[MCOH-EH] Does anyone have a furlough policy for HCW with potential exposure? Were the Dallas HCW's furloughed ?
Cassano Victoria
vcassano at bhs1.org
Fri Oct 17 11:46:01 PDT 2014
I am trying to draft up a post-exposure policy as well for employees.
I think for high risk exposure (needle stick etc:) to a known infectious patient, we may need to be a bit more conservative.
Finally, if the EE has kids/spouse; are they really going to want to go home and possibly infect their family??? I agree that they shouldn’t be working;
It is believed that someone is not contagious until they spike a fever, but some of the prior beliefs are being rethunk at this point.
I agree with them not working and being offered shower. Whether paid or earned time is used for furlough is an HR decision.
Any other thought out there?
Torie Cassano
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Angeli Mancuso
Sent: Friday, October 17, 2014 2:26 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Does anyone have a furlough policy for HCW with potential exposure? Were the Dallas HCW's furloughed ?
I’m finalizing my EH&S policy and hope to share by early next week.
However, I can tell you that employees with known unprotected exposure (before case is identified or after a break in PPE), will immediately be removed from work, offered a shower and a change of clothes and placed on a paid leave of absence. They will NOT be allowed to continue working. EH&S will do twice daily check-ins with this employee regarding symptoms. After 21 days, they will be returned to work. This is above the CDC recommendation that says employees can keep working (this recommendation was as of Monday; not sure if they’ve changed their stance now).
Employees who are assigned to care for these patients under the appropriate precautions will have symptoms monitored 2x per shift.
Should anyone come down with symptoms while at work, they will be removed from the patient care area, done mask/gown/gloves and are instructed to go directly to the unit that has been designated to care for these patients. Basically, they are now admitted to that unit for treatment. This would generally only apply to the employees who are working with those patients and during this care, we were not aware of a breech in PPE (unknown exposure). If we know about the exposure, the employee goes home immediately before symptoms start.
I haven’t read what Dallas did regarding pay but this is our plan.
Hope this helps. I’m so thankful for groups like this so we are not all inventing the same wheel in parallel.
Angeli Mancuso, RN, COHN-S/CM
Employee Health & Safety Manager
Cottage Health System
Ph: 805.569.7866/Internal Ext. 57866
Fax: 805.569.8271
a1mancus at sbch.org<mailto:a1mancus at sbch.org>
www.cottagehealthsystem.org<http://cp.mcafee.com/d/FZsSd6Qm4mnNRS1PxKVJd55BeZQn63qqabatXFTodFEEIFTKyU-rhKMYqenS66kjpCSQFIawEwjEzM04Sg9QhU02rd7eKLEIcfZvxPOr_nKnjpsLOb0V4tORQX8FGTd7afaxVZicHs3jq9IsUrLOb2rPUV5xcQsCXCM0lGPDF7OvWvcDgJivGY01MSJ4PgWXbwWOp0sCysHqFcLVcKgGT2TQ1iFo-l9Y3jrbUVZBYS2_id41Fr6N8c1sKd1sQKCy0eHZ3h1I2Rouq82uCvd46Cy1RK9ZmO9cQgblfBoIq87qNd40n4w5d41ykOpEwmHfUjBFVEwYfmHhKfAzh00LNYQgj9-q80XjPZEq80K90aq9W6y1RK9ZmO9fQ3h0idEEK6SkytI1r5>
“Hope is not a strategy.”
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Sparhawk, Dana MD
Sent: Thursday, October 16, 2014 1:29 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Does anyone have a furlough policy for HCW with potential exposure? Were the Dallas HCW's furloughed ?
I have been following this chain with great interest as I have been facing a lot of similar challenges and questions. My understanding in my state is the same as Mark’s regarding WC not applying to precautionary isolation. Aside from addressing the pay issues, I don’t see an answer to the original question of whether or not the HCW’s in Dallas were furloughed.
In light of the two nurses in Dallas this week, I have been asked by my hospital systems Ebola group to come up with a policy about what to do with a HCW who breaches or does not use appropriate PPE protocol when working with a suspected Ebola patient. Aside from 21 days of monitoring temps and symptoms, should they be allowed to continue working or place on mandatory furlough? What are others doing and has anyone developed such a policy?
Your thoughts are appreciated.
Thanks.
Dana
Dana Sparhawk, MD, MPH
Director, Lifespan Employee and Occupational Health Services
Clinical Assistant Professor, Alpert Medical School, Brown University
Grads Dorm, Rhode Island Hospital
593 Eddy Street
Providence, RI 02903
(401) 444-7412
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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net]<mailto:[mailto:mcoh-eh-bounces at mylist.net]> On Behalf Of Mark Catlin
Sent: Thursday, October 16, 2014 8:13 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] Were the Dallas HCW's furloughed ?
Thanks Deborah, my experience had been that state wc laws won't apply to precautionary isolation, until and if the disease develops. That was the reason the CA ATD standard included the pay and benefit protection provision.
Mark
SEIU
Sent from my iPhone
On Oct 16, 2014, at 7:58 AM, "Deborah Sampson" <dsampson at crhc.org<mailto:dsampson at crhc.org>> wrote:
So it looks like different w/c state laws will apply and also specific hospital decisions above and beyond state/fed laws. It is/will be so interesting to see how this all shakes out and how our policies/laws evolve about HCW rights.
I encourage us to look to the historical perspectives of the influenza epidemic of 1918 for examples of global and local social, economic, and medical effects of a wide epidemic. There are lessons to be learned- perhaps we haven't learned them. But deaths among nurse caregivers in that epidemic was huge.....
http://www.archives.gov/exhibits/influenza-epidemic/<http://cp.mcafee.com/d/avndy1J5x5BYttwsUrKrjhhpjLt5NwSCyyODuWtS3qqabatXEKfCQrIf6zBZxxB4SpJJar2Ea84W8Y01dA2t4u00CPhPHHWb33_nUsYC_RXBQSnbYyMeh7sJteOaqJPhOzOEuvkzaT0QSCr7e6XYyMCY-ehojd79KVI05Ir4V6vFN6FDf3Osy4FQOk7jS_waqnZqi7GOJxJq9CxRSn1RAO0Vd4VmRipvOpsxlK5LE2BiNYGjU6CSnNPXbVI5-Aq83iSdygo2Vsq2VFtd40tnW6y3o5GMYQg4Zc-q8dd43HsjWJAipEwmGvaNoQgeRyq80K90aq834FAPh0JmvMDbjPh1UuJmzsv96y01vzVEwCjYQg1SDDXgQg1si0kQjQd43HsjWJAivE6y0ArhhsdNsenqYbB>
http://www.flu.gov/pandemic/history/1918/<http://cp.mcafee.com/d/5fHCN0q4zqb2bbUWX0VMTsSCyyODuWbz1Jd55BeZQXI6QQkmkXThsvdEToud7bX33a9IPrqkS5gkg9QhU02r84W8Y01dCzDnnQm67-LMVVd_HTbFIKnV5wsyeVqWtAkRrCzB7BgY-F6lK1FJASesdTV5xdVYsyMCqejtPo09QZLydjebr13RpmMDaAWNboyqeknIdHhcQeKOUeICg79EDaSGjb-jbAaJMJZ0kGmfBiv0QSO-evpvdwLQzh0qmNIi30nbzgndbFEw3G_gQgr0Jm7Cy0DFDPh1FEwtryvlIyjd42RjVmb6y1SIjh05N81jh0oBcCq85GP-4Vquq8f3RGQrzV8Qg0bYvd44OvCy0eQY_q6y0byg2CyuxEwtryvlIyjZ0Qg4zqabxIvj53Bm6AE2o>
https://virus.stanford.edu/uda/<http://cp.mcafee.com/d/5fHCN0p3xASyMyO-eKMesdTdFEEIFTKyUMrjhhpjLteX1Jd55BeZQn7PqdS7zhO-MMOyrcSSBdxk542t4u00CO1eyf00jpEVRRZ5xx_HYeujvWZOWrbB-ho78zKmKDp5dmVEVhVkffGhBrwqrodzD3t-hojuv78I9CzATsSjDdqymopB5KDkDI7qNgXQ6YrgT3qQjd3HIK3H9A1Oq9OJGAO_AOV2Hsbvg5aBzVkDMddILzDSnPobZ8Qg6BIr4wM5OUQ5PiWq80WLQd46MblxVEw9WpYQgqq87mUDRr8APh0Jk-lyNEwtH4Qg1si0kQg69j9Cy1qI_xemDCy3MZqJ6U-id402_7Ph1cDVEw3JffSxEw2UA0FEDEq87mUDRr8A_gd418SyyUr1gMg00YXoC0>
Deb
Deborah A. Sampson, PhD, APRN,
FNP-BC, COHN-S, FAANP, NCRME
Concord Hospital
Occupational Health
60 Commercial Street
Concord NH 03301
Tel 603-230-1220
Fax 603-230-1225
>>> Mark Catlin <mark.catlin at seiu.org<mailto:mark.catlin at seiu.org>> 10/15/2014 8:36 PM >>>
Thanks. I've asked CalOSHA and they view it as a requirement under the ATD standard. The ATD only applies in California
Mark
(202) 436-0856 cell
Sent from my iPhone
On Oct 15, 2014, at 7:52 PM, Angeli Mancuso <a1mancus at sbch.org<mailto:a1mancus at sbch.org>> wrote:
Mark,
Wow! Thank you for reminding me to review the ATD standard for this. Some great nuggets so as not to reinvent the wheel completely.
