Now we have thousands of Americans in the military being exposed to Ebola and I wonder how many of them are going to need to be medivaced back to the states for treatment. It is only a matter of when and how many that remains to be seen!

I hope the National Nurses United are strong enough to get action throughout the countries hospitals since the govt and CDC haven't been of much use. The CDC telling people a simple mask and gown is enough! What a big fat lie! I would like to see the head of the CDC gowning up in a simple mask and gown taking care of these patients and see if he gets it? He knows damn well it is not safe and a gown and mask are not enough to protect us!

I have not read anywhere where it says exactly what protective garmets this poor nurse was given to take care of the patient in the ICU in Texas . can you please enlightened us with the information that you have? thank you.
Specializes in Clinical Research, Outpt Women's Health.

How can it be the nurses fault if she doesn't remember a breach? I say it is the CDC's fault for not providing stronger guidance and support.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I have to say I have been a lurker on these boards for years, but now I have something to add to this conversation.

I am saddened by the number of nurses who are of the opinion that this ‘un-named nurse’ must have broken protocol to become infected with ebola. Sure, we all get lazy at times with isolation precautions- but it is when there is no chance of it being something that can kill our families, pets and ourselves.

This nurse, in my opinion, is a hero. She was assigned to the patient that is our worst nightmare. She was given isolation gear, and told that it would protect her, that she would be safe. She did her best to provide care and comfort to another human being who was dying a terrible death. And I know, if it was me, she was terrified for her entire shift. Yet, she did her job, she was a professional. Now, the whole world is criticizing her, and saying she must have made a mistake.

No one is looking at the manufacturer of the isolation gear- does it really provide the protection it promises? Has anyone looked at the memo that was probably sent out about how to deal with ebola? There is no mention of training that was offered to her before she was assigned to that patient.

The CDC says any hospital should be able to manage a patient with ebola- and in theory, that might be right. In reality nurses are working short staffed, extra shifts and with minimal supplies. Having another nurse to observe you while in isolation!! There isn’t even another nurse to cover for a bathroom break.

Ebola is here. It is the new reality. Pointing fingers, and blaming each other is not how we will survive this crisis. We need to share compassion and respect with each other.

I have not seen posts on this thread blaming the nurse for breaking protocol. I fact I have seen the opposite. I have seen posts calling her brave and posters being angry for her being thrown under the bus.

The thoughts about PPE was how dome staff members are lackadaisical about PPE... but posts blaming the nurse who is ill?.... I have not seen them on this thread.

However I am angry and friustrated at the CDC tossing the nurse under the bus. The hospital insists that protocol was followed. The CDC as of this mornig is "re-evaluating" about having the patients being handled at only certain facilities.

The thing is they just don't know.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
26 y/o female RN, BSN, CCRN. TX Christian University grad.
The nurse? You know her? Please tell her we think she is brave and are praying for her and her family (pet included).
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I have not read anywhere where it says exactly what protective garmets this poor nurse was given to take care of the patient in the ICU in Texas . can you please enlightened us with the information that you have? thank you.
Questions remain on how Dallas nurse got Ebola - CNN.com

A day after the Centers for Disease Control and Prevention said a Texas health care worker tested positive for Ebola, health officials are still trying to figure out how exactly she caught it.

There are few details that are known about what might have gone wrong. She wore a mask, gown, shield and gloves when treating Thomas Eric Duncan, who was in isolation at Texas Health Presbyterian Hospital, officials said.

But on Monday, Dr. Tom Frieden, director of the CDC, told reporters that it's still unknown how the infection occurred, only that a "breach in protocol" for treating a patient happened. CDC: We have to rethink Ebola protocols

Frieden said state and federal health officials are re-examining those protocols, including the removal of protective gear after contact with an Ebola patient and if it might be helpful to spray virus-killing solution on workers as they leave an isolation unit. He said Monday that the nurse is "clinically stable."

I love how they keep saying "she wore a mask, gloves, a gown" etc., super vague references but they don't list the type of PPE she had on in detail. Was it a surgical N95 mask? Was it sealed to her face? Was she triple gloved? Did she have a flimsy yellow gown on or was it like a TyChem gown that's coated so things can't seep through? Of course they're not going to give details, because then they won't be able to point the blame at the poor nurse who was just trying to do her job the best she could with what she had. I don't care who you are, if you're caring for an infectious disease patient, you don't just "forget" that they're ID and lapse on protocol. I'd bet she was so scared she made sure she did everything right. This nurse didn't fail, the hospital and CDC failed her. So sad.

Specializes in Critical Care.
The hospital personnel are not using HAZMAT suits from what I hear. But practice practice practice is key.

That's because we don't have hazmat suits! You can't wear what the hospital doesn't provide. They had better start buying some hazmat suits and respirators stat!

Specializes in Critical Care.
You are right on about our own vigilance with PPE. The nurse in Spain remembers one time when she brushed her gloved hand against her cheek. That was the transmission contact.

Let's be truthful now: how many times have you put on PPE to enter a contact room for say VRE in urine and because you "know" you're not touching urine, the gown is flopping open and you keep readjusting it, and you remove the PPE in whatever order gets you out of that hot mess as quickly as possible?

I see it everyday.

I just don't think nurses wouldn't pay attention when dealing with such a lethal disease where it is a known fact how many nurses and doctors have died from caring for Ebola. This is much more dangerous than VRE and MRSA or Hep C or HIV. You don't see healthcare workers getting infected let alone dying like you are seeing with Ebola! Even a needlestick has only a slight chance of infection! Ebola is not the same!

Specializes in Critical Care.
No, there's no confusion on the CDC's part. When the fluids become more copious or there are procedures where fluids might become aerosolized (ie: suctioning an intubated patient, dealing with high pressures such as dialysis...), the CDC does recommend further protection to include foot covers and N95 masks on top of eye protection and the regular contact and droplet precaution gear.

I don't want to use a N95 mask if dealing with Ebola. I want an actual respirator covering my whole face and a hazmat suit covering my whole body and nothing less!

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