[MCOH-EH] PPE for patients with Ebola virus disease
Harriman, Kathleen (CDPH-CID-DCDC-IMM)
Kathleen.Harriman at cdph.ca.gov
Wed Oct 15 13:31:16 PDT 2014
There was a CDC COCA call yesterday in which Emory and Nebraska discussed their experiences. Although they weren't completely clear about saying it, both centers are using PAPRs and Tyvek suits.
Dr. T. Warner Hudson, Medical Director of the UCLA Health System Occupational and Employee Health program took notes on the call and graciously permitted me to send his notes (see below).
The Emory group published a paper on the safe management of Ebola patients that is available at: http://annals.org/article.aspx?articleid=1906849
Slides from the call are available at: http://emergency.cdc.gov/coca/ppt/2014/10_14_14_preparing_for_ebola.pdf
Main Nebraska link:
http://blog.unmc.edu/heroes/2013/09/05/ilm-ppe-biological-level-c-doffing/
NE video link:
http://app1.unmc.edu/nursing/heroes/mpv.cfm?updateindex=53&src=yt
Minnesota Department of Health donning/doffing video and posters: http://www.health.state.mn.us/divs/idepc/dtopics/infectioncontrol/ppe/ppen95.html
Here are the notes from the call:
Pre hospital care Grady/Emory - Isakov
* Need extensive training in donning and doffing
* Decon, disinfection, ambulance and waste all supervised
* Know which hospitals can receive these patients
* Monitor EMS staff for 21 days after transporting Ebola patients
ICU care - Ribner Emory
* Annals Int Med 9/23/14 article (see link above)
* These patients are critically ill
* Need many specialties
* Only used ICU nurses
* Used whole body suits in ICUs; patients ill with fluids from many orifices
* Nurses in patient room 3-4 hours at a stretch
* Used hooded PAPRs
* All are observed in don and doff with check lists
Nebraska Smith and Hewlett
* Lead Ebola team - 2 ID docs, decon specialist, transport specialist, admin nurse is incident commander, lead nurse, education nurse, clinical studies specialist, media relations
* Incident Command post used many times a day for huddles near room
* 40 nurses/RTs/techs on ICU team, 6 on duty in unit with patient
* Used ICU nurses, Peds nurses, ED nurses, OR nurses
* Both Emory and Nebraska autoclave everything that leaves unit then to incinerator or laundry
* Toilet waste; quat ammonia 10 min dwell time then flush
* Wear rubber Crocs in unit and bleach bath after
* Need media relations involved
* Also had associate dean for clinical research to help with experimental drugs
* Check list on wall in unit
* Have family advocate for patient's family
* Extensive use of telemed - nurse station to ICU, family to ICU
* Need critical care medicine docs with ID input as lead and need help from experimental drugs, monitoring, anesthesia, nephrology
Q & A
* 10-12 quarts diarrhea/day
* If diarrhea, can use Tyvek suit for patient or ISOPOD
* Use boot covers, hard to remove so buddy does that
* 3-4 hours in suits worked for nurses
* Used vaporized H202 for cleaning room after
* HCP staff worked with patient - BID web based temp and 8-9 sxs check in log
* Enter to donning area naked; then scrubs, then don; same out and also shower before into street clothes
* Found no environmental Ebola virus in sampling
Kathleen Harriman
California Department of Public Health
kathleen.harriman at cdph.ca.gov
-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces+kathleen.harriman=cdph.ca.gov at mylist.net] On Behalf Of mcoh-eh-request at mylist.net
Sent: Wednesday, October 15, 2014 1:10 PM
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Subject: MCOH-EH Digest, Vol 247, Issue 26
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1. Re: MCOH-EH Digest, Vol 247, Issue 14 (Swift, Melanie)
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Message: 1
Date: Wed, 15 Oct 2014 20:09:36 +0000
From: "Swift, Melanie" <melanie.swift at Vanderbilt.Edu>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] MCOH-EH Digest, Vol 247, Issue 14
Message-ID:
<984BE23843F0DE4EBE652D6EE07600BE1D8E8016 at ITS-HCWNEM104.ds.vanderbilt.edu>
Content-Type: text/plain; charset="utf-8"
Many resources have been posted to the ACOEM Idea Marketplace. They are free and accessible to all ACOEM members.
Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic http://occupationalhealth.vanderbilt.edu
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Robinson, Geoffrey
Sent: Wednesday, October 15, 2014 2:34 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] MCOH-EH Digest, Vol 247, Issue 14
Cheryl,
There is also a good amount of info on the CT Dept of Public Health website. Our policies are a work in progress.
http://www.ct.gov/dph/cwp/view.asp?a=3115&Q=554408&PM=1
Geoff Robinson PAC
MedWorks - Bristol Hospital
Bristol CT 06010
(Phone) 860-589-0114
(Fax) 860-589-1936
grobinso at bristolhospital.org<mailto:grobinso at bristolhospital.org>
Connecticut Occupational Medicine Partners http://compllc.org/
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Kathy Dayvault
Sent: Wednesday, October 15, 2014 3:20 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] MCOH-EH Digest, Vol 247, Issue 14
WHO has provided a guide for HC workers regarding appropriate PPE when caring for patients suspected of being infevted with Ebola. I am sure Emory Healthcare in Atlanta Ga would also share best practices with you Kathy Dayvault RN BSN MPH COHN-S/CM Sent via the Samsung Galaxy Mega?, an AT&T 4G LTE smartphone
-------- Original message --------
From: "Marenick,Cheryl"
Date:10/15/2014 13:30 (GMT-06:00)
To: "'mcoh-eh at mylist.net'"
Subject: Re: [MCOH-EH] MCOH-EH Digest, Vol 247, Issue 14
I wish this group would weigh in on the Ebola issue here!
This has caught many facilities off guard and administration, IC, Epidemiology, are scrambling to produce effective policies and procedures for protecting HCW with this outbreak.
The fact that the information going form the CDC is conflicted and still evolving makes me uneasy as to what should be the most effective treatment, protection, and information we can give our employees and patients.
If the group has anything to share, it would be most appreciated.
Cheryl J Marenick RN BSN MPH CN3
UCONN Health
Occupational Medicine/Employee Health Services Farmington, CT 06033-6210 Ph (860)679-8327 Fx (860)679-1256 cmarenick at uchc.edu<mailto:cmarenick at uchc.edu>
-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of mcoh-eh-request at mylist.net<mailto:mcoh-eh-request at mylist.net>
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Today's Topics:
1. Ebola infected HCW (Band, Michael DO)
2. Re: Ebola infected HCW (Mark Catlin)
3. Re: Ebola infected HCW (Thrasher, Terri)
4. Re: Ebola infected HCW (Hudson, T. Warner)
5. Re: Ebola infected HCW (Johnson, Cathreen)
6. Re: Ebola infected HCW (Swift, Melanie)
----------------------------------------------------------------------
Message: 1
Date: Mon, 13 Oct 2014 17:30:58 -0400
From: "Band, Michael DO" <MBand at watsonclinic.com<mailto:MBand at watsonclinic.com>>
To: 'MCOH/EH' <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: [MCOH-EH] Ebola infected HCW
Message-ID: <4ADBC49F2610AB48BDED8CC66577A04103203FE43274 at Exchange07>
Content-Type: text/plain; charset="us-ascii"
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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Message: 2
Date: Mon, 13 Oct 2014 17:52:33 -0400
From: Mark Catlin <mark.catlin at seiu.org<mailto:mark.catlin at seiu.org>>
To: "MCOH/EH" <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Ebola infected HCW
Message-ID:
<CAEErhHAa2MKbbB4BcLTJDshmPXiPKeYqn3Qy0aKocXeiyjdqPg at mail.gmail.com<mailto:CAEErhHAa2MKbbB4BcLTJDshmPXiPKeYqn3Qy0aKocXeiyjdqPg at mail.gmail.com>>
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Thanks Michael for starting this discussion.
With the Ebola transmission to the nurse in Texas over the weekend, this issue requires discussion from groups like this one.
While some of our hospital employers are stepping up and trying to figure out the complex site specific procedures and policies to implement the CDC guidance for Ebola (or better), other hospitals are doing nothing or next to nothing to prepare. Without these site specific plans, no amount of training of front-line healthcare workers, no amount of care taken by workers or wearing of PPE will be effective.
Many lesson have been learned that could be useful to consider from those in the environmental field over the past 30 years regarding donning, wearing and working in and doffing of contaminated PPE and equipment.
I look forward to sharing good ideas and solutions and learning lessons from everyone.
