[MCOH-EH] MCOH-EH Digest, Vol 247, Issue 48

[lafoster at bidmc.harvard.edu]

Thank you, all for sharing your institutional practices.  Is anyone doing any psychological screening as part of the baseline assessment?

Thank you
Lisa

Lisa A. Foster, MS, ANP-BC
Clinical Director
Employee Occupational Health Services
Beth Israel Deaconess Medical Center
110 Francis St, Suite 6C
Boston, MA  02215
617-632-7805
2014-15 Flu Vacciniation Portal address:
https://portal.bidmc.org/Intranets/Clinical/Flu-and-Norovirus-Central-2014-2015/Flu/Vaccination/FormsAllLanguages.aspx



-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of mcoh-eh-request at mylist.net
Sent: Wednesday, October 22, 2014 6:22 PM
To: mcoh-eh at mylist.net
Subject: MCOH-EH Digest, Vol 247, Issue 48

Send MCOH-EH mailing list submissions to
        mcoh-eh at mylist.net

To subscribe or unsubscribe via the World Wide Web, visit
        http://mylist.net/listinfo/mcoh-eh
or, via email, send a message with subject or body 'help' to
        mcoh-eh-request at mylist.net

You can reach the person managing the list at
        mcoh-eh-owner at mylist.net

When replying, please edit your Subject line so it is more specific than "Re: Contents of MCOH-EH digest..."


Today's Topics:

   1. Re:  Medical clearance for Ebola PPE (Swift, Melanie)
   2. Re:  Medical clearance for Ebola PPE (Hudson, T. Warner)


----------------------------------------------------------------------

Message: 1
Date: Wed, 22 Oct 2014 21:55:54 +0000
From: "Swift, Melanie" <melanie.swift at Vanderbilt.Edu>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Medical clearance for Ebola PPE
Message-ID:
        <984BE23843F0DE4EBE652D6EE07600BE1D8FB6A9 at ITS-HCWNEM104.ds.vanderbilt.edu>

Content-Type: text/plain; charset="us-ascii"

In this particular application, other issues also come to mind. Insulin pumps could not be accessed, for example. Anyone with a condition causing urinary frequency or urgency would have difficulty. It reminds me very much of the BSL 4 containment requirements, where egress is delayed and people must be in the suits for long periods.

I've put calls in to Emory and NIH to see what they do for clearance.

Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic http://occupationalhealth.vanderbilt.edu

From: MCOH-EH [mailto:mcoh-eh-bounces+melanie.swift=vanderbilt.edu at mylist.net] On Behalf Of Shea, Joann
Sent: Wednesday, October 22, 2014 4:45 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Medical clearance for Ebola PPE

Here is ours...just a brief one page screening.     We are using the PAPRS with hoods and full body suit.   We are just doing a brief screening and our RN then meets with those with positive responses.  We had three HCWs who could not participate today.   They can elect to see the ARNP if they still want to participate so we can do additional testing and examination.

[TGH_employee health serv-color]
JoAnn Shea, ARNP, MS, COHN-S
Director, Employee Health and Wellness
P.O. Box 1289, Tampa, FL 33601  Mobile: 813-789-3441   Work: 813-844-7692  FAX: 813-844-8144



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Adamo, Philip
Sent: Wednesday, October 22, 2014 5:18 PM
To: MCOH/EH
Cc: MCOH/EH
Subject: Re: [MCOH-EH] Medical clearance for Ebola PPE

Hi Deb
I am at an Ebola task force meeting and just raised this issue. After listening to one of the physician training the nurses he expressed that many complain about being warm, sweaty and anxious. We must  be careful about applying a federal form on more than a respirator issue. My thoughts are:
1. Pregnant health care workers should not work in that PPE.
2. HCW with chronic skin conditions should not be expected to be in the PPE for extended times.
3. HCW with medical conditions that are at risk for dehydration should not work with that level of PPE 4. General question to ask prior to training is do you want to be evaluated by EHS?

At this time we are making this a volunteer based training.

I welcome others to contribute to this conversation.
Phil Adamo M.D.
UMass Memorial Health Care



Sent from my iPhone

On Oct 22, 2014, at 5:08 PM, "Foley MD, Deborah" <DFoley at NCH.ORG<mailto:DFoley at NCH.ORG>> wrote:
Is anyone developing a medical evaluation tool to help determine an employee's ability to work in the PPE recommended for Ebola patient care? We think that a nurse may be in the gear for up to a 4 hour shift. I am considering the long form respiratory questionnaire as a possibility. What are others thinking?

