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MUHA Communications Corner - Ebola Update: What you need to know

MUSC leadership is committed to frequent and transparent communications with our employees regarding Ebola. The medical center’s Ebola Information page (www.musc.edu/medcenter/news/ebola.htm) which includes educational resources: FAQs for staff and patients, Screening Criteria, MUSC Instructions, and links to external sources, such as the CDC, remains the go-to site for all Ebola information for the MUSC community and is updated regularly.

We all need to do the following with a suspected case (Remember — SICK):

  • Screen: Fever + Travel to West Africa within 30 days (or Ebola exposure) = Suspected Case (Make sure you know how your area is screening for fever and travel history)
  • Isolate: Immediately isolate suspected patient in a single room, with standard–contact–droplet precautions (Make sure you know what room which will be in your area)
  • Communicate: Immediately call the Communications Coordinator (792-3333) and page Infection Prevention and Control; they will escalate communications from there.
  • Keep Calm

In the unlikely case we hospitalize a patient, we anticipate using existing isolated space in the main hospital and will utilize attending physicians only (no trainees), ICU nursing only and respiratory therapy if needed. Visit the Ebola Information intranet site to see a full communications grid outlining how to expect ongoing communications and updates regarding Ebola. (Review now)

Brian Fletcher, R.N., disaster preparedness program manager, demonstrates how an Ebola patient would be transported. photo by Sarah Pack, Public Relations

What is MUSC doing to prepare?   
Training / Education

  • The Infection Prevention and Control (IPC) Department is collaborating with the Nursing Professional Development Department to develop education and training information for staff and to encourage staff to visit the CDC Web page for up-to-date guidelines and recommendations.
  • The Emergency Management Committee, IPC Department and Organizational Leadership are developing a comprehensive plan and actively preparing for Ebola. This includes ensuring protective attire is available, educating staff on screening criteria, planning to admit the possible Ebola patient, developing communication plans, and performing drills.

Points of Entry (any clinic, ED, urgent care, etc.): Any point of entry needs to screen, isolate, communicate, and keep calm (“SICK”).

Transport: All transport will be done by Meducare in an Isopod — we have 10 isopods on site.

Destination Unit: “Little” STICU (short term) until/unless 6C can be appropriately renovated.

Staffing

  • A specialized medical team will consist of two ICU nurses, physician, and 1 RT (if needed) per patient per patient per shift.
  • A volunteer list is being generated and training on donning–doffing the personal protective equipment (PPE) has started. Any potential exposure will be managed based on CDC guidelines.
  • The attending team will be intensivists, but may involve hospitalists for non–ICU level attending staffing. Our first priority for attending training will be intensivists.

Other Services

  • Patients may require intubation and dialysis; plans are underway to ensure these can be safely accomplished.
  • Lab testing will be done with point–of–care testing.
  • Any blood work that has to be processed in the lab will be double bagged (3–person process) and hand delivered.


Waste Management

  • We expect 8 to 10–55 gallon drums of waste per day.
  • We have confirmed our vendor will manage our waste.
  • Terminal room cleans will be outsourced to a company (not our EVS).


Security

  • Will be posted outside the destination unit at all times, and will monitor anyone coming or going.
  • Only designated specialized medical teams will be allowed in.
  • There will be no visitors allowed in the unit.
  • There will also be no students or trainees allowed in the care.

Communications
We have dedicated an intranet site for internal communications, have held Ebola Information town halls and are working with PR on external communications.

Other
We are working with DHEC and SCHA to coordinate efforts with other centers in S.C.

FAQs for Staff
What is Ebola?  Ebola is a rare and often fatal disease in humans and nonhuman primates, caused by infection with viruses of the Ebolavirus Genus.   

How is a person infected with the Ebola virus? How is it spread?

  • A person is infected by direct contact with blood or other body fluids (urine, feces, sweat, saliva, breast milk or semen) from a person who is sick with Ebola.
  • A person can also get Ebola by touching contaminated needles, syringes or other things with body fluids of a person sick with Ebola.  
  • The virus enters through broken skin or unprotected mucous membranes (i.e. eyes, nose or mouth). Aerosols, such as cough droplets, can also spread the virus.
  • A person can also get Ebola from infected animals.

When is a person with Ebola considered infectious and capable of spreading the Ebola virus? A person is not infectious or contagious before they are symptomatic.   

What is the incubation period? An exposed person can develop disease anywhere from 2 to 21 days after exposure, but the average is 8 to 10 days.

What are the signs and symptoms of Ebola?

  • Recent travel or contact with someone who has traveled to a country or area that is experiencing an outbreak.
  • Fever greater than 38 degrees C (100.4 degrees F)
  • Severe headache
  • Muscle pain  
  • Throwing up
  • Diarrhea
  • Stomach pain
  • Unexplained bleeding or bruising

What is the treatment for a patient infected with the Ebola virus?

  • Currently, no specific vaccines or medications have proven to be effective.  Some experimental drugs have been used for patients with Ebola.  
  • Treatment currently consists of supportive care for symptoms that are present (i.e. IV fluids, electrolyte replacement, comfort measures).


How is Ebola diagnosed?

  • Through laboratory testing of a blood specimen: Need at least 4 mL in a lavender/purple top vacutainer and at least 4 mL in a red vacutainer.
  • The tests are sent to the CDC and takes 48 hours for results.
  • All specimens must be double bagged (3-step process).


What is the prognosis of a patient infected with Ebola? Does everybody die who has Ebola? Current statistics show 1 of every 2 people who became infected with Ebola has died.  

The Team Leaders for MUSC’s Ebola response:

  • Overall - Dr. Danielle Scheurer, Chief Quality Officer
  • Disaster Preparedness - Dr. Kathy Lehman-Huskamkp and Brian Fletcher
  • Specialized medical teams (coordination, communication, training–education content) - Dr. Kathy Lehman-Huskamkp
  • Educational roll out - Angela Egner and Lisa Langdale
  • Infection Prevention and Control - Linda Formby
  • Hospital Epidemiology - Dr. Cassandra Salgado and Dr. Lauren Richey

While the risk of Ebola at MUSC is small, we are taking action to be well prepared.

If you have any further questions, refer to the Ebola Information intranet site, or contact Chief Quality Officer Dr. Danielle Scheurer at scheured@musc.edu.

October 23, 2014

 

 
 
 

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