Ebola outbreak - general thread #5

[SStarr33]

Seems like I've read the problem with doing transfusions in WA is the testing for HIV, hepatitis, etc...

 

[nrdsb4]

Blood transfusions could be dangerous in the long term, considering blood born pathogens. Such as HIV or malaria.
It would be hard to implement wide spread blood transfusions in Africa.

That's a very good point.

 

[SwampMama]

http://www.wafb.com/story/26774327/judge-halts-ebola-victims-burned-belongs-burial-in-louisiana

"The Lake Charles, La, landfill was to take in six truckloads of items from Ebola patient Thomas Duncan's apartment that were incinerated at the Veolia facility in Port Arthur, TX.............

A judge has signed the request for a temporary restraining order against Veolia Environmental Services in TX & Chemical Waste Management in Lake Charles, La.

A hearing date on the temporary restraining order is set for Oct. 22."

While I don't see a danger from properly incinerated ashes, I still wondered why they would not be disposed of in state, not shipped to another state.

 

[cady]

That's a very good point.

AGREE Transfusion is not the solution but at least it can save some lives until we have a verified vaccine. Better than nothing! JMO

 

[CARIIS]

Well, we don't even know if it antibodies in the blood which is making the difference. We can hope it is, but as of yet that is not established.

Re: Well, we don't even know if it antibodies in the blood which is making the difference. We can hope it is, but as of yet that is not established



We don't know it specific for Ebola at this time. We do ,however, know historically that that injecting “things” from previously ill folks, in thousands of illness worked. That is what most vaccines are – small amount of the entity casing any infection. allowing the body to develop immunity .

Ebola IMO is not a like one of a kind thing. It is a very well understood entity (virus) . We kn know much. It makes sense (time has proven it ) n that blood products from ill people will help other people build immunity

– Ebola is one of many, and at his point, worldwide, deathtoll wise t pales by compassion to other many many bacterial/virus cased deaths



IMO

 

[popsicle]

CNN Breaking News ‏@cnnbrk 14m14 minutes ago
“There were no protocols” for treating #Ebola at Texas Health Presbyterian Hospital Dallas, nurses union co-president says.

 

[nrdsb4]

Dallas nurse is 'clinically stable'
Officials are still trying to figure out how a Dallas nurse who cared for Duncan was infected. Nina Pham, a recent nursing college graduate, got her certification less than two months earlier. On Monday, she got a blood transfusion from American Ebola survivor Kent Brantly and is "clinically stable." http://www.cnn.com/2014/10/14/health/ebola-up-to-speed/

Ok, this conflicts with other reports I've read about this nurse. I had read that this young woman graduated with a BSN from TCU in 2010. That is a full four years ago, not "a recent nursing college graduate."

This report is disingenuous, stating she "got her certification less than two months earlier." Yes, she was recently "ICU certified." That sentence makes it sound like she just passed her boards, which isn't the case. The fact that she recently got ICU certification doesn't necessarily mean she was not qualified to take care of Mr. Duncan.

I do wonder, though, how caregivers were assigned, and if there were nurses who refused. I follow a national nursing message board, and MANY of them stated that they WOULD NOT take care of an ebola patient.

 

[jjenny]

Little Bentley is living up in style.


"City spokeswoman Sana Syed said Tuesday that Bentley is staying in the former residence of the executive officer at the decommissioned Hensley Field, which is owned by the city. Bentley was moved Monday from nurse Nina Pham's apartment to his new home, where he'll be monitored."

http://www.kvoa.com/news/dog-of-dallas-nurse-with-ebola-moved-to-air-base/

 

[lawstudent]

Well, we don't even know if it antibodies in the blood which is making the difference. We can hope it is, but as of yet that is not established.

I'm pretty sure we do. What else could it be? The only thing a survivor's blood would have that could make a difference would be antibodies. Obviously replacing lost blood is a factor as well, but if they want blood from the survivor then that indicates merely replacing blood with that from a comparable donor is not the main goal.

ETA: I guess I would agree that we don't know that those who survived did so because of the transfusion, but if it did aid in their recovery, it would be due to the antibodies.

