By Prue Salasky, firstname.lastname@example.org
The key to identifying any potential Ebola patients lies in preparation, education, and asking appropriate travel questions, according to Peninsula health and safety officials.
All are uniformly following the protocols and practices issued by the U.S. Centers for Disease Control and Prevention, which are updated daily through bulletins and alerts from the Virginia Department of Health.
The initial screening of all patients with flu-like systems — which can be the prelude to Ebola — now starts with a questionnaire about travel in the past 30 days. "If they've been in West Africa and have a fever of 101.5, then they should go immediately to the nearest emergency department," said Lynne Zultanky, spokeswoman for Bon Secours Hampton Roads, summing up the two most identifiable early factors.
With no identified cases in Virginia, chances are slim that local clinics and hospitals will see any Ebola patients — but they're prepping anyway. Preparations range from being more attentive to travel histories at every facility to Riverside Health System's construction of isolation triage areas in each of its five hospitals.
In the past couple of weeks, Riverside has taken its preparations beyond the CDC's guidelines. "We've tried to exceed their recommendations at every intersection," said Doug Smith, emergency operations officer for Riverside and a York County firefighter.
Late last week, the health system completed construction on a conversion of four rooms in the emergency room at Riverside Regional Medical Center into an isolation triage area for two patients. "It takes two to three days to confirm the virus," said spokesman Peter Glagola. He explained that samples would be sent to the state lab and then to the CDC for confirmation. He emphasized that the same policies and protocols have been instituted at all five Riverside hospitals, including any necessary construction.
With health-care workers the most at-risk in the population, Riverside has instituted a rolling cart system for personal protective equipment (PPE) for two clinicians. Supplies include disposable thermometers, radios, and stethoscopes, along with pre-assembled lab kits.
Riverside has Tychem body suits and face-covering masks with respirators that were purchased in response to the avian flu scare in 2007, said Smith. As needed, designated staff would don the equipment in negative pressure rooms — there are five in the emergency department and more on other floors. Riverside has 100 cases of each size suit on order and half that number already in stock, he said. Health-care personnel are trained in a buddy system to ensure the correct donning and doffing of the protective clothing, including double-gloving, taping sleeves, and the appropriate use of hand sanitizer and a bleach spray.
Darryll Griffiths, a HAZMAT specialist for Riverside Emergency Management, oversaw a demonstration of the procedure with emergency room nurse Amy Manning. "You have to do the same thing each time," said Manning as she gently peeled off the suit, following Griffiths' instructions to the letter. It's always possible to reverse a mistake during the process, he said.
The one-time wear suits are "virus resistant" for more than four hours and impervious to direct liquid contact; the neck-covering masks have a positive air pressure respirator; and the room has an "air-scrubber," a machine that uses UV light and an advanced filtration system to keep the surroundings clean. The hospital also has "isolation pod stretchers" that are completely enclosed — "they're the same as the CDC used for patients brought to the U.S. from Africa," said Smith — for use in transporting suspected cases both internally and between facilities.
By contrast, other facilities are taking a lower-tech approach.
"The perception is, our risk is low in Virginia, but we want to be prepared and to help keep people from panicking," said Golden Bethune-Hill, executive director of The Community Free Clinic in downtown Newport News.
There, signs with the symptoms of Ebola are posted in the waiting area, and anyone with a flu-like illness is asked to put on a mask before being taken immediately to a separate room for evaluation. After their examination, the room is then thoroughly cleaned. "We've stepped it up a little bit," she said, expressing greater concern about the flu. "It can cause severe illness. It's airborne and it kills more people in the U.S.," she said, emphasizing the simple precaution of hand-washing.
At Patient First medical centers, if a patient has risk factors for Ebola and symptoms, "that patient is directed to the nearest hospital accepting patients for Ebola testing and further assessment and one of our doctors contacts the emergency room by phone to notify them," said Dr. Malak Isaac, medical director, Patient First-Denbigh and Patient First-Hampton.
The risk factors he cited are: having traveled to specific countries in Africa (i.e., Sierra Leone, Guinea, Liberia, Nigeria, and Senegal) within the past 21 days, having been exposed within the past 21 days to persons who have traveled to these countries recently, or having been exposed to patients who may have Ebola, and having one or more symptoms of Ebola.
Both Bon Secours and Sentara, which has formed a system-wide task force to centralize its efforts, reported following CDC guidelines and keeping staff regularly updated.
- Pictures: Riverside Prepares For Ebola Patients
Published: October 20, 2014