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EBOLA VIRUS DISEASE PREPAREDNESS
Screening, Detection & Planning
Assumptions
• P/SL will only have 1 potential Ebola patient at a time– With more than 1 patient the plan would be altered
• Ebola is transmitted through contact with infectious droplets and contact with body fluids
• Donning and doffing of PPE presents the highest risk of exposure to healthcare workers
• Limit staff and physicians in the room to essential personnel only
3
EBOLA BACKGROUND
Predominantly in West AfricaHIGH RISK Countries = Liberia, Sierra Leone, Guinea Medium Risk Countries = Democratic Republic of Congo (DRC), Republic of Congo (ROC), Uganda, Senegal, Gabon, Ivory Coast, South Sudan, NigeriaLow Risk= Other African countries
Understanding the GeographyPatients are screened for recent travel outside of the US. It’s important to know which areas of the world currently present the highest risk
Ebola Symptoms
Symptoms may appear from 2 to 21 days after exposure, average is 8 to 10 days.Initial Signs
– Fever (at least 100.4°F)– Weakness & exhaustion – Pain
• Severe headache• Muscles & joints• Abdominal pain
– Sore throat– Nausea– Dizziness
Ebola Transmission
Should I be concerned?
• HCA/HealthONE & PSL Leadership and Physicians are implementing best practices across the system.
• Our priority is the health and safety of our patients, employees, physicians, and the community.
• Anticipate additional communication, education and training as we continue to prepare
• The initial step of SCREENING & DETECTION is essential and your role is very important
First Point of Contact Infectious Disease Screening
• Patient registration staff all have infectious disease and Ebola risk screening questions on Meditech.
• Will immediately notify Infection Prevention and appropriate staff if patient screens positive for Ebola risk.
• Screening questions also in Meditech for nursing staff during assessment.
First Point of Contact Infectious Disease Screening
• Emergency Department Screening 100% of patients and visitors – Security completes screening form • If positive, Security contacts ED staff– Patient is masked– Asked to wait in wheelchair for ED staff
• If negative, form is given to patient or visitor
Levels of Isolation• Level 1 ( Possible Ebola):
– Airborne and Contact Isolation– Gown, gloves, N95
• Level 2* (Probable Ebola):– Impermeable gown– 3 layers of gloves– N95 or PAPR hood– Face shield– Surgical hood– Boot covers
*For patients with advanced disease including uncontrollable vomiting and diarrhea that cannot be contained use Tyvek suits with impervious apron and option of PAPR hood
If, at any time, a patient is deemed high risk for Ebola Virus, initiate Level II Isolation immediately.
Patient’s Infectious Disease Screen positive for travel history, exposure, and/or
symptoms
Put Patient in Level I isolation (contact &
airborne)
Page Infection Prevention through PBX
Travel history, exposures, onset date, symptoms,
and any pertinent clinical information
Infection Prevention to Call CDPHE
CDPHE to determine index of suspicion and
initiate testing
Infection Prevention to notify ED
Infection Prevention to initiate Level II
Isolation
R/O Ebola Not Ebola
House Supervisor AOC Physician Leadership
Notify:Receiving Unit
LabRadiology
EVSFANSRT
Other Related Departments
Evaluate need to activate Incident
Command
Notify Dr. Quach and Dr Terra
Provide
To Notify
If physician has high clinical
suspicion, initiate Level II Isolation
Location of Care
• All patients will be cared for in ICU setting– Ideal location equipped with:• Negative pressure room • Sink outside door to patient room• Anterooms no longer required or needed for negative
air pressure rooms due to more efficient design.
– Location isolated from other patients if possible– Locations may vary within hospitals.• All PSL patients will be in room 15 in the ICU with
dedicated equipment stored in room 14
Established Protocols for:
• Personal Protective Equipment ( PPE) donning and doffing
• Environmental cleaning• Waste management• Laboratory• Specimen Transport• Patient transport
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