Sincerely,
Mark Catlin
Health and Safety Director
SEIU
1800 Massachusetts Ave NW
Washington, DC 20036
(202) 730 - 7290
(202) 436 - 0856 cell
mark.catlin at seiu.org<mailto:mark.catlin at seiu.org>
On Mon, Oct 13, 2014 at 5:30 PM, Band, Michael DO <MBand at watsonclinic.com<mailto:MBand at watsonclinic.com>>
wrote:
> 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
>
> NOTICE OF CONFIDENTIALITY
> ---------------------------------------------------
>
> The information in this email, including attachments, may be
> confidential and/or privileged and may contain confidential health
> information.
> This email is intended to be reviewed only by the individual or
> organization named as addressee.
> If you have received this email in error please notify Watson Clinic
> immediately by return message to the sender or to
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> Destroy all copies of this message and any attachments.
> Please note that any views or opinions presented in this email are
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Message: 3
Date: Mon, 13 Oct 2014 22:51:01 +0000
From: "Thrasher, Terri" <Terri.Thrasher at cchmc.org<mailto:Terri.Thrasher at cchmc.org>>
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Ebola infected HCW
Message-ID:
<6D0F651D183C00439FDA321943976C13311FA20B at MCEXMB1.chmccorp.cchmc.org<mailto:6D0F651D183C00439FDA321943976C13311FA20B at MCEXMB1.chmccorp.cchmc.org>>
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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
NOTICE OF CONFIDENTIALITY
---------------------------------------------------
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This email is intended to be reviewed only by the individual or organization named as addressee.
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Destroy all copies of this message and any attachments.
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Message: 4
Date: Mon, 13 Oct 2014 22:58:32 +0000
From: "Hudson, T. Warner" <TWHudson at mednet.ucla.edu<mailto:TWHudson at mednet.ucla.edu>>
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Ebola infected HCW
Message-ID:
<2134A5387858914BBE80D079ECF6880C3BD476C2 at SOPEXMB2.ad.medctr.ucla.edu<mailto:2134A5387858914BBE80D079ECF6880C3BD476C2 at SOPEXMB2.ad.medctr.ucla.edu>>
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Same at UCLA; monitor for donning, use and doffing; 2:1 nurse: patient ratio; CAPRs (Maxair) in ICU care team, dedicated ebola team, and probably N95 for others in addition to the rest of the full PPE. I noticed WHO has convened a group of about a dozen top experts to relook a the science; as I recall Peter Piot is chairing it, and I see CDC is relooking at best approach: http://www.cidrap.umn.edu/news-perspective/2014/10/ebola-texas-nurse-triggers-changes-battle-plan. This is one of those things we need to get right and learn from what's not working as we want.
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<mailto:twhudson at mednet.ucla.edu%3cmailto:twhudson at mednet.ucla.edu>>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org<http://www.ohs.uclahealth.org%3chttp:/www.ohs.uclahealth.org>>
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Thrasher, Terri
Sent: Monday, October 13, 2014 3:51 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
NOTICE OF CONFIDENTIALITY
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The information in this email, including attachments, may be confidential and/or privileged and may contain confidential health information.
This email is intended to be reviewed only by the individual or organization named as addressee.
If you have received this email in error please notify Watson Clinic immediately by return message to the sender or to administrator at watsonclinic.com<mailto:administrator at watsonclinic.com<mailto:administrator at watsonclinic.com%3cmailto:administrator at watsonclinic.com>>
Destroy all copies of this message and any attachments.
Please note that any views or opinions presented in this email are solely those of the author and do not necessarily represent those of Watson Clinic.
Confidential health information is protected by state and federal law, including, but not limited to:
The Health Insurance Portability and Accountability Act of 1996 and related regulations.
________________________________
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.
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Message: 5
Date: Mon, 13 Oct 2014 21:52:47 -0700
From: "Johnson, Cathreen" <CaJohnson at coh.org<mailto:CaJohnson at coh.org>>
To: "MCOH/EH" <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Ebola infected HCW
Message-ID:
<E007BC030513A144987D5A41E3A1DC5555E963CBCB at EXCHMBX2.coh.org<mailto:E007BC030513A144987D5A41E3A1DC5555E963CBCB at EXCHMBX2.coh.org>>
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Hello,
Not sure about protocol with the list. May I forward these emails to my Infection Prevention team? Thank you for the discussion.