However, I wonder if the interpretation below of “pay full pay and benefits” is correct. I’m reading the ATD standard (h) (8) (B)
• “Where the PLHCP recommends precautionary removal…the employer shall maintain until the employee is determined to me noninfectious, the employee’s earnings, seniority, and all other employee right and benefits, including the employee’s right to his or her former job status, as if the employee had not been removed from his or her job or otherwise medically limited.”
The red text is obviously my addition as I can see where this is interpreted to mean “paid during leave” but couldn’t you argue that the ATD standard is really just saying the exposed employee has to come back to their position at the same rate of pay?
It’s a moot point for us as our facility is planning for a paid leave due to historic instances when we had to “furlough” someone due to a varicella exposure with negative titers and no vaccination records. However, I wouldn’t want to make it sound like this is a mandate.
CHS is having numerous meetings tomorrow shoring up our policies. I’ll share what I can afterwards.
Regards,
Angeli
Angeli Mancuso, RN, COHN-S/CM
Employee Health & Safety Manager
Cottage Health System
Ph: 805.569.7866/Internal Ext. 57866
Fax: 805.569.8271
a1mancus at sbch.org<mailto:a1mancus at sbch.org>
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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Mark Catlin
Sent: Wednesday, October 15, 2014 3:06 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] Were the Dallas HCW's furloughed ?
Heard from CDC source that healthcare workers on precautionary isolation in Texas were not going to be paid for the 21 days by the hospital. In California, the Cal/OSHA Aerosol Transmittable Disease (ATD) standard, which specifically covers Ebola as a droplet spread disease) requires healthcare employers to pay full pay and benefits during such leave.
Mark
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 Wed, Oct 15, 2014 at 5:03 PM, Johnson, Nancy (Tacoma) <NancyJohnson at fhshealth.org<mailto:NancyJohnson at fhshealth.org>> wrote:
Does anyone know if the Dallas HCW's were furloughed while on a Temp. Monitoring Program?
Thank you
Nancy Johnson RN, BSN, COHN-S
Infection Prevention/Employee Health Manager
CHI Franciscan Health System
1717 S J St MS 01-47
Tacoma WA 98401
|
P 253-426-6411<tel:253-426-6411>| I 127-6411 |
nancyjohnson at fhshealth.org<mailto:nancyjohnson at fhshealth.org>
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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>] On Behalf Of mcoh-eh-request at mylist.net<mailto:mcoh-eh-request at mylist.net>
Sent: Wednesday, October 15, 2014 12:34 PM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: MCOH-EH Digest, Vol 247, Issue 25
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Today's Topics:
1. Re: MCOH-EH Digest, Vol 247, Issue 14 (Hawks, Denise J)
2. Re: MCOH-EH Digest, Vol 247, Issue 14 (Robinson, Geoffrey)
----------------------------------------------------------------------
Message: 1
Date: Wed, 15 Oct 2014 19:31:46 +0000
From: "Hawks, Denise J" <hawks.denise at marshfieldclinic.org<mailto:hawks.denise at marshfieldclinic.org>>
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] MCOH-EH Digest, Vol 247, Issue 14
Message-ID:
<99155EE5CCAAB14794DE52D9E34838BC038B497C at MCL-EXMB02.mfldclin.org<mailto:99155EE5CCAAB14794DE52D9E34838BC038B497C at MCL-EXMB02.mfldclin.org>>
Content-Type: text/plain; charset="us-ascii"
Let me know if you did not get it is a teleconference.
From: BHPP Medical Directors and Coordinators [mailto:BHPPGRANTEES at LIST.NIH.GOV<mailto:BHPPGRANTEES at LIST.NIH.GOV>] On Behalf Of Kunko, Nicole (OS/ASPR) (CTR)
Sent: Wednesday, October 15, 2014 12:16 PM
To: BHPPGRANTEES at LIST.NIH.GOV<mailto:BHPPGRANTEES at LIST.NIH.GOV>
Subject: TOMORROW: Call with Officials from the U.S. Department of Health & Human Services on Ebola Preparedness
Preparing America's Nurses to Safely Care for a Patient with Ebola
What: Conference call with nurses across the United States and officials from the U.S. Department of Health and Human Services to discuss protecting the health of nurses while safely caring for a patient with Ebola. Please share this invitation with members of your organization.
When: Thursday, October 16, 1:30 to 2:30 p.m. EDT
How: Dial-in: 1-888-395-7964<tel:1-888-395-7964>
Passcode: 6429111
Leaders from: HHS Assistant Secretary for Preparedness and Response
The Health Resources and Services Administration
The Centers for Disease Control and Prevention
Nicole Lurie, MD, MSPH Mary Wakefield, PhD, RN
Assistant Secretary for Preparedness and Response Administrator
US Department of Health & Human Services Health Resources and Services Administration
US Department of Health & Human Services
***This call is closed to the media***
________________________________________
CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation.
Dee Hawks System IC Mgr
Infection Prevention
IQIPS
75410
CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation.
-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces+hawks.denise<mailto:mcoh-eh-bounces%2Bhawks.denise>=marshfieldclinic.org at mylist.net<mailto:marshfieldclinic.org at mylist.net>] On Behalf Of Long, Deryl
Sent: Wednesday, October 15, 2014 2:31 PM
To: 'MCOH/EH'
Subject: Re: [MCOH-EH] MCOH-EH Digest, Vol 247, Issue 14
What is the link for this webinar?
Deryl Long, RN, COHN
Director of WellStar Employee Health Services
677 Church Street
Marietta, Georgia 30060
Office -770-793-7227<tel:770-793-7227>
Fax-770-793-7952<tel:770-793-7952>
Deryl.Long at Wellstar.org<mailto:Deryl.Long at Wellstar.org>
The Flu Ends with You! Get Vaccinated!
It's the right thing to do for our patients, our families, and our community.
-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces+deryl.long<mailto:mcoh-eh-bounces%2Bderyl.long>=wellstar.org at mylist.net<mailto:wellstar.org at mylist.net>] On Behalf Of Kim.Thompson at hcahealthcare.com<mailto:Kim.Thompson at hcahealthcare.com>
Sent: Wednesday, October 15, 2014 3:22 PM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] MCOH-EH Digest, Vol 247, Issue 14
This is the webinar tomorrow that I am aware of...same one?