 

[LaborDayRN]

Shaking my head at the arrogance. The first rule of professionalism in health care is to always strive for self- improvement.

I'd like to explain my earlier comment. When I watched the video, I saw several things that needed improvement. I was in no way laughing at the video or the people who made it. I meant this as constructive criticism. As professionals we do strive for self-improvement and I would hope that this would be an opportunity for learning the right way to remove PPE.

At one point the nurse reached up with her gloved hand and grabbed her gown by her neck/shoulder. It appeared to me that she touched her scrubs with her gloved hand. This is not how I was trained to remove an iso gown. Also, after removing her boot covers, she stood in the same spot in her shoes. In the real world you may walk through body fluids when someone is bleeding or sick. It didn't show any disinfection process when she left the area, which IMO would be very important. You could track the virus onto the ward or when you take your shoes off later, you could contaminate your hands. MOO

 

[popsicle]

[h=1]Hospital Officials: Patient Does Not Have Ebola[/h]
University of Kansas Hospital officials say preliminary tests show a patient who arrived Monday with Ebola-like symptoms does not have the deadly disease

http://stlouis.cbslocal.com/2014/10/14/hospital-officials-say-patient-does-not-have-ebola/

 

[SeekingJana]

CDC issues new statement regarding the role of the CDC in future USA suspected or confirmed cases of Ebola virus.
http://www.medscape.com/viewarticle/833226?src=wnl_edit_newsal&uac=89707MG

They are now backtracking somewhat on their original statement that any hospital can safely care for an Ebola- positive patient. They will be on the scene and assessing for transport to one of the 4 designated biohazard containment hospitals, in addition to the care given by the receiving facility.
It's a little late, but I think it's an appropriate response considering that a young, healthy nurse is now sick... and as LaborDayRN points out above, there are some problems in the Parkland PPE video and maybe the CDC doctors watched it and saw the problems... Thank you for your professional input LaborDayRN. I'm going to have a closer look at the video but will never ever laugh at what Parkland put together- as you didn't, either.

I have extreme respect for my fellow RNs.

 

[WichitaFalls]

How could this be?

(CNN) -- [Breaking news update, posted at 8:45 p.m. ET]

"The guidelines were constantly changing" and "there were no protocols" at Texas Health Presbyterian Hospital Dallas as the hospital treated a patient with Ebola, the president of National Nurses United said in a statement on Tuesday. Protective gear nurses wore at first left their necks exposed, union co-president Deborah Burger said, citing information she said came from nurses at the hospital. The union said it would not identify the nurses it spoke with in order to protect them from possible retaliation.

CNN has reached out to Texas Health Presbyterian Hospital, but the hospital did not immediately respond to a request for comment on the allegations.
http://www.cnn.com/2014/10/14/health/ebola-up-to-speed/index.html

A note to those here that know employees there that are working so hard and that have had many good experiences at this hospital, I'm right there with you. My history with this hospital goes back almost 40 years to 1974 when I was a volunteer. I'm shocked at some of the information coming out but all of the truth must come out.

 

[LaborDayRN]

It can be exhausting nursing a child through a nasty bout with the flu, so imagine how 22-year-old Fatu Kekula felt nursing her entire family through Ebola.

Her father. Her mother. Her sister. Her cousin.
Fatu took care of them all, single-handedly feeding them, cleaning them and giving them medications.
And she did so with remarkable success. Three out of her four patients survived. That's a 25% death rate -- considerably better than the estimated Ebola death rate of 70%.

http://www.cnn.com/2014/09/25/health/ebola-fatu-family/index.html

 

[alwaysonmymind]

Antimalarial drug Chloroquine shows promise against Ebola

https://plus.google.com/app/basic/stream/z12bd3jaxvucgbfgj04cf5a5eryicvizims0k

 

[WichitaFalls]

Antimalarial drug Chloroquine shows promise against Ebola

https://plus.google.com/app/basic/stream/z12bd3jaxvucgbfgj04cf5a5eryicvizims0k

Very interesting. I take this for Rheumatoid Arthritis and it's very inexpensive with no side effects (for me).

