Ebola outbreak - general thread #4

[rabidstoat]

I am a nurse in a designated Ebola unit, not in the US. Ask away.

Is it an active unit? That is, do you currently (or have you recently) have patients, for Ebola or any other similarly highly infectious disease? Or is it 'just in case'?

P.S. Nice username!

 

[FlamingoLady]

I am a nurse in a designated Ebola unit, not in the US. Ask away.

Approx how many patients with Ebola is your unit capable of caring for? And is there a special sub-section of nurses specially trained to prvide care, or would they be pulled from any floor/unit to assist?

 

[RabidBadger]

I have seen images of Ebola victims. Does it vary that widely? Dr. Brantly and Nancy Writebol didn't "look" like they had suffered from a hemorrhagic virus. No blisters, bruising, red eyes etc...
Duncan's mother couldn't bear to look at him... Maybe because they got ZMapp??

All posts are MOO

Yes the symptoms are very non specific early on and later are much like a multiorgan failure patient. To be clear, we are a designated unit but haven't recieved any suspected ebola patients yet. Knock on wood.

 

[RabidBadger]

Is it an active unit? That is, do you currently (or have you recently) have patients, for Ebola or any other similarly highly infectious disease? Or is it 'just in case'?

P.S. Nice username!

We are currently an icu unit that is active but not with ebola patients.

 

[RabidBadger]

Approx how many patients with Ebola is your unit capable of caring for? And is there a special sub-section of nurses specially trained to prvide care, or would they be pulled from any floor/unit to assist?

4 in negative pressure rooms. All our unit's nurses have been trained, and we will not pull from other units.

 

[Zuri]

Although we have recieved training in appropriate PPE, they keep changing their minds. Right now double gloves, double gown, face shield, hair cover, booties, N95 respirator, hospital supplied scrubs.

Do you think the N95 mask is enough of protection? I hated those masks. Are you required to wear goggles as well as the face shield? Are you supposed to draw the labs Instead of the phlebotomist? And what about respiratory for vents, hemodialysis techs/RNs? How do you keep their interaction to a minimum? Thanks so much!

 

[lonetraveler]

It is probably not feasible to have a BSL-4 area in every hospital, and transportation of patients to one is also problematic.

But ITA that we need to stop talking about and treating it as carelessly as we have and accepting inadequate treatment, isolation, and PPE protocols when and where the highest ones possible can be implemented.

I also agree that we need to restrict flights to allow only those necessary for aid and use real quarantines. Not doing so is inexcusable and makes those who refuse to take these critical measures complicit in the consequences of every uncontrolled escape of the virus that ensues, imo.

BBM: I totally agree with restricting flights from affected areas. What possible good does it do to allow the possibly infected passengers fly in an enclosed cabin with unknowing passengers and then enter the airport/restrooms before they are screened for the virus? That is too little, too late IMO.

 

[RabidBadger]

Do you think the N95 mask is enough of protection? I hated those masks. Are you required to wear goggles as well as the face shield? Are you supposed to draw the labs Instead of the phlebotomist? And what about respiratory for vents, hemodialysis techs/RNs? How do you keep their interaction to a minimum? Thanks so much!

Yes i think the n95 will be enough with the face shield. They may convert us to a full head cover though. There are 2 designated nurses per ebola pt and one dedicated respiratory therapist. One nurse stays out of the room and acts as decontamination buddy, logs everyone in and out.

Not sure about the phleb, as we currently don't do the phlebotomy, just draws from central lines and art lines.

There will not be any hemodialysis nurses, we will run CRRT on the patients ourselves if needed.

 

[Sophieandme]

I so admire you RabidBadger! Thanks for being here!

What is your current protocol regarding:
length of shift

number (if any) of staff to assist you in properly taking off your PPE and decontaminating

are "suspected" or likely/probable Ebola patients isolated immediately (before test results come back)?

Do you have dedicated equipment for Ebola patients?

a dedicated lab just for Ebola patients?

will your facility notify all inpatients when you have a suspected Ebola patient or will your facility wait until Ebola is confirmed thru testing?

Are you only to render care to Ebola patients? If you have cared for an Ebola victim and then have none in your facility, do you then care for other patients in your facility? Immediately?

Thank you so much!!!

 

[Zuri]

Another question: If you have an Ebola patient in the ICU, I assume it is 1:1 care. Will you be allowed to leave the hospital after your shift is over or do you have to remain in a designated area? Will the hospital extend extra insurance coverage to you and your family while caring for the patient?

 

[jjenny]

Sounds like some guy with a sore throat got dragged of into isolation because of Ebola fears. I guess it's better than sending an actual Ebola patient home, but I find this funny.

http://www.bostonglobe.com/metro/2014/10/12/ebola/z3DybKoXBg0XjPO6m5yVgK/story.html

 

[gngr~snap]

Yes the symptoms are very non specific early on and later are much like a multiorgan failure patient. To be clear, we are a designated unit but haven't recieved any suspected ebola patients yet. Knock on wood.

http://outfront.blogs.cnn.com/2014/...r-thomas-cairns-it-was-a-very-difficult-time/

This Doctot had it. He had peeling skin and temp hearing loss... A different strain I guess.

I do think if this gets big, Ebola patients should be cared for at special facilities where babies aren't being born etc...
Why risk it?
Kinda like TB patients back in the day.