Occupational Health Hot Topics: Ebola Update
Kim Thompson RN, BSN
Employee Health Nurse Manager
Medical Center of McKinney
4500 Medical Center Drive - MOB, Suite 105
McKinney, TX 75069
972- 540- 4218<tel:972-%20540-%204218> (phone)
469 - 713- 8660<tel:469%20-%20713-%208660> (fax)
-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>] On Behalf Of Hawks, Denise J
Sent: Wednesday, October 15, 2014 2:18 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] MCOH-EH Digest, Vol 247, Issue 14
We are an outpatient center with clinics everywhere in the central, north east and west of the state as well as Urgen Care and ASC's.
We have the same concerns with the CDC. I would customize the CDC hospital checklist to your facilities.
We have created a nurse line triage, Urgent Care situation algorithm, and a center algorithm.
Amb. Surgery care is asking have you had travel and do you have a fever.
Because it is unknown the actual transmission, we know it is contact and droplet however the body fluids Can also be aerosolized, we will be using N.95 masks and hoods.
I would say, do what it takes to protect your patients and staff. Call your HEICS team, incident command now Rather than later.
CDC website is good, just customize those areas that do not apply.
There is a nurse call with the CDC tomorrow, has everyone received this information?
I will send if not.
Dee Hawks RN MsM CIC
System Infection Prevention & Control Manager Institute for Quality, Innovation & Patient safety Marshfield Clinic Marshfield WI 54449
1-715-387-5410<tel:1-715-387-5410>
CONFIDENTIALITY NOTICE: This e-mail communication and any attachments may contain confidential and privileged information for the use of the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or its contents is prohibited. If you have received this communication in error, please notify the sender at the electronic mail address noted above and destroy all copies of this communication and any attachments. Thank you for your cooperation.
-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>] On Behalf Of Marenick,Cheryl
Sent: Wednesday, October 15, 2014 1:31 PM
To: 'mcoh-eh at mylist.net<mailto: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<tel:%28860%29679-8327> Fx (860)679-1256<tel:%28860%29679-1256> cmarenick at uchc.edu<mailto:cmarenick at uchc.edu>
-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>] On Behalf Of mcoh-eh-request at mylist.net<mailto:mcoh-eh-request at mylist.net>
Sent: Tuesday, October 14, 2014 7:31 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: MCOH-EH Digest, Vol 247, Issue 14
Send MCOH-EH mailing list submissions to
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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>>
Content-Type: text/plain; charset="utf-8"
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<tel:%28202%29%20730%20-%207290>
(202) 436 - 0856<tel:%28202%29%20436%20-%200856> 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
> ---------------------------------------------------
>
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> confidential and/or privileged and may contain confidential health
> information.
> This email is intended to be reviewed only by the individual or
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> ---------------------------------------
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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>>
Content-Type: text/plain; charset="us-ascii"
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<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<mailto: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.
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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: https://urldefense.proofpoint.com/v1/url?u=http://www.cidrap.umn.edu/news-perspective/2014/10/ebola-texas-nurse-triggers-changes-battle-plan&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=42278bba5dd9380185f5731d25b4906fe0efc257b4e813303defbaeca2aae28e<http://cp.mcafee.com/d/avndy1J5x5BYttwsUrKrjhhpjLt5NwSCyyODuWtS3qqabatXEKfCQrIf6zBZxxB4SpJJar2Ea84W8Y01dA2t4u00CPhPHHWb33_nUsYC_RXBQSnbYyMeh7sJteOaqJPhOzOEuvkzaT0QSyMr7e6XYyMCY-ehojd79KVIDeqR4INK9W7K_2DYJ6JnlGOxfBYcEUT4YASs02J92eHsSH3LgrO7Ca5RLzhrXjAp_4XEIozvf8lfQLfM_q5UdNFVusp4ifNEnIjS17W5O6PCvVto_od1045jwo18Eyc3oS30QwGbyhdkd8z1wOy0UZAe7IxM-UwQ40h4UGCc3QNCwQ60UayU5g3MCx84yUSG6gQDdxlmOEzEq30Myy5MiPci0CUZAe7T46ww25jwUbJJBg6mcwkfj6g92hwQsR2lnxuwj0E61kYg81MUrh2obA-0Uq70cc23M3zSgUvsgq208EsMCCeu84dvggd7bbRQnDTnNPaa2rV1wQsTst-_KSjv746fuhppKOxXF3vJGuXWrTCRECq7nps7mj83AQjBrl9B_9BO5mUm-walb7OFfwqrpv7fILCMnWhEwdboS91wbBNEbCBQQg1RvEq8dwmH3Ph0jQPVEwQQgeJNfGSh9Cy1qFYH5zh0Xm9Ew2UA0FEwciCjd42Rp_2sJfd47xWRqdNYAq805-fCy2pfPh07quvJ3h05N81jhfgQgeJNfGSh9-wq82hJ55MTC0Y8YWXiBXp>. 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<tel: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><https://urldefense.proofpoint.com/v1/url?u=http://mailto:twhudson%40mednet.ucla.edu&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=b97393e456f0fb11da2c8ec63589f6589f0d6b5a7a040b81c7773cf47d6f1b6d<http://cp.mcafee.com/d/FZsSczgs96Qm4mnNRS1PxKVJd55BeZQn63qqabatXFTodFEEIFTKyU-rhKMYqenS66kjpCSQFIawEwjEzM04Sg9QhU02rd7eKLEIcfZvxPOr_nKnjpsLOb0V4tORQX8FGTd7afaxVZicHs3jqbVIsUrLOb2rPUV5xcQsCXCOsVHkiP6UDEuXYavOQqRtmHa4-nMOzzsjOjpM0cjDlapwCSxiI1X5Rvg1LdSfTLgrq208aD0M2hh4o6NI61F1kn4yqEqh631B41NX8sfp3xZN1E80y9Nlco7Fzd1Ec1Ml5Maw7xd2g95NJkcxFer2GJBh7gQ61x54bwBCoA1dNX8sfK8d104aD1MnrrawcIp0EuCcwi4z1EVG4GL2Z0C1gc2FUwg3xMSy4Mn9Y1MQe0oo47w77IxM-UwQ40hgUwqehP9EVpZxZNSXF1553kXfvpNBZUQsKKfL6zBSW3x1_hSToKguhIe73CreI3A77ki3y1Jq9CxRSn1RAO0Vd4VmRipvOpsxlK5LE2BiNYGjU6CSnNPXbVI5-Aq83iSdygo2Vsq2VFtd40tnW6y3o5GMYQg4Zc-q8dd43HsjWJAipEwmGvaNoQgeRyq80K90aq834FAPh0JmvMDbjPh1UuJmzsv96y01vzVEwCjYQg1SDDXgQg1si0kQjQd43HsjWJAivE6y0ArhhsdzvO3D6tu>>