 

[LaborDayRN]

CDC issues new statement regarding the role of the CDC in future USA suspected or confirmed cases of Ebola virus.
http://www.medscape.com/viewarticle/833226?src=wnl_edit_newsal&uac=89707MG

They are now backtracking somewhat on their original statement that any hospital can safely care for an Ebola- positive patient. They will be on the scene and assessing for transport to one of the 4 designated biohazard containment hospitals, in addition to the care given by the receiving facility.
It's a little late, but I think it's an appropriate response considering that a young, healthy nurse is now sick... and as LaborDayRN points out above, there are some problems in the Parkland PPE video and maybe the CDC doctors watched it and saw the problems... Thank you for your professional input LaborDayRN. I'm going to have a closer look at the video but will never ever laugh at what Parkland put together- as you didn't, either.

I have extreme respect for my fellow RNs.

:tyou: I'm glad you understand. I didn't want anyone to get the wrong impression. I work on a very busy L&D unit. with between 5,000 and 6,000 births a year. I've been splashed (sometimes in the face) with amniotic fluid (meconium :shame and blood. I've been vomited on.....it's a glamorous job...... I love my PPE!! :heartbeat:

 

[SeekingJana]

I'd like to explain my earlier comment. When I watched the video, I saw several things that needed improvement. I was in no way laughing at the video or the people who made it. I meant this as constructive criticism. As professionals we do strive for self-improvement and I would hope that this would be an opportunity for learning the right way to remove PPE.

At one point the nurse reached up with her gloved hand and grabbed her gown by her neck/shoulder. It appeared to me that she touched her scrubs with her gloved hand. This is not how I was trained to remove an iso gown. Also, after removing her boot covers, she stood in the same spot in her shoes. In the real world you may walk through body fluids when someone is bleeding or sick. It didn't show any disinfection process when she left the area, which IMO would be very important. You could track the virus onto the ward or when you take your shoes off later, you could contaminate your hands. MOO

Oh, I never thought you were laughing or otherwise impertinent. I didn't look that closely at what the nurse was doing, but I am going to be reviewing it again more closely.
We both saw two things that I would consider major- first of all, if a fluid barrier is required from head to toe, then paper head coverings are not going to be sufficient to keep particulate projectile matter out of hair. Meaning that the wearer has potentially contaminated hair. The narrator made the comment that they were using a 2 layer N-95 mask to keep secretions away from health care professionals' mouths, but stopped a bit short with all the paper, I think.
The shoe boots were also paper, I believe. So it doesn't require standing in the same spot, it would only require saturation with blood or another body fluid to make a break in the isolation field, if they were the paper ones I've worn that look just like those. If they were polyurethane or like substance, then you are right, she would have walked though her previously potentially contaminated footsteps with her own shoes.
The times I've used a 2 person isolation procedure, the second person is also gowned and gloved in clean or sterile gown and gloves, and assists with the removal of the outermost layer of waterproof clothing, always from the inside, though, never touching the waterproofed outside.

 

[SeekingJana]

Antimalarial drug Chloroquine shows promise against Ebola

https://plus.google.com/app/basic/stream/z12bd3jaxvucgbfgj04cf5a5eryicvizims0k

This is so eerie. I was reading one of the " Outlander" series of books last week on my Kindle Fire HD, and I was reading about the treatment of malaria and how a doctor from the 1970's used her knowledge of quinine to treat malaria in the 17th century with a Cichona tree bark infusion. ( She was a time traveler).
I wondered then if the Chloroquines might work against Ebola but dismissed it as too simplistic an answer for such a gruesome febrile illness.

 

[SeekingJana]

:tyou: I'm glad you understand. I didn't want anyone to get the wrong impression. I work on a very busy L&D unit. with between 5,000 and 6,000 births a year. I've been splashed (sometimes in the face) with amniotic fluid (meconium :shame and blood. I've been vomited on.....it's a glamorous job...... I love my PPE!! :heartbeat:

BTDT too, usually w/o benefit of anything except gloves. OMG, nurses have been exposed to so much in the past 40 years.. I don't see how they did what they did during the Polio epidemic years and before.