Thank you,
Cathreen Johnson FNPc
Employee Health
City of Hope
________________________________________
From: MCOH-EH [mcoh-eh-bounces+cajohnson=coh.org at mylist.net] On Behalf Of Hudson, T. Warner [TWHudson at mednet.ucla.edu]
Sent: Monday, October 13, 2014 3:58 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Ebola infected HCW
Same at UCLA; monitor for donning, use and doffing; 2:1 nurse: patient ratio; CAPRs (Maxair) in ICU care team, dedicated ebola team, and probably N95 for others in addition to the rest of the full PPE. I noticed WHO has convened a group of about a dozen top experts to relook a the science; as I recall Peter Piot is chairing it, and I see CDC is relooking at best approach: http://www.cidrap.umn.edu/news-perspective/2014/10/ebola-texas-nurse-triggers-changes-battle-plan. This is one of those things we need to get right and learn from what?s not working as we want.
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<mailto:twhudson at mednet.ucla.edu%3cmailto:twhudson at mednet.ucla.edu>>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org<http://www.ohs.uclahealth.org%3chttp:/www.ohs.uclahealth.org>>
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Thrasher, Terri
Sent: Monday, October 13, 2014 3:51 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
NOTICE OF CONFIDENTIALITY
---------------------------------------------------
The information in this email, including attachments, may be confidential and/or privileged and may contain confidential health information.
This email is intended to be reviewed only by the individual or organization named as addressee.
If you have received this email in error please notify Watson Clinic immediately by return message to the sender or to administrator at watsonclinic.com<mailto:administrator at watsonclinic.com<mailto:administrator at watsonclinic.com%3cmailto:administrator at watsonclinic.com>>
Destroy all copies of this message and any attachments.
Please note that any views or opinions presented in this email are solely those of the author and do not necessarily represent those of Watson Clinic.
Confidential health information is protected by state and federal law, including, but not limited to:
The Health Insurance Portability and Accountability Act of 1996 and related regulations.
________________________________
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.
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Message: 6
Date: Tue, 14 Oct 2014 11:30:22 +0000
From: "Swift, Melanie" <melanie.swift at Vanderbilt.Edu<mailto:melanie.swift at Vanderbilt.Edu>>
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Ebola infected HCW
Message-ID: <D903F772-4E2E-49D5-87D3-EFD062BBFC07 at Vanderbilt.Edu<mailto:D903F772-4E2E-49D5-87D3-EFD062BBFC07 at Vanderbilt.Edu>>
Content-Type: text/plain; charset="Windows-1252"
Yes, unless the person who shared expressly requests not to share. In which case they'd probably not post it!
Melanie Swift, MD
Medical Director, Vanderbilt Occupational Health Clinic occupationalhealth.vanderbilt.edu
Excuse any typos please - Sent from my iPad.
> On Oct 13, 2014, at 11:54 PM, Johnson, Cathreen <CaJohnson at coh.org<mailto:CaJohnson at coh.org>> wrote:
>
> Hello,
>
> Not sure about protocol with the list. May I forward these emails to my Infection Prevention team? Thank you for the discussion.
>
> Thank you,
>
> Cathreen Johnson FNPc
> Employee Health
> City of Hope
> ________________________________________
> From: MCOH-EH [mcoh-eh-bounces+cajohnson=coh.org at mylist.net] On Behalf
> Of Hudson, T. Warner [TWHudson at mednet.ucla.edu]
> Sent: Monday, October 13, 2014 3:58 PM
> To: MCOH/EH
> Subject: Re: [MCOH-EH] Ebola infected HCW
>
> Same at UCLA; monitor for donning, use and doffing; 2:1 nurse: patient ratio; CAPRs (Maxair) in ICU care team, dedicated ebola team, and probably N95 for others in addition to the rest of the full PPE. I noticed WHO has convened a group of about a dozen top experts to relook a the science; as I recall Peter Piot is chairing it, and I see CDC is relooking at best approach: http://www.cidrap.umn.edu/news-perspective/2014/10/ebola-texas-nurse-triggers-changes-battle-plan. This is one of those things we need to get right and learn from what?s not working as we want.
>
> 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<mailto:twhuds
> on at mednet.ucla.edu%3cmailto:twhudson at mednet.ucla.edu>>
> Website
> www.ohs.uclahealth.org<http://www.ohs.uclahealth.org<http://www.ohs.uc
> lahealth.org%3chttp:/www.ohs.uclahealth.org>>
>
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of
> Thrasher, Terri
> Sent: Monday, October 13, 2014 3:51 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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