Website www.ohs.uclahealth.org<http://cp.mcafee.com/d/1jWVIq4zqb2bbUWX0VMTsSCyyODuWbz1Jd55BeZQXI6QQkmkXThsvdEToud7bX33a9IPrqkS5gkg9QhU02r84W8Y01dCzDnnQm67-LMVVd_HTbFIKnV5wsyeVqWtAkRrCzB7BgY-F6lK1FJ5MSesdTV5xdVYsyMCqejtPo0aFeDdSfQD-DP9Y01dHhcQeKOUeICg79EDaSGjb-jbAaJMJZ0kGmfBiv0QSO-evpvdwLQzh0qmNIi30nbzgndbFEw3G_gQgr0Jm7Cy0DFDPh1FEwtryvlIyjd42RjVmb6y1SIjh05N81jh0oBcCq85GP-4Vquq8f3RGQrzV8Qg0bYvd44OvCy0eQY_q6y0byg2CyuxEwtryvlIyjZ0Qg4zqabxK9pjnZsO><https://urldefense.proofpoint.com/v1/url?u=http://www.ohs.uclahealth.org/&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=9a926982d06cce88a3e4dde68e25c7749fce18852cb6be180dc0bc72035883e7<http://cp.mcafee.com/d/5fHCMUSyMyO-eKMesdTdFEEIFTKyUMrjhhpjLteX1Jd55BeZQn7PqdS7zhO-MMOyrcSSBdxk542t4u00CO1eyf00jpEVRRZ5xx_HYeujvWZOWrbB-ho78zKmKDp5dmVEVhVkffGhBrwqrh76NPxK_8I9LfzAm4PhOrKr9PCJhbcryuxXLMF_bhHlRqIEjVv3aedNf9dD00GAWsTo_ivWvcDM076ww22FMc0Akh61Ir1wqgl5N8CG6AhwMph0suO73SgUvsgq208yslj61WoPgq30s5hs2E1UjgA2hsrl38qjCMGHpkhQd1wohh2U9pC90jsuO73Xy3gg12FMs5SSOE3b6ga7Fz84x8MqeqxaHMLg9wk30Gu840UsdExc5Ov0sd3w6611U1NX8sfK8d104ked7eCzBdMQsL9EnsJrTDJpZx13T7LjvIe7c6zBSTELffFS8e4fhuKxqV2MVeXbXPPfzzqQjd3HIK3H9A1Oq9OJGAO_AOV2Hsbvg5aBzVkDMddILzDSnPobZ8Qg6BIr4wM5OUQ5PiWq80WLQd46MblxVEw9WpYQgqq87mUDRr8APh0Jk-lyNEwtH4Qg1si0kQg69j9Cy1qI_xemDCy3MZqJ6U-id402_7Ph1cDVEw3JffSxEw2UA0FEDEq87mUDRr8A_gd418SyyUr20V465NpGV4>>
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<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<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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------------------------------
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>>
Content-Type: text/plain; charset="windows-1252"
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<mailto:coh.org at mylist.net>] On Behalf Of Hudson, T. Warner [TWHudson at mednet.ucla.edu<mailto: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: https://urldefense.proofpoint.com/v1/url?u=http://www.cidrap.umn.edu/news-perspective/2014/10/ebola-texas-nurse-triggers-changes-battle-plan&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=42278bba5dd9380185f5731d25b4906fe0efc257b4e813303defbaeca2aae28e<http://cp.mcafee.com/d/avndxNJ5x5BYttwsUrKrjhhpjLt5NwSCyyODuWtS3qqabatXEKfCQrIf6zBZxxB4SpJJar2Ea84W8Y01dA2t4u00CPhPHHWb33_nUsYC_RXBQSnbYyMeh7sJteOaqJPhOzOEuvkzaT0QSyqejoVMTvAm4TDNOb2pEVdTdAVPmEBCdNfgZTUk_BERGWJmk9YLxB76UDACPw0lF8hRrCRotW3ugYNgKJYqbvqszfUDt5z4rVV2F-BV-7XgL1KdfbPz8yh-d2ZyuM8_gKgSsP_bH7X1E80wGs30954hwr6Mo6A5hsi9GxF4oc6kg77IxMZAe7T46ww28D5kNwuCcQ6wM71kn0G0u4Q90An6RgO6AVIaGSl4t3go64kgK2mpyg4T7IxM-UwQ40gGs71tJIG0ONA2xWoO18ic6zCEiGYbQ2o50MaDy10e73q8j1sDM73gU1xwgu0suO73Xy3gg153C4QNPN0xHW21EVpuKyY-W-ephgjv8c6zCXzLTZSOrUUwNXObbdSkft8rZJjTvjuYSJ4PgWXbwWOp0sCysHqFcLVcKgGT2TQ1iFo-l9Y3jrbUVZBYS2_id41Fr6N8c1sKd1sQKCy0eHZ3h1I2Rouq82uCvd46Cy1RK9ZmO9cQgblfBoIq87qNd40n4w5d41ykOpEwmHfUjBFVEwYfmHhKfAzh00LNYQgj9-q80XjPZEq80K90aq9W6y1RK9ZmO9fQ3h0idEEK6PuM62-WR>. 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><https://urldefense.proofpoint.com/v1/url?u=http://mailto:twhudson%40mednet.ucla.edu&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=b97393e456f0fb11da2c8ec63589f6589f0d6b5a7a040b81c7773cf47d6f1b6d<http://cp.mcafee.com/d/FZsS93gsrhohpv7no7e6XCQQkmkXThsodFEEIFTKDtwSCyyODuWbzVJ6X3NEVvoophdCrriCMG2y1eyf00jp0Dh7w09IQsWW-yMM_R-7f9LZuVtdBO_8I3AhTbnjIyCHsQsEYG7DR8OJMddFTdzD3t-hojuv78I9CzATsSjDdqymoT4Z3Tvxj-mzmHGRpgDO-6ksryuire01ysWFjc4SQalwfoKHW0dVKN-ZW3rgg11kU60ia8z0SdwMd8ayUAjl3i8MocEwefp3xX8sfK8d104heaFz0ZcpEd1we2EK1k0Y9Ei18KdGxAd9PollIG8W6wMc8Exs4IP4w9Kfp3xZN1E80xkUe2Xrpk1Bz853QNA2gAod7dgBlUnE4Ma1wlf420se6QgC2Vfwe6xM330wY0UZAe7T46ww2a743hOepd7bfIfKeTt88EEqDpXXecLL6zBRNZUQsKTgs8fWeSX5O3OdxMUsPpRwswUWygsgdHhcQeKOUeICg79EDaSGjb-jbAaJMJZ0kGmfBiv0QSO-evpvdwLQzh0qmNIi30nbzgndbFEw3G_gQgr0Jm7Cy0DFDPh1FEwtryvlIyjd42RjVmb6y1SIjh05N81jh0oBcCq85GP-4Vquq8f3RGQrzV8Qg0bYvd44OvCy0eQY_q6y0byg2CyuxEwtryvlIyjZ0Qg4zqabxIA6e7BGF>>
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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<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<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<mailto: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<http://cp.mcafee.com/d/FZsSczgwrhohpv7no7e6XCQQkmkXThsodFEEIFTKDtwSCyyODuWbzVJ6X3NEVvoophdCrriCMG2y1eyf00jp0Dh7w09IQsWW-yMM_R-7f9LZuVtdBO_8I3AhTbnjIyCHsQsEYG7DR8OJMddFICNPxK_8I9LfzAm4PhOrKr01RJpJrpOH3jOvWvcDNDo8v4x8-vuwSrmypEttBMtpcwejhelJkCnYCn8lrxrW0FkIvaA-1FJBYs-O-r1vF6y0QJzoA60Kn6wKqnjh07l-xEwS1qIfd41fjfCy3jh0WT4-Hp4Cq85GDOImd43JoCy0byg2Cy0NapcQgblDY9OQYQgu7HlET7OhEw0nU-q89A_d40tFV-Qd40n4w5d4Z3h0WT4-Hp4DW1Ew96Qkn3qnqzdbG_BxZ>
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<mailto:coh.org at mylist.net>] On Behalf
