Ebola outbreak - general thread #4

[RabidBadger]

"The CDC is recommending that the hospital perform only “essential procedures” on Ebola patients to limit workers’ possible exposure to the virus. Under these guidelines, Duncan would not have received the kidney dialysis and respiratory intubation treatments."

Read more here: http://www.modbee.com/2014/10/12/3588162/new-case-of-ebola-in-dallas-brings.html#storylink=cpy

Intubation/ventilation and dialysis are essential procedures that are life saving. I think the media misinterpreted the statement by the cdc.

 

[SeekingJana]

People take photos in the ER all the time. ICU as well... Usually of themselves or a friend/relative takes them. I have never thought twice about it. I have taken pictures in the hospital as well. Ours has disposable gowns that hook up to a hose and keep you as warm/cool as you please. I had to take a pic of that!

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The two hospital corporations I worked for had a strict no photography policy for staff and visitors.. except in the mother- baby unit and then it was " anything goes". I worked on that unit and it was a lot of fun after so many years in ICU. I took a lot of " first family" photos with patients' cameras, etc.
Facilities and especially corporate- owned hospitals do set their own rules.
I live in a place where a person can be fined for taking an " unauthorized photo" of another person's home. The exterior.. the security guards have the right to call the local sheriff's dept.
I would not know this had it not happened to the people who lived down the street and the report was in our monthly homeowner's magazine.
This is a weird world.

 

[jjenny]

Intubation/ventilation and dialysis are essential procedures that are life saving. I think the media misinterpreted the statement by the cdc.

I don't think so. Ventilation/dialysis are high risk procedures for spreading the virus. Sounds like CDC doesn't want them done.

 

[RabidBadger]

I don't think so. Ventilation/dialysis are high risk procedures for spreading the virus. Sounds like CDC doesn't want them done.

Will have to agree to disagree here.

 

[okiedokietoo]

The vomit cleaner used a pressure washer. That would cause the germs to vaporize basically.
Pressure washers should be avoided in any hazardous clean up.

All posts are MOO

Yes, right, I didn't add all the details, it was the photo in the news showing them spraying it down the drain - the ranting point is all of it combined.

And I really would like to know how Mr. Lively is doing.

 

[SeekingJana]

"The CDC is recommending that the hospital perform only “essential procedures” on Ebola patients to limit workers’ possible exposure to the virus. Under these guidelines, Duncan would not have received the kidney dialysis and respiratory intubation treatments."

Read more here: http://www.modbee.com/2014/10/12/3588162/new-case-of-ebola-in-dallas-brings.html#storylink=cpy

Hmm, I'll bet if someone from the CDC has Ebola and extreme respiratory distress and is not in the hemorrhagic phase ( it can happen), they'd want to be on a ventilator until they had recovered sufficiently. I hope it never happens, but having needed emergency mechanical ventilatory assistance once myself, that's an extreme position, IMO.. I can see no hemodialysis in ICU though. It's hard as heck to dialyze and maintain isolation precautions, plus renal failure is usually not something from which one can recover in this infection. Respiratory distress can be present in an earlier stage, though.

 

[jjenny]

Will have to agree to disagree here.

CDC said that intubation and dialysis are high risk procedures. The whole point of new guidelines is to prevent spread of the infection. Which is why CDC says to keep nurses/doctors treating Ebola patients to a minimum and carry out only essential procedures.

 

[jjenny]

Hmm, I'll bet if someone from the CDC has Ebola and extreme respiratory distress and is not in the hemorrhagic phase ( it can happen), they'd want to be on a ventilator until they had recovered sufficiently. I hope it never happens, but having needed emergency mechanical ventilatory assistance once myself, that's an extreme position, IMO.. I can see no hemodialysis in ICU though. It's hard as heck to dialyze and maintain isolation precautions, plus renal failure is usually not something from which one can recover in this infection. Respiratory distress can be present in an earlier stage, though.

Well, of course. But it doesn't sound like it could be safely done in a regular hospital.

 

[FlamingoLady]

Yes, right, I didn't add all the details, it was the photo in the news showing them spraying it down the drain - the ranting point is all of it combined.

And I really would like to know how Mr. Lively is doing.

Yeah, I wonder if they ever even found him? I can't find any info on him.

 

[gngr~snap]

The two hospital corporations I worked for had a strict no photography policy for staff and visitors.. except in the mother- baby unit and then it was " anything goes". I worked on that unit and it was a lot of fun after so many years in ICU. I took a lot of " first family" photos with patients' cameras, etc.
Facilities and especially corporate- owned hospitals do set their own rules.
I live in a place where a person can be fined for taking an " unauthorized photo" of another person's home. The exterior.. the security guards have the right to call the local sheriff's dept.
I would not know this had it not happened to the people who lived down the street and the report was in our monthly homeowner's magazine.
This is a weird world.

