Toward a Level 4 Protocol for Ebola

Nurses COVID

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I've looked over the Ebola safety protocol for health care workers and was a little shocked.

Anyone who might be working with treating a patient in the future might try putting some gloves on at home, dipping them within a centimeter of their edge in paint, and trying to remove them without getting a single speck of paint on their skin using any protocol - not easy to do.

Comparing the health care protocol with the level 4 biohazard safety protocol for lab techs working with Ebola http://en.wikipedia.org/wiki/Biosafety_level#Biosafety_level_4 shows rather large gaps. To be fair, it would obviously be impractical to construct level 4 containment facilities in all hospitals by tomorrow. It would be reasonably easy, on the other hand, to start implementing some of the level 4 standards. Starting with:

- Positive pressure safety suits with a segregated air supply for health care workers

- UV light treatment, vacuuming, and showering in disinfectant solutions before suits are removed. (This would be analogous to washing paint off a glove that went all the way up your arm before removing it - not a speck of paint would hit your skin.)

Has anyone discussed something like this with hospital management? Are your suits on their way? If I were a nurse I'd get my own level 4 PPE and tell the staff they either let me use it or "I'm not going in there" as a form of self preservation, determination to win a war with a case of the disease, and extremely reasonable civil disobedience.

I'll research this more this evening.

We, as a nation, are just so ill prepared. Texas could have been any other hospital in the U.S. Emory and Nebraska have had 10 years to prepare for this, and have done a tremendous job treating Ebola patients. Why wouldn't we want to follow their protocol? I understand that they may have a lot more resources than the regular community hospital, but changes can be made to fit each hospitals specific needs. I was at an infection control meeting where we were discussing our ebola preparedness. I was told "we are following the CDC guidelines, with additional PPE." We are adding boot covers, and instead of traditional isolation gowns we are using surgical gowns because they cover the back. Whoopie! I just can't understand how the CDC puts guidelines out that WE are supposed to follow, yet they don't follow. I read that an ebola patient can expel 10-12 liters of fluids daily, yeah boot covers and surgical gowns are not going to protect me from sh*t, literally!

Sorry double post!

Specializes in RN CRRN.

Please everyone, refuse to go into or work with a patient with suspected ebola unless protected in better PPE. PPE to the level of Biosafety Level 4 scientists. Please insist we are all protected at least in a respirator with NO SKIN exposed. We deserve it as much as the CDC scientists deserve it who work in a Biosafety LEVEL 4 lab. They work with ebola in a petri dish. We may have it coming at us in a projectile manner. Refuse the just the

gown mask and face shield." It is NOT enough to protect us. Refuse to be put at risk, your families at risk. No skin exposed. Shower available.

The different levels of protection/PPE used in Biosafety labs. Short and informative. On the CDC site. Very informative!

CDC LC Quick Learn: Recognize the four Biosafety Levels

See what they wear and in what environment they work in on a biosafety level 4 pathogen. Check out the suit. They change clothes going in, shower coming out, wear a positive pressure suit (a suit-not a room). All work by them with the Safety equipment

  • All work with the microbe must be performed within an appropriate Class III BSC , or by wearing a full body, air-supplied, positive pressure suit.
  • "Class III BSC" which is defined as:

Class III BSC

A gas-tight sealed container that is designed to allow for the manipulation of objects, hazardous substances, or infectious disease agents. Class III BSCs have a HEPA filtered air supply and double HEPA filtered exhaust. They provide the ultimate protection for personnel, product, and the environment.

also http://www.cdc.gov/biosafety/publications/bmbl5/BMLB5sectIV.pdf

hope these links to CDC are allowed here...if not please delete and sorry!

Otherwise please share the links with your ICU and ER staff...give them the links to educate themselves. We can't just trust others to know what is best for us, what PPE is best for us. Where are these scientists who work with this? Shouldn't they be advocating for better PPE for us? I am sure they don't want us to be spreading this around their grocery stores or public restrooms where they can pick it up. How do we prevent an outbreak when we aren't fully protected - according to the CDC?

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