> Of Hudson, T. Warner [TWHudson at mednet.ucla.edu<mailto: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: https://urldefense.proofpoint.com/v1/url?u=http://www.cidrap.umn.edu/news-perspective/2014/10/ebola-texas-nurse-triggers-changes-battle-plan&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=42278bba5dd9380185f5731d25b4906fe0efc257b4e813303defbaeca2aae28e<http://cp.mcafee.com/d/k-Kr6hEqdEI8ILzHI3D3tPqqabatXEKc6QQkmkXTjKMrjhhpjLt5NYSztxUQsLIccECPdJFjol1h0Dh7w09IwjEzM04SqettvhoovW_3DAT-LsKCOVvAm1O8XBHFShjlKqekul3PWApmU6CQS3oVMTvAm4TDNOb2pEVdTdAVPmEBCdNfgZTUk_BERGWJmk9YLxB76UDACPw0lF8hRrCRotW3ugYNgKJYqbvqszfUDt5z4rVV2F-BV-7XgL1KdfbPz8yh-d2ZyuM8_gKgSsP_bH7X1E80wGs30954hwr6Mo6A5hsi9GxF4oc6kg77IxMZAe7T46ww28D5kNwuCcQ6wM71kn0G0u4Q90An6RgO6AVIaGSl4t3go64kgK2mpyg4T7IxM-UwQ40gGs71tJIG0ONA2xWoO18ic6zCEiGYbQ2o50MaDy10e73q8j1sDM73gU1xwgu0suO73Xy3gg153C4QNPN0xHW21EVpuKyY-W-ephgjv8c6zCXzLTZSOrUUwNXObbdSkft8rZJjTvjuYSJ4PgWXbwWOp0sCysHqFcLVcKgGT2TQ1iFo-l9Y3jrbUVZBYS2_id41Fr6N8c1sKd1sQKCy0eHZ3h1I2Rouq82uCvd46Cy1RK9ZmO9cQgblfBoIq87qNd40n4w5d41ykOpEwmHfUjBFVEwYfmHhKfAzh00LNYQgj9-q80XjPZEq80K90aq9W6y1RK9ZmO9fQ3h0idEEK6VJl2i20b3QKm>. 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><https://urldefense.proofpoint.com/v1/url?u=http://mailto:twhudson%40mednet.ucla.edu&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=b97393e456f0fb11da2c8ec63589f6589f0d6b5a7a040b81c7773cf47d6f1b6d<http://cp.mcafee.com/d/2DRPosrhohpv7no7e6XCQQkmkXThsodFEEIFTKDtwSCyyODuWbzVJ6X3NEVvoophdCrriCMG2y1eyf00jp0Dh7w09IQsWW-yMM_R-7f9LZuVtdBO_8I3AhTbnjIyCHsQsEYG7DR8OJMddFLCNPxK_8I9LfzAm4PhOrKr9PCJhbcryuxXLMF_bhHlRqIEjVv3aedNf9dD00NetkFC2rq5aM7InlZ06YTo_uZ1JE80wGs30954hwr6Mo6A5hsi9GxF4oc6kg77IxMZAe7T46ww28D5kNwuCcQ6wM71kn0G0u4Q90An6RgO6AVIaGSl4t3go64kgK2mpyg4T7IxM-UwQ40gGs71tJIG0ONA2xWoO18ic6zCEiGYbQ2o50MaDy10e73q8j1sDM73gU1xwgu0suO73Xy3gg153y1EV7cCzBDS7T7rKA4kkdjIZZD6nTzhOWU-YqenrEe47Z7rtyV1V6MUsepIWMegsth8e86RECq7nps7mj83AQjBrl9B_9BO5mUm-walb7OFfwqrpv7fILCMnWhEwdboS91wbBNEbCBQQg1RvEq8dwmH3Ph0jQPVEwQQgeJNfGSh9Cy1qFYH5zh0Xm9Ew2UA0FEwciCjd42Rp_2sJfd47xWRqdNYAq805-fCy2pfPh07quvJ3h05N81jhfgQgeJNfGSh9-wq82hJ55MSpEYOb3cyuAk>>
> Website www.ohs.uclahealth.org<http://cp.mcafee.com/d/avndygw86Qm4mnNRS1PxKVJd55BeZQn63qqabatXFTodFEEIFTKyU-rhKMYqenS66kjpCSQFIawEwjEzM04Sg9QhU02rd7eKLEIcfZvxPOr_nKnjpsLOb0V4tORQX8FGTd7afaxVZicHs3jqrxIsUrLOb2rPUV5xcQsCXCM0literIvFfZfCjU02rmypEttBMtpcwejhelJkCnYCn8lrxrW0FkIvaA-1FJBYs-O-r1vF6y0QJzoA60Kn6wKqnjh07l-xEwS1qIfd41fjfCy3jh0WT4-Hp4Cq85GDOImd43JoCy0byg2Cy0NapcQgblDY9OQYQgu7HlET7OhEw0nU-q89A_d40tFV-Qd40n4w5d4Z3h0WT4-Hp4DW1Ew96Qkn3urak><https://urldefense.proofpoint.com/v1/url?u=http://www.ohs.uclahealth.org/&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=9a926982d06cce88a3e4dde68e25c7749fce18852cb6be180dc0bc72035883e7<http://cp.mcafee.com/d/k-Kr6jqb2bbUWX0VMTsSCyyODuWbz1Jd55BeZQXI6QQkmkXThsvdEToud7bX33a9IPrqkS5gkg9QhU02r84W8Y01dCzDnnQm67-LMVVd_HTbFIKnV5wsyeVqWtAkRrCzB7BgY-F6lK1FJcsr7e6XYyMCY-ehojd79KVIDeqR4INK9W7K_2DYJ6JnlGOxfBYcEUT4YASs02GjFPtzZ9_FYOv00sq208aD0M2hh4o6NI61F1kn4yqEqh631B41NX8sfp3xZN1E80y9Nlco7Fzd1Ec1Ml5Maw7xd2g95NJkcxFer2GJBh7gQ61x54bwBCoA1dNX8sfK8d104aD1MnrrawcIp0EuCcwi4z1EVG4GL2Z0C1gc2FUwg3xMSy4Mn9Y1MQe0oo47w77IxM-UwQ40hgUQsWqekT3hOYCxtORLuuRDS44fsuZd-MUsMqenruyYY-DowUgZ5WW5HAb3AXILLfc-edHhcQeKOUeICg79EDaSGjb-jbAaJMJZ0kGmfBiv0QSO-evpvdwLQzh0qmNIi30nbzgndbFEw3G_gQgr0Jm7Cy0DFDPh1FEwtryvlIyjd42RjVmb6y1SIjh05N81jh0oBcCq85GP-4Vquq8f3RGQrzV8Qg0bYvd44OvCy0eQY_q6y0byg2CyuxEwtryvlIyjZ0Qg4zqabxJ3Wb>>
>
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<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<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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End of MCOH-EH Digest, Vol 247, Issue 14
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------------------------------
Message: 2
Date: Wed, 15 Oct 2014 19:34:02 +0000
From: "Robinson, Geoffrey" <GRobinso at bristolhospital.org<mailto:GRobinso at bristolhospital.org>>
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] MCOH-EH Digest, Vol 247, Issue 14
Message-ID:
<E6D8665BC5B13B4282CC3F248D3D48E2F1C918C6 at BRH6624M1.BHAD.org<mailto:E6D8665BC5B13B4282CC3F248D3D48E2F1C918C6 at BRH6624M1.BHAD.org>>
Content-Type: text/plain; charset="utf-8"
Cheryl,
There is also a good amount of info on the CT Dept of Public Health website. Our policies are a work in progress.
https://urldefense.proofpoint.com/v1/url?u=http://www.ct.gov/dph/cwp/view.asp?a%3D3115%26Q%3D554408%26PM%3D1&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=26a507a1e41afa1bc681305279dc5d8f1ea6cbda4a86850066860fb63de694df<http://cp.mcafee.com/d/avndzgQrhohpv7no7e6XCQQkmkXThsodFEEIFTKDtwSCyyODuWbzVJ6X3NEVvoophdCrriCMG2y1eyf00jp0Dh7w09IQsWW-yMM_R-7f9LZuVtdBO_8I3AhTbnjIyCHsQsEYG7DR8OJMddIndzD3t-hojuv78I9CzATsSjDdqymoT4Z3Tvxj-mzmHGRpgDO-6ksryuire01mDN6FD45yumcbopBVzwuiQuO7cEELzQT077IxPXX35TxWrwm6NX8syQ40gle1w4yy8Mdzoc3i2EK94RgQyc63a83zSgUuO73Xy3gg14jyGoMfj6q3go3wGbwl0f2q4wibzqEp3isS5lrayexEc32a8n1bcN82rzSgUvsgq208le3wKSSl0poO1gZcp0A963hPk9lu5W1c2wo5jN0w73xJ49wKjU3xEs0MM8f0efp3xZN1E80yxOrCLT7qzX2eKWygIUYyPtZcsqekbfEfeE_HBy26IqYUY_uXzzPBTi3za7K6zBx1QSJ4PgWXbwWOp0sCysHqFcLVcKgGT2TQ1iFo-l9Y3jrbUVZBYS2_id41Fr6N8c1sKd1sQKCy0eHZ3h1I2Rouq82uCvd46Cy1RK9ZmO9cQgblfBoIq87qNd40n4w5d41ykOpEwmHfUjBFVEwYfmHhKfAzh00LNYQgj9-q80XjPZEq80K90aq9W6y1RK9ZmO9fQ3h0idEEK6U4xc>
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><mailto:grobinso at bristolhospital.org<mailto:grobinso at bristolhospital.org>>
Connecticut Occupational Medicine Partners
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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<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<mailto: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-----
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Subject: MCOH-EH Digest, Vol 247, Issue 14
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When replying, please edit your Subject line so it is more specific than "Re: Contents of MCOH-EH digest..."