Thanks,
Deborah Foley MD
Employee Health and Safety
Northwest Community Healthcare
Arlington Heights IL
******************* PLEASE NOTE ******************* This E-Mail/telefax message and any documents accompanying this transmission may contain information that is privileged, confidential, and/or exempt from disclosure under applicable law and is intended solely for the addressee(s) named above. If you are not the intended addressee/recipient, you are hereby notified that any use of, disclosure, copying, distribution, or reliance on the contents of this E-Mail/telefax information is strictly prohibited and may result in legal action against you. Please reply to the sender advising of the error in transmission and immediately delete/destroy the message and any accompanying documents. Thank you.
---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): http://mylist.net/archives/mcoh-eh/
---------------------------------------
Send administrative requests to: drjoe at meditrax.com<mailto:drjoe at meditrax.com>
---------------------------------------
________________________________
The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material. Any review, transmission, re-transmission, dissemination or other use of, or taking of any action in reliance upon this information by persons or entities other than the intended recipient is prohibited. If you received this in error, please contact the sender and delete the material from any computer.
Unless otherwise indicated or obvious from the nature of the transmittal, the information contained in this message is privileged and/or confidential information intended solely for the use of the addressee. The information contained herein is protected by Federal and State laws. If the reader of this message is not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient, you are hereby notified that any unauthorized distribution, copying, review or printing of such information is strictly prohibited and may be unlawful. If you have received this communication in error, please advise the sender by reply e-mail and then delete the message and any attachments. Also notify Tampa General Hospital's Security Officer at cso at tgh.org<mailto:cso at tgh.org>.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://mylist.net/archives/mcoh-eh/attachments/20141022/f1a79d7b/attachment-0001.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: image001.jpg
Type: image/jpeg
Size: 5009 bytes
Desc: image001.jpg
URL: <http://mylist.net/archives/mcoh-eh/attachments/20141022/f1a79d7b/attachment-0001.jpg>

------------------------------

Message: 2
Date: Wed, 22 Oct 2014 22:21:47 +0000
From: "Hudson, T. Warner" <TWHudson at mednet.ucla.edu>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Medical clearance for Ebola PPE
Message-ID:
        <2134A5387858914BBE80D079ECF6880C3BD60C74 at SOPEXMB2.ad.medctr.ucla.edu>
Content-Type: text/plain; charset="us-ascii"

Not a bad idea. Some considerations as follows highlighted

Occupational Health Considerations: Working with HFV
                Preparation prior to caring for Ebola patients

*   Undergo PPE training (including donning and doffing PPE) and CAPR.

*   Review the possible impact of Ebola on your own health, especially for individuals with chronic diseases and / or taking medication.

*   Considerations include pregnancy, immune suppressing conditions and medications, difficulty donning and doffing PPE, poorly controlled seizures or narcolepsy, claustrophobia, planned surgery, chemotherapy, current illness which could be confused with Ebola.

*   Ensure vaccines are up to date; especially influenza

*   Train to provide care for Ebola patients wearing the correct personal protective equipment (PPE) and become proficient and comfortable with this.

*   Understand the travel restrictions for "known exposures and contacts" with Ebola patients.

*   Wear scrubs only under PPE.

                While on Ebola care duty

*   Your temperature will be checked twice daily and logged by Infection Prevention officer.

*   If temperature or any possible Ebola symptoms, or any potential exposure, contact Medical Director of Infection Prevention on call: Dr. XXXXX or Dr. XXXXXX)

*   Make a daily check in call to Occupational Health at xxxxxxxxxx while on Ebola Response Team duty.

                Preparation prior to returning to non-Ebola UCLA patient care duties

*         Undertake an "Exit Exposure Review" by Occupational Health officer.

*         Employees should be aware that current CDC guidelines indicate that asymptomatic persons with "Close Contact" (defined below) should not travel by commercial conveyance (airlines, ships, trains) for 21 days after last contact.

*         Healthcare workers in Ebola facilities who observe strict infection control measure with consistent and appropriate PPE use are not considered as having "close contact".

*         Brief interactions, such as walking by a person or through a hospital, do not constitute close contact.

