CDC officials reiterated this week that chances are quite slim that a patient infected with the Ebola virus will appear at a U.S. health facility in need of care during a conference call to offer preparedness guidance to hospitals, physicians, and other caregivers.
Although patients who have recently returned from Ebola-stricken areas of west Africa with complaints of fever are more likely to be suffering from malaria or some other illness, “every emergency department should be prepared for this,” said Alexander P. Isakov, MD, MPH, Director, Prehospital and Disaster Medicine at Emory Healthcare.
There have been no diagnosed cases of Ebola in Massachusetts, said DPH Commissioner Cheryl Bartlett in a separate call for Massachusetts hospitals on Wednesday, but the reported infections of two Dallas health care workers who cared for an Ebola patient “makes us all anxious,” she said.
The state’s hospitals have been doing well in running drills and implementing proper procedures, she said. “The most important thing we can do is communicate, coordinate our efforts and learn from each other,” Bartlett said.
DPH Medical Director Al DeMaria, MD, said the responsibility for diagnosing and treating Ebola cannot be placed only on large medical centers. “We have to take care of these patients where they turn up,” he said. The Massachusetts state laboratory is one of 16 labs nationwide equipped to test for Ebola, and results can be obtained in 4-6 hours.
Comprehensive Initial Patient Screening – State and federal officials recommend health providers ask patients who present with possible symptoms of Ebola the following: “In the past three weeks, have you traveled outside the U.S. If so, where?”
If the patient has traveled to a location with an Ebola outbreak, he/she should be moved to a private room, and contact with other patients and staffers limited. Asking about travel history is a useful healthcare routine in general, said Dr. DeMaria “There are lots of diseases where travel can be a component.”
Prepare Your Staff – CDC officials recommend all health care staffers be briefed on proper infection-control procedures, and all facilities designate point persons to handle patients who could be at risk of Ebola. This limits possible protocol breaches, and unnecessary exposure to other staffers and patients.
Obtain Proper Equipment – The CDC recommends all facilities obtain an adequate amount of personal protective gear for staff, and all staff receive training on proper donning and doffing procedures. See CDC links to information on hospital preparedness.
Contact Public Health Officials – The DPH said providers with concerns or questions should consult local health authorities, or the DPH directly at its 24/7 Epidemiology Hotline at (617) 983-6800. More DPH Ebola online resources.
Communicate Ahead of Time with Your Vendors – Consider how you would transfer a possibly infectious patient, if needed. Officials recommend providers consider the following questions: Is your ambulance/transport company prepared to handle a patient possibly infected with Ebola? Are you able to conduct needed procedures safely and do you have a testing company with proper protocols in place?
Is your waste disposal company prepared to dispose of any medical waste related to the patient’s visit? These are questions that should be answered “before the first patient comes through the door” said Bruce S. Ribner, MD, MPH, Director, Emory’s Serious Communicable Disease Unit.
— Erica Noonan