[MCOH-EH] Ebola infected HCW

[Band, Michael DO]

What HCWs are doing is not working.  I see on TV every clean up person wearing full hazmat suit.  It seems wrong to me that someone cleaning an apartment has a higher level of PPE than HCW taking care of the patient.

It seems logical the full hazmat suit with papr would offer more protection along with double gloving.

Anyone using full hazmat suits?

Michael Band DO, MS

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Gwen Brachman
Sent: Wednesday, October 15, 2014 10:38 AM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] Ebola infected HCW

This is an evolving situation for all of us.

In our area (northern NJ) anyone coming into Newark airport (we are a NYC area airport with lots of international travel) from a high risk area will be screened by the State Health Dept. (I assume they will be checking travel from the past 3-4 weeks as there are no direct flights from high risk countries to Newark - all connect somewhere - usually someplace in Europe.  Anyone with symptoms will be taken to University Hospital (our hospital) for further evaluation and treatment.  Those without symptoms can go home, but will be monitored daily for 21 days for fever and other symptoms by the Health Department.

My understanding (as of Monday) was that two tents will be set up on an unused floor of one of our clinical buildings - not the hospital or near the ER.   These tents are basically decontamination tents - one to evaluate patients and the second for patients with confirmed ebola that need treatment.  Each tent has a clean area for donning PPE, patient area and dirty area (for doffing PPE).  Each tent has its own self-contained ventilation system.

HCWs returning from high risk areas who are asymptomatic will be allowed to work - with the above monitoring by the health department.  This may change.


Gwen Brachman MD

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Steivang, Kristen
Sent: Tuesday, October 14, 2014 8:23 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] Ebola infected HCW

Our local public health department says no healthcare work for 21 days after last exposure to Ebola patient and BID temperature monitoring.

Kristen

Kristen L. Steivang, MSN, RN, ANP-BC, APNP
Nurse Practitoner, Employee Health Services
St. Mary's Hospital
700 S. Park St.
Madison, WI 53715
Ph. 608-258-6995
Fax 608-259-3239

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From: MCOH-EH [mailto:mcoh-eh-bounces+kristen_steivang=ssmhc.com at mylist.net] On Behalf Of Giovannetti, Mary
Sent: Tuesday, October 14, 2014 7:16 AM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] Ebola infected HCW

Does anyone have guidance on your healthcare workers returning to work from mission trips to care for ebola patients?

Mary C Giovannetti, APRN, BC-FNP
Nurse Practitioner/Interim Manger | Employee Health

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853 North Church St, Suite 400 | Spartanburg, SC 29303
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e: mgiovannetti at srhs.com<mailto:mgiovannetti at srhs.com> | w: SpartanburgRegional.com<http://www.spartanburgregional.com/>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net]<mailto:[mailto:mcoh-eh-bounces at mylist.net]> On Behalf Of Thrasher, Terri
Sent: Monday, October 13, 2014 6:51 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Ebola infected HCW

At Cincinnati Children's we are planning double gloving so that one set of gloves is removed at the end of the doffing

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Band, Michael DO
Sent: Monday, October 13, 2014 5:31 PM
To: 'MCOH/EH'
Subject: [MCOH-EH] Ebola infected HCW

I thought I would start the discussion on this topic.  I am surprised how quiet we are.

Something about Ebola does not pass my "sniff test."  I have always been disturbed that HCWs have been infected from patient care in Africa and now one of our HCWs has become infected.  Are we missing something?

I told our committee reviewing Ebola planning I disagreed with the Ebola PPE removal process as recommended by CDC.  They recommend removing gloves first and then removing rest of PPE with bare hand.   Seems like double gloving or donning a new pair of gloves would be better, then last step removing second set of gloves.

Is the spread through contact source still apply? Are we missing something?

Michael Band DO, MS
Watson Clinic

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