It is. I have a 40 year history with this hospital. I did my nursing clinicals there. I gave birth to my premie there. I did rounds with the pediatricians I worked for.
Never was an issue.
In fact, I wouldn't use a facility that fined people for taking pictures (if I had another option)
I have been to one place that wouldn't even allow a purse inside. Car key only...
That tells me they are hiding something.
Look at the facebook pages of children fighting cancer and there are hospital pics everywhere!
Teens in ICU after accidents etc..

Not many photos available of Ebola victims though are there? It seems to be the same 25-30 pictures on a rotating basis....
I can see why there aren't many, but in this day and age with go pro and cell phones it seems like we would see more of 4000+ have died since March 2014.

Jmo


All posts are MOO

 

[RabidBadger]

CDC said that intubation and dialysis are high risk procedures. The whole point of new guidelines is to prevent spread of the infection. Which is why CDC says to keep nurses/doctors treating Ebola patients to a minimum and carry out only essential procedures.

Can you link me to where on the cdc website it specifically says intubation and dialysis are non essential procedures and are recommended against using them?

 

[FlamingoLady]

http://www.dailymail.co.uk/news/art...las-wandering-supposed-observation-virus.html

This is from Oct 6th. Not very complimentary coverage of the poor guy but whatever......
ETA: Info on Mr Lively

 

[SeekingJana]

Well, of course. But it doesn't sound like it could be safely done in a regular hospital.

Do you mean in a hospital on a general patient unit vs. an ICU, or are you referring to some specialty hospital? Because ICU personnel usually have a very high percentage of ventilated patients- regular hospital with ICU unit.

 

[jjenny]

Can you link me to where on the cdc website it specifically says intubation and dialysis are non essential procedures and are recommended against using them?

No, but there is a whole bunch of msm articles that say that.
Are they all wrong?

 

[jjenny]

Do you mean in a hospital on a general patient unit vs. an ICU, or are you referring to some specialty hospital? Because ICU personnel usually have a very high percentage of ventilated patients- regular hospital with ICU unit.

But not on Ebola patients. Which is what I meant by safely. It would appear these procedures might not be done safely on Ebola patients without spreading the virus.

 

[RabidBadger]

No, but there is a whole bunch of msm articles that say that.
Are they all wrong?

I prefer to get my information regarding ebola recommendations directly from the cdc and the scientific literature.

 

[jjenny]

I prefer to get my information regarding ebola recommendations directly from the cdc and the scientific literature.

Here is a direct statement from CDC. These procedures are considered to be major areas of risk.

"The two areas where we will be looking particularly closely is the performance of kidney dialysis and respiratory intubation," Frieden said this morning. "Both of those procedures may spread contaminated materials and are considered high-risk procedures. They were undertaken … as a desperate measure to try to save his life. In taking off respiratory protective equipment, we identified this as a major potential area for risk."

http://keranews.org/post/dallas-hospital-worker-tests-positive-ebola-cdc-confirms

 

[chipmunk]

Thanks Okeydokey2. Developments moving so fast. We are sleuthers, foremost. And good at that. Do any of you know of a forum of virologists, infectious disease specialists that are discussing this now? This is simply crazy how CDC slipped, IMO. Thx.

So far I found this but don't think I'm allowed to give link since it's labeled a blog. Search VDU down under or virology + down under. Found with basic word search. Ian Mackay virologist has several posts with a modest number of replies. Dr Mckay has been active on twitter CDC chats and various ebola chats. I followed one a couple months ago in which he emphasized and explained how Ebola is not airborne. @MckayIM

I'll continue looking for another with wider input.

Another with some ebola content and podcast, first link:http://www.flutrackers.com/forum/showthread.php?p=547871

Add on: http://ebola.thelancet.com/ Ebola trials, situation, MD comments, some researchers and clinicians.

 

[RabidBadger]

Here is a direct statement from CDC. These procedures are considered to be major areas of risk.

"The two areas where we will be looking particularly closely is the performance of kidney dialysis and respiratory intubation," Frieden said this morning. "Both of those procedures may spread contaminated materials and are considered high-risk procedures. They were undertaken … as a desperate measure to try to save his life. In taking off respiratory protective equipment, we identified this as a major potential area for risk."

http://keranews.org/post/dallas-hospital-worker-tests-positive-ebola-cdc-confirms

I am not debating that these procedures are high risk. I am debating whether they can be considered thus non essential and to be avoided. That is the cdc guideline you are claiming exists yet appears nowhere in the actual cdc literature.

 

[SeekingJana]

ITA with the statement that in the case of Mr. Duncan, intubation and dialysis were desperate, last minute measures.
They have every right to question why the procedures were done on a person who was a DNR and also was in the hemorrhagic stage of Ebola.

But, respiratory distress not managed with O2 therapy alone may require intubation in a stage earlier than the last hemorrhagic stage. Then, I would professionally consider mechanical ventilation to be entirely appropriate and not a last- gasp measure.