[MCOH-EH] MCOH-EH Digest, Vol 247, Issue 48
KMccracken at mcleodhealth.org
KMccracken at mcleodhealth.org
Tue Nov 4 07:05:25 PST 2014
Armed security officers undergo this testing.
From:
<lafoster at bidmc.harvard.edu>
To:
<mcoh-eh at mylist.net>
Date:
11/04/2014 08:20 AM
Subject:
Re: [MCOH-EH] MCOH-EH Digest, Vol 247, Issue 48
Sent by:
"MCOH-EH" <mcoh-eh-bounces at mylist.net>
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
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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of
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Sent: Wednesday, October 22, 2014 6:22 PM
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Subject: MCOH-EH Digest, Vol 247, Issue 48
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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
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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
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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.
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To become a subscriber, or to change your subscription options (turn off
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