All posts are MOO

 

[RabidBadger]

I so admire you RabidBadger! Thanks for being here!

What is your current protocol regarding:
length of shift

number (if any) of staff to assist you in properly taking off your PPE and decontaminating

are "suspected" or likely/probable Ebola patients isolated immediately (before test results come back)?

Do you have dedicated equipment for Ebola patients?

a dedicated lab just for Ebola patients?

will your facility notify all inpatients when you have a suspected Ebola patient or will your facility wait until Ebola is confirmed thru testing?

Are you only to render care to Ebola patients? If you have cared for an Ebola victim and then have none in your facility, do you then care for other patients in your facility? Immediately?

Thank you so much!!!

Length of shift: 12 hrs

Assistance with PPE: a second nurse and probably every infection prevention and control officer in existence watching us like a hawk.

Pts will be isolated immediately.

Dedicated equipment yes, dedicated lab no but extreme measures are in place for labs.

There will be no notification for privacy reasons unless health officials decide to release that info to the public.

We would only render care to the ebola patient. After they are gone, I'm not sure how long if at all they would make us wait before rendering care to others.

 

[LyndyLoo]

I would like to gently remind everybody panicking here...That Malaria ( a very very common disease from that area of the world has the same symptomology see link below~~
http://www.webmd.com/a-to-z-guides/malaria-symptoms

snippet~~
Common symptoms of malaria
In the early stages, malaria symptoms are sometimes similar to those of many other infections caused by bacteria, viruses, or parasites. Symptoms may include:

Fever.
Chills.
Headache.
Sweats.
Fatigue.
Nausea and vomiting.

SO I would think that anyone having a fever needs to be quarantined until CLEARED by Blood testings.

I really wish folks would take a deep breath here...I can attest containments of deadly virus's can and is done..as a RN actively nursing immuno-compromised patients during the SARS epidemic....Some deaths of HC providers occurred during that ..BUT it did not become a pandemic by any means.. I can also say SARS was a far more easily transmitted deadly virus..Airbourne virus easily transmitted ..Not necessary to have CLOSE contact nor body fluid accesses...

Don't throw tomatoes at me..Im just trying to decrease the panic Im reading here..Wash hands..use common sense hygiene and chances are almost non-existent....It's the hands on HC providers who need our prayers and support now!! :tyou:

 

[RabidBadger]

Another question: If you have an Ebola patient in the ICU, I assume it is 1:1 care. Will you be allowed to leave the hospital after your shift is over or do you have to remain in a designated area? Will the hospital extend extra insurance coverage to you and your family while caring for the patient?

2 nurses to one patient. We will be allowed to go home after work. Not sure what you mean by extra insurance, health care is "free" here.

 

[Sophieandme]

Thank you for all your responses RabidBadger.

What is your guess as to what happened in Texas with the infected nurse?

 

[SeekingJana]

Information/details on the hospital the military is setting up. Very informative. MOO

http://www.defenseone.com/threats/2...als-air-force-using-fight-ebola-africa/96098/

Your link sent me to a site which says " Request an invitation"... Is this the correct link?

 

[FlamingoLady]

I would like to gently remind everybody panicking here...That Malaria ( a very very common disease from that area of the world has the same symptomology see link below~~
http://www.webmd.com/a-to-z-guides/malaria-symptoms

snippet~~
Common symptoms of malaria
In the early stages, malaria symptoms are sometimes similar to those of many other infections caused by bacteria, viruses, or parasites. Symptoms may include:

Fever.
Chills.
Headache.
Sweats.
Fatigue.
Nausea and vomiting.

SO I would think that anyone having a fever needs to be quarantined until CLEARED by Blood testings.

I really wish folks would take a deep breath here...I can attest containments of deadly virus's can and is done..as a RN actively nursing immuno-compromised patients during the SARS epidemic....Some deaths of HC providers occurred during that ..BUT it did not become a pandemic by any means.. I can also say SARS was a far more easily transmitted deadly virus..Airbourne virus easily transmitted ..Not necessary to have CLOSE contact nor body fluid accesses...

Don't throw tomatoes at me..Im just trying to decrease the panic Im reading here..Wash hands..use common sense hygiene and chances are almost non-existent....It's the hands on HC providers who need our prayers and support now!! :tyou:

With all due respect, I don't see panic on here. I see valid questions being asked of an RN working in an Ebola designated unit of a hospital. I also see people bringing up the subject of a hospital being faced with more Ebola patients than they are capable of providing care for. Not throwing tomatoes at you, just disagree with your panic assessment.

 

[RabidBadger]

Thank you for all your responses RabidBadger.

What is your guess as to what happened in Texas with the infected nurse?

My uneducated guess is an unintended breach in protocol. In our taped trials here we found that the more complex, more unfamiliar the PPE is, the number of contaminated breaches went way up, usually in removing the PPE.

 

[SophieRose]

First I have heard of "explosive" diarrhea. Ever.

At the end of one 4th of July weekend, a friend and I stopped at a fast food place on the way home to use the bathroom. There was quite a wait with a long line of travelers. Then a woman barged in and went to the front of the line and grabbed the first stall that opened. Everyone was angry until we heard the sound of explosive diarrhea. We still had a wait and the smell was horrific, I told my friend "let's go." What was funny, we stopped at the next fast food place and there was absolutely no line.