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>>
Content-Type: text/plain; charset="utf-8"
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
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> Watson Clinic.
> Confidential health information is protected by state and federal law,
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> The Health Insurance Portability and Accountability Act of 1996 and
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>
> ---------------------------------------
> The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
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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>>
Content-Type: text/plain; charset="us-ascii"
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<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.
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<mailto: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.
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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: https://urldefense.proofpoint.com/v1/url?u=http://www.cidrap.umn.edu/news-perspective/2014/10/ebola-texas-nurse-triggers-changes-battle-plan&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=42278bba5dd9380185f5731d25b4906fe0efc257b4e813303defbaeca2aae28e<http://cp.mcafee.com/d/5fHCN0i6xAqdEI8ILzHI3D3tPqqabatXEKc6QQkmkXTjKMrjhhpjLt5NYSztxUQsLIccECPdJFjol1h0Dh7w09IwjEzM04SqettvhoovW_3DAT-LsKCOVvAm1O8XBHFShjlKqekul3PWApmU6CS7zoVMTvAm4TDNOb2pEVdTdAVPmEBCdNfgZTUk_BERGWJmk9YLxB76UDACPw0lF8hRrCRotW3ugYNgKJYqbvqszfUDt5z4rVV2F-BV-7XgL1KdfbPz8yh-d2ZyuM8_gKgSsP_bH7X1E80wGs30954hwr6Mo6A5hsi9GxF4oc6kg77IxMZAe7T46ww28D5kNwuCcQ6wM71kn0G0u4Q90An6RgO6AVIaGSl4t3go64kgK2mpyg4T7IxM-UwQ40gGs71tJIG0ONA2xWoO18ic6zCEiGYbQ2o50MaDy10e73q8j1sDM73gU1xwgu0suO73Xy3gg153C4QNPN0xHW21EVpuKyY-W-ephgjv8c6zCXzLTZSOrUUwNXObbdSkft8rZJjTvjuYSJ4PgWXbwWOp0sCysHqFcLVcKgGT2TQ1iFo-l9Y3jrbUVZBYS2_id41Fr6N8c1sKd1sQKCy0eHZ3h1I2Rouq82uCvd46Cy1RK9ZmO9cQgblfBoIq87qNd40n4w5d41ykOpEwmHfUjBFVEwYfmHhKfAzh00LNYQgj9-q80XjPZEq80K90aq9W6y1RK9ZmO9fQ3h0idEEK6_70iQ7unnTz>. 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><https://urldefense.proofpoint.com/v1/url?u=http://mailto:twhudson%40mednet.ucla.edu&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=b97393e456f0fb11da2c8ec63589f6589f0d6b5a7a040b81c7773cf47d6f1b6d<http://cp.mcafee.com/d/avndy1J5x5BYttwsUrKrjhhpjLt5NwSCyyODuWtS3qqabatXEKfCQrIf6zBZxxB4SpJJar2Ea84W8Y01dA2t4u00CPhPHHWb33_nUsYC_RXBQSnbYyMeh7sJteOaqJPhOzOEuvkzaT0QSMqejoVMTvAm4TDNOb2pEVdTdAVPmEBCdNfgZTUk_BERGWJmk9YLxB76UDACPw0oDeGkP1dJ2Bo3SbG-w3urIvLuwSQ40gle1w4yy8Mdzoc3i2EK94RgQyc63a83zSgUuO73Xy3gg14jyGoMfj6q3go3wGbwl0f2q4wibzqEp3isS5lrayexEc32a8n1bcN82rzSgUvsgq208le3wKSSl0poO1gZcp0A963hPk9lu5W1c2wo5jN0w73xJ49wKjU3xEs0MM8f0efp3xZN1E80yxN0QszCjhOPX3XzJTi2aa6FSu-PzbXNEVtsvud7bJQ723-zJKNswYzose7cSto78eeEA743qQjd3HIK3H9A1Oq9OJGAO_AOV2Hsbvg5aBzVkDMddILzDSnPobZ8Qg6BIr4wM5OUQ5PiWq80WLQd46MblxVEw9WpYQgqq87mUDRr8APh0Jk-lyNEwtH4Qg1si0kQg69j9Cy1qI_xemDCy3MZqJ6U-id402_7Ph1cDVEw3JffSxEw2UA0FEDEq87mUDRr8A_gd418SyyUr9YXI>>
Website www.ohs.uclahealth.org<http://cp.mcafee.com/d/1jWVIpdEI8ILzHI3D3tPqqabatXEKc6QQkmkXTjKMrjhhpjLt5NYSztxUQsLIccECPdJFjol1h0Dh7w09IwjEzM04SqettvhoovW_3DAT-LsKCOVvAm1O8XBHFShjlKqekul3PWApmU6CTXCNPxK_8I9LfzAm4PhOrKr01l9QVKN-A_Q-pfw09Jq9CxRSn1RAO0Vd4VmRipvOpsxlK5LE2BiNYGjU6CSnNPXbVI5-Aq83iSdygo2Vsq2VFtd40tnW6y3o5GMYQg4Zc-q8dd43HsjWJAipEwmGvaNoQgeRyq80K90aq834FAPh0JmvMDbjPh1UuJmzsv96y01vzVEwCjYQg1SDDXgQg1si0kQjQd43HsjWJAivE6y0ArhhsdDkl_><https://urldefense.proofpoint.com/v1/url?u=http://www.ohs.uclahealth.org/&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=9a926982d06cce88a3e4dde68e25c7749fce18852cb6be180dc0bc72035883e7<http://cp.mcafee.com/d/2DRPosrhohpv7no7e6XCQQkmkXThsodFEEIFTKDtwSCyyODuWbzVJ6X3NEVvoophdCrriCMG2y1eyf00jp0Dh7w09IQsWW-yMM_R-7f9LZuVtdBO_8I3AhTbnjIyCHsQsEYG7DR8OJMddLECNPxK_8I9LfzAm4PhOrKr9PCJhbcryuxXLMF_bhHlRqIEjVv3aedNf9dD00GAWsTo_ivWvcDM076ww22FMc0Akh61Ir1wqgl5N8CG6AhwMph0suO73SgUvsgq208yslj61WoPgq30s5hs2E1UjgA2hsrl38qjCMGHpkhQd1wohh2U9pC90jsuO73Xy3gg12FMs5SSOE3b6ga7Fz84x8MqeqxaHMLg9wk30Gu840UsdExc5Ov0sd3w6611U1NX8sfK8d104ked7eCzBdMQsL9EnsJrTDJpZx13T7LjvIe7c6zBSTELffFS8e4fhuKxqV2MVeXbXPPfzzqQjd3HIK3H9A1Oq9OJGAO_AOV2Hsbvg5aBzVkDMddILzDSnPobZ8Qg6BIr4wM5OUQ5PiWq80WLQd46MblxVEw9WpYQgqq87mUDRr8APh0Jk-lyNEwtH4Qg1si0kQg69j9Cy1qI_xemDCy3MZqJ6U-id402_7Ph1cDVEw3JffSxEw2UA0FEDEq87mUDRr8A_gd418SyyUrjEji>>