*         For health care workers classified as "no known Ebola exposure", there will still be medical surveillance for 21 days as follows:

1.      Self-monitoring: daily symptom review and twice daily temperature check for 21 days following return from West Africa.

2.      Daily contact with local Occupational Health

3.      Notification of Infection Prevention on the presentation of any  symptoms.

*   Health care workers who appropriately use PPE in the presence of known cases should also understand the potential for risk that may arise from unprotected contact with asymptomatic, or individuals assumed ill with another disease, who develop EVD a few days later.

*   Medical surveillance during the 21 days following last exposure will include risk assessment for direct patient contact .  Decisions regarding fitness for duty will be locally determined and coordinated with local Infectious Disease and Infection Control hospital/clinic personnel, and based on characteristics of patient population, scope of services and setting of services provided by clinician.
Close contact is defined as

*   being within approximately 3 feet (1 meter) of an EVD patient or within the patient's room or care area for a prolonged period of time (e.g., health care personnel, household members) while not wearing recommended personal protective equipment (i.e., standard, droplet, and contact precautions; see Infection Prevention and Control Recommendations<http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html>); or

*   having direct brief contact (e.g., shaking hands) with an EVD patient while not wearing recommended personal protective equipment.

*   Individuals with brief interactions, such as walking by a person or moving through a hospital, do not constitute close contact and no travel restrictions apply, however should self-monitor for 21 days following last exposure.


T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health UCLA Health System and Campus Office 310.825.9146 Fax 310.206.4585 Pager 800.233.7231  ID 27132 E-mail twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org>

From: MCOH-EH [mailto:mcoh-eh-bounces+twhudson=mednet.ucla.edu at mylist.net] On Behalf Of Foley MD, Deborah
Sent: Wednesday, October 22, 2014 2:08 PM
To: 'MCOH/EH'
Subject: [MCOH-EH] Medical clearance for Ebola PPE

Is anyone developing a medical evaluation tool to help determine an employee's ability to work in the PPE recommended for Ebola patient care? We think that a nurse may be in the gear for up to a 4 hour shift. I am considering the long form respiratory questionnaire as a possibility. What are others thinking?

Thanks,
Deborah Foley MD
Employee Health and Safety
Northwest Community Healthcare
Arlington Heights IL
******************* PLEASE NOTE ******************* This E-Mail/telefax message and any documents accompanying this transmission may contain information that is privileged, confidential, and/or exempt from disclosure under applicable law and is intended solely for the addressee(s) named above. If you are not the intended addressee/recipient, you are hereby notified that any use of, disclosure, copying, distribution, or reliance on the contents of this E-Mail/telefax information is strictly prohibited and may result in legal action against you. Please reply to the sender advising of the error in transmission and immediately delete/destroy the message and any accompanying documents. Thank you.

________________________________

IMPORTANT WARNING: This email (and any attachments) is only intended for the use of the person or entity to which it is addressed, and may contain information that is privileged and confidential. You, the recipient, are obligated to maintain it in a safe, secure and confidential manner. Unauthorized redisclosure or failure to maintain confidentiality may subject you to federal and state penalties. If you are not the intended recipient, please immediately notify us by return email, and delete this message from your computer.
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://mylist.net/archives/mcoh-eh/attachments/20141022/346efeae/attachment.html>

------------------------------

Subject: Digest Footer

---------------------------------------
The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
List membership is free, but only subscribers may post to the list.
To post send messages to: mcoh-eh at mylist.net
To become a subscriber, or to change your subscription options (turn off email while you're on vacation, etc):   http://www.mcoh-eh.net
MediTrax / Occupational Health Systems, Inc. provides financial support to ensure the list remains a free resource for the occupational health community.
---------------------------------------
List archives (public): http://mylist.net/archives/mcoh-eh/
---------------------------------------
Send administrative requests to: drjoe at meditrax.com
---------------------------------------
When replying to a message, PLEASE delete all footers, and all messages to which you're NOT replying, so the topic of your reply is immediately clear to other list members.

------------------------------

End of MCOH-EH Digest, Vol 247, Issue 48
****************************************

This message is intended for the use of the person(s) to whom it may be addressed. It may contain information that is privileged, confidential, or otherwise protected from disclosure under applicable law. If you are not the intended recipient, any dissemination, distribution, copying, or use of this information is prohibited. If you have received this message in error, please permanently delete it and immediately notify the sender. Thank you.