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<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<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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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>>
Content-Type: text/plain; charset="windows-1252"
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<mailto:coh.org at mylist.net>] On Behalf Of Hudson, T. Warner [TWHudson at mednet.ucla.edu<mailto: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: https://urldefense.proofpoint.com/v1/url?u=http://www.cidrap.umn.edu/news-perspective/2014/10/ebola-texas-nurse-triggers-changes-battle-plan&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=42278bba5dd9380185f5731d25b4906fe0efc257b4e813303defbaeca2aae28e<http://cp.mcafee.com/d/2DRPos920Orhohpv7no7e6XCQQkmkXThsodFEEIFTKDtwSCyyODuWbzVJ6X3NEVvoophdCrriCMG2y1eyf00jp0Dh7w09IQsWW-yMM_R-7f9LZuVtdBO_8I3AhTbnjIyCHsQsEYG7DR8OJMddLICNPxK_8I9LfzAm4PhOrKr9PCJhbcryuxXLMF_bhHlRqIEjVv3aedNf9dD00HigzGTdGMXQ6YxVyxtrUQm-QV6vNeWb68TPO5jZbPYfSxu3squnD6h4zYq5X4Zwh-xsxIVD-nmfS3gg11kU60ia8z0SdwMd8ayUAjl3i8MocEwefp3xX8sfK8d104heaFz0ZcpEd1we2EK1k0Y9Ei18KdGxAd9PollIG8W6wMc8Exs4IP4w9Kfp3xZN1E80xkUe2Xrpk1Bz853QNA2gAod7dgBlUnE4Ma1wlf420se6QgC2Vfwe6xM330wY0UZAe7T46ww2a7c9FzDy13nQ43hOOZt5VZRYsOywC-god7dT7vLXJATNN1zTAmmrIEuWgTXqDK-CZVJq9CxRSn1RAO0Vd4VmRipvOpsxlK5LE2BiNYGjU6CSnNPXbVI5-Aq83iSdygo2Vsq2VFtd40tnW6y3o5GMYQg4Zc-q8dd43HsjWJAipEwmGvaNoQgeRyq80K90aq834FAPh0JmvMDbjPh1UuJmzsv96y01vzVEwCjYQg1SDDXgQg1si0kQjQd43HsjWJAivE6y0Arhhsdw0bbExGT>. 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><https://urldefense.proofpoint.com/v1/url?u=http://mailto:twhudson%40mednet.ucla.edu&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=b97393e456f0fb11da2c8ec63589f6589f0d6b5a7a040b81c7773cf47d6f1b6d<http://cp.mcafee.com/d/2DRPowczhJ5x5BYttwsUrKrjhhpjLt5NwSCyyODuWtS3qqabatXEKfCQrIf6zBZxxB4SpJJar2Ea84W8Y01dA2t4u00CPhPHHWb33_nUsYC_RXBQSnbYyMeh7sJteOaqJPhOzOEuvkzaT0QS-Mr7e6XYyMCY-ehojd79KVIDeqR4INK9W7K_2DYJ6JnlGOxfBYcEUT4YASs034VRiCo9JEkH0uNtnQ0rPtzZXQ6Sww22FMc0Akh61Ir1wqgl5N8CG6AhwMph0suO73SgUvsgq208yslj61WoPgq30s5hs2E1UjgA2hsrl38qjCMGHpkhQd1wohh2U9pC90jsuO73Xy3gg12FMs5SSOE3b6ga7Fz84x8MqeqxaHMLg9wk30Gu840UsdExc5Ov0sd3w6611U1NX8sfK8d104ke86zAsOqemvovstKWghhgRePTSspvud7bHzXNEVtKwUgvQtJSbA7Ar3xMVCPH0V1NR4wUwrmypEttBMtpcwejhelJkCnYCn8lrxrW0FkIvaA-1FJBYs-O-r1vF6y0QJzoA60Kn6wKqnjh07l-xEwS1qIfd41fjfCy3jh0WT4-Hp4Cq85GDOImd43JoCy0byg2Cy0NapcQgblDY9OQYQgu7HlET7OhEw0nU-q89A_d40tFV-Qd40n4w5d4Z3h0WT4-Hp4DW1Ew96Qkn3rNDusg_VkXSQ>>
Website www.ohs.uclahealth.org<http://cp.mcafee.com/d/avndy0s86Qm4mnNRS1PxKVJd55BeZQn63qqabatXFTodFEEIFTKyU-rhKMYqenS66kjpCSQFIawEwjEzM04Sg9QhU02rd7eKLEIcfZvxPOr_nKnjpsLOb0V4tORQX8FGTd7afaxVZicHs3jrXVIsUrLOb2rPUV5xcQsCXCM0literIvFfZfCjU02rmypEttBMtpcwejhelJkCnYCn8lrxrW0FkIvaA-1FJBYs-O-r1vF6y0QJzoA60Kn6wKqnjh07l-xEwS1qIfd41fjfCy3jh0WT4-Hp4Cq85GDOImd43JoCy0byg2Cy0NapcQgblDY9OQYQgu7HlET7OhEw0nU-q89A_d40tFV-Qd40n4w5d4Z3h0WT4-Hp4DW1Ew96Qkn3qAanNc7Y7jxB><https://urldefense.proofpoint.com/v1/url?u=http://www.ohs.uclahealth.org/&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=9a926982d06cce88a3e4dde68e25c7749fce18852cb6be180dc0bc72035883e7<http://cp.mcafee.com/d/1jWVIi4x8i4zqb2bbUWX0VMTsSCyyODuWbz1Jd55BeZQXI6QQkmkXThsvdEToud7bX33a9IPrqkS5gkg9QhU02r84W8Y01dCzDnnQm67-LMVVd_HTbFIKnV5wsyeVqWtAkRrCzB7BgY-F6lK1FJZMSesdTV5xdVYsyMCqejtPpesRG9pzsjQft-5fVqdqKHlB2vbUphNK9V9IU05kDjCX7Wj_jVA-00UQ40gle1w4yy8Mdzoc3i2EK94RgQyc63a83zSgUuO73Xy3gg14jyGoMfj6q3go3wGbwl0f2q4wibzqEp3isS5lrayexEc32a8n1bcN82rzSgUvsgq208le3wKSSl0poO1gZcp0A963hPk9lu5W1c2wo5jN0w73xJ49wKjU3xEs0MM8f0efp3xZN1E80yxNEVQQsFK6zBVd2XBHuYZHfI88uUZWrZxMVwQsKSZ5VVZeN1MxWbRQbn8m79TpvuupYsrmypEttBMtpcwejhelJkCnYCn8lrxrW0FkIvaA-1FJBYs-O-r1vF6y0QJzoA60Kn6wKqnjh07l-xEwS1qIfd41fjfCy3jh0WT4-Hp4Cq85GDOImd43JoCy0byg2Cy0NapcQgblDY9OQYQgu7HlET7OhEw0nU-q89A_d40tFV-Qd40n4w5d4Z3h0WT4-Hp4DW1Ew96Qkn3psgMAfKHgtFm>>
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<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<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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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<http://cp.mcafee.com/d/k-Kr3x8gdEI8ILzHI3D3tPqqabatXEKc6QQkmkXTjKMrjhhpjLt5NYSztxUQsLIccECPdJFjol1h0Dh7w09IwjEzM04SqettvhoovW_3DAT-LsKCOVvAm1O8XBHFShjlKqekul3PWApmU6CTNNIsUrLOb2rPUV5xcQsCXCM0trmrmSsGMQYD-DP9YpS27N8ifDTEdCRECq7nps7mj83AQjBrl9B_9BO5mUm-walb7OFfwqrpv7fILCMnWhEwdboS91wbBNEbCBQQg1RvEq8dwmH3Ph0jQPVEwQQgeJNfGSh9Cy1qFYH5zh0Xm9Ew2UA0FEwciCjd42Rp_2sJfd47xWRqdNYAq805-fCy2pfPh07quvJ3h05N81jhfgQgeJNfGSh9-wq82hJ55MS6XTe5ug>
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<mailto:coh.org at mylist.net>] On Behalf
> Of Hudson, T. Warner [TWHudson at mednet.ucla.edu<mailto: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: https://urldefense.proofpoint.com/v1/url?u=http://www.cidrap.umn.edu/news-perspective/2014/10/ebola-texas-nurse-triggers-changes-battle-plan&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=42278bba5dd9380185f5731d25b4906fe0efc257b4e813303defbaeca2aae28e<http://cp.mcafee.com/d/5fHCNEedEI8ILzHI3D3tPqqabatXEKc6QQkmkXTjKMrjhhpjLt5NYSztxUQsLIccECPdJFjol1h0Dh7w09IwjEzM04SqettvhoovW_3DAT-LsKCOVvAm1O8XBHFShjlKqekul3PWApmU6CTTzoVMTvAm4TDNOb2pEVdTdAVPmEBCdNfgZTUk_BERGWJmk9YLxB76UDACPw0lF8hRrCRotW3ugYNgKJYqbvqszfUDt5z4rVV2F-BV-7XgL1KdfbPz8yh-d2ZyuM8_gKgSsP_bH7X1E80wGs30954hwr6Mo6A5hsi9GxF4oc6kg77IxMZAe7T46ww28D5kNwuCcQ6wM71kn0G0u4Q90An6RgO6AVIaGSl4t3go64kgK2mpyg4T7IxM-UwQ40gGs71tJIG0ONA2xWoO18ic6zCEiGYbQ2o50MaDy10e73q8j1sDM73gU1xwgu0suO73Xy3gg153C4QNPN0xHW21EVpuKyY-W-ephgjv8c6zCXzLTZSOrUUwNXObbdSkft8rZJjTvjuYSJ4PgWXbwWOp0sCysHqFcLVcKgGT2TQ1iFo-l9Y3jrbUVZBYS2_id41Fr6N8c1sKd1sQKCy0eHZ3h1I2Rouq82uCvd46Cy1RK9ZmO9cQgblfBoIq87qNd40n4w5d41ykOpEwmHfUjBFVEwYfmHhKfAzh00LNYQgj9-q80XjPZEq80K90aq9W6y1RK9ZmO9fQ3h0idEEK6QvJShtlP>. 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><https://urldefense.proofpoint.com/v1/url?u=http://mailto:twhudson%40mednet.ucla.edu&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=b97393e456f0fb11da2c8ec63589f6589f0d6b5a7a040b81c7773cf47d6f1b6d<http://cp.mcafee.com/d/2DRPoOcz8Arhohpv7no7e6XCQQkmkXThsodFEEIFTKDtwSCyyODuWbzVJ6X3NEVvoophdCrriCMG2y1eyf00jp0Dh7w09IQsWW-yMM_R-7f9LZuVtdBO_8I3AhTbnjIyCHsQsEYG7DR8OJMddLCzASesdTV5xdVYsyMCqejtPpesRG9pzsjQft-5fVqdqKHlB2vbUphNK9V9IU069PGBcMjrgFm0ZyWLE0TCX7XTEdJ1045jwo18Eyc3oS30QwGbyhdkd8z1wOy0UZAe7IxM-UwQ40h4UGCc3QNCwQ60UayU5g3MCx84yUSG6gQDdxlmOEzEq30Myy5MiPci0CUZAe7T46ww25jwUbJJBg6mcwkfj6g92hwQsR2lnxuwj0E61kYg81MUrh2obA-0Uq70cc23M3zSgUvsgq208Esgd78VAQsI-M-UXtQwyyxGtDLIUO-Yqenn7TzhOXt1Mw_EXrIn8f8S73xPdDm1O3zG91N0SJ4PgWXbwWOp0sCysHqFcLVcKgGT2TQ1iFo-l9Y3jrbUVZBYS2_id41Fr6N8c1sKd1sQKCy0eHZ3h1I2Rouq82uCvd46Cy1RK9ZmO9cQgblfBoIq87qNd40n4w5d41ykOpEwmHfUjBFVEwYfmHhKfAzh00LNYQgj9-q80XjPZEq80K90aq9W6y1RK9ZmO9fQ3h0idEEK6XXP5VQyy>>
> Website www.ohs.uclahealth.org<http://cp.mcafee.com/d/avndz8wrhohpv7no7e6XCQQkmkXThsodFEEIFTKDtwSCyyODuWbzVJ6X3NEVvoophdCrriCMG2y1eyf00jp0Dh7w09IQsWW-yMM_R-7f9LZuVtdBO_8I3AhTbnjIyCHsQsEYG7DR8OJMddKndzD3t-hojuv78I9CzATsS02GjFPtzZ9_FYOv00jqQjd3HIK3H9A1Oq9OJGAO_AOV2Hsbvg5aBzVkDMddILzDSnPobZ8Qg6BIr4wM5OUQ5PiWq80WLQd46MblxVEw9WpYQgqq87mUDRr8APh0Jk-lyNEwtH4Qg1si0kQg69j9Cy1qI_xemDCy3MZqJ6U-id402_7Ph1cDVEw3JffSxEw2UA0FEDEq87mUDRr8A_gd418SyyUrqoktdsRQE-Yi><https://urldefense.proofpoint.com/v1/url?u=http://www.ohs.uclahealth.org/&k=NZz1SMMNIbmFChmIgSwv1Q%3D%3D%0A&r=k2S%2BsEODLFKnxUdiTFMmVIht4mmcmjaINO11HT3tCZ0%3D%0A&m=DHuukXpvK%2BZGw9oGo8FsUKNLlAbD7M1URi5QIDXSA8Q%3D%0A&s=9a926982d06cce88a3e4dde68e25c7749fce18852cb6be180dc0bc72035883e7<http://cp.mcafee.com/d/k-Kr4xEg4zqb2bbUWX0VMTsSCyyODuWbz1Jd55BeZQXI6QQkmkXThsvdEToud7bX33a9IPrqkS5gkg9QhU02r84W8Y01dCzDnnQm67-LMVVd_HTbFIKnV5wsyeVqWtAkRrCzB7BgY-F6lK1FJN4SesdTV5xdVYsyMCqejtPpesRG9pzsjQft-5fVqdqKHlB2vbUphNK9V9IU05kDjCX7Wj_jVA-00UQ40gle1w4yy8Mdzoc3i2EK94RgQyc63a83zSgUuO73Xy3gg14jyGoMfj6q3go3wGbwl0f2q4wibzqEp3isS5lrayexEc32a8n1bcN82rzSgUvsgq208le3wKSSl0poO1gZcp0A963hPk9lu5W1c2wo5jN0w73xJ49wKjU3xEs0MM8f0efp3xZN1E80yxNEVQQsFK6zBVd2XBHuYZHfI88uUZWrZxMVwQsKSZ5VVZeN1MxWbRQbn8m79TpvuupYsrmypEttBMtpcwejhelJkCnYCn8lrxrW0FkIvaA-1FJBYs-O-r1vF6y0QJzoA60Kn6wKqnjh07l-xEwS1qIfd41fjfCy3jh0WT4-Hp4Cq85GDOImd43JoCy0byg2Cy0NapcQgblDY9OQYQgu7HlET7OhEw0nU-q89A_d40tFV-Qd40n4w5d4Z3h0WT4-Hp4DW1Ew96Qkn3sxIj7t--peWd>>
>
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<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<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<mailto: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.
> <mg_info.txt>
> ---------------------------------------
> The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band DO.
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End of MCOH-EH Digest, Vol 247, Issue 14
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