Locals prepare for Ebola
By Phyllis Moore
Published in News on October 25, 2014 10:44 PM
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News-Argus/CASEY MOZINGO
Crystal Stroud wipes down her latex gloves with a bacteria killing wipe during an Ebola training exercise at Wayne Memorial Hospital. Ms. Stroud is the emergency department clinical educator at the hospital.
Keep calm and carry on.
That is the message that health officials and emergency services personnel are sending to the community in the wake of the national scares about the deadly Ebola virus.
And don't worry, Wayne County is ready. Those who would deal with any infection in this county have been practicing for weeks, just in case.
As the Centers for Disease Control has tweaked and revamped its game plan, so have local agencies -- from the Office of Emergency Services and EMS to the Health Department and Wayne Memorial Hospital.
And there are some facts local health experts want residents to keep in mind.
Ebola is not airborne. Symptoms include nausea, vomiting and diarrhea.
If a person has traveled outside the country or has come in contact with someone else who has, and exhibits any of the above symptoms, getting checked by a health professional is appropriate.
Just don't take unnecessary risks.
Do not walk into an urgent care facility or get on a GATEWAY bus and make your way to the hospital.
Call 911.
"The likelihood (of Ebola) might be small but they may come into contact with others," said Mel Powers, director of emergency services. "We have set up protocols to try to get them treatment."
There is a process, he said, and it starts at the 911 call center.
The operator will ask a series of questions, Powers said.
"The answers to the questions are going to dictate what type of response you're going to receive from our emergency services. It's very important that our citizens answer those questions very truthfully and honestly."
Following the battery of questions, a specialized EMS unit will be dispatched.
The vehicle, which outwardly appears like any other emergency vehicle, is designed for ease of decontamination. It is equipped with plastic sheeting that covers the interior area where the patient will be.
Likewise, personnel handling the transport will be covered "head to toe" in personal protective equipment, called PPE, which includes a mask and two pairs of gloves, respirator, goggles, face shield and eye protector.
"There will be three on the scene in full PPE, two in the back with the patient and one driver," said Jeremy Hill, Wayne County EMS manager.
The process will be done methodically, but quickly, with the safety of staff and the community in mind, he said.
"Typically, we want to be at the patient in eight minutes," Powers said.
The first EMS worker to encounter the patient at home will ask a series of questions to assess the situation, take vital signs including temperature and provide the patient with a mask. Once the information is confirmed, the patient is wrapped tightly in a sheet and secured in the EMS vehicle for transport.
Throughout, from the call to the arrival at the hospital, there is ongoing communication with the CDC, the Health Department and the hospital, so personnel have adequate time to prepare.
Upon arrival at the hospital, EMS will wait in a designated area. They will not enter the building, Hill said.
Once the patient is transferred to hospital personnel, the decontamination process begins -- for the vehicle as well as EMS staff.
"The decontamination piece is critical," Hill said.
The entire process has been thoughtfully planned out, he said, with every person selected for the team provided extensive education and training.
"EMS will come in here, take off their suit, we'll provide them scrubs, even offer them a shower," said Jeff Brogneaux, emergency preparedness coordinator for Wayne Memorial Hospital. He was describing the "decontamination room" near the ambulance entrance.
"This room is easily cleaned and scrubbed down," he said.
Meanwhile, in the isolation room, a nurse, also suited up in protective clothing, will take the patient's vital signs, ask additional questions, start an IV and draw blood, Brogneaux said.
"At that point, we'll be looking for medical care, have physicians to be involved, start the testing process, things like that," he said. "Essentially from here, we have a lot of control.
"They're going to stay here until they can go to some other tertiary facility, it depends on where the CDC is setting up a regional (site), and transfer to some other facility for more long-term care."
The hospital will use a "two-nurse buddy team" in the isolation room and an attached anteroom where an infection control practitioner remains.
"One nurse is out there aiding and getting supplies, basically things like medications, but also monitoring to make sure equipment is appropriately on but also that second (person) makes sure they're not compromising things they're doing, that they're safe," Brogneaux said.
He said he expects the CDC would arrive quickly to give additional guidance and to make the transfer to the next facility.
After that is done, the decontamination of the isolation room will take place.
"We would sterilize everything, throw everything in the room away, no matter how expensive it is," he said. "We're working on cleaning procedures -- walls are now to be cleaned, curtains will come down, basically the room will be stripped and anything that can be cleaned will be."
Brogneaux said the hospital has been following CDC guidelines all along and in some cases has been ahead of the curve.
"A lot of the nuances we had already been working toward prior to the CDC coming out (with them) because it just made sense," he said. "We knew that skin exposure was at risk. We had already trained our nurses based on the CDC recommendations, like the surgical hood covering the neck.
"Late (Monday) night they really reinforced the things we had been doing."
As a hospital, select groups have been trained, and that will be expanded to include the rest of the staff, he said.
Local officials say they will continue to work to alleviate fear in the community.
"The big key is we're at very low risk in this area," Brogneaux said. "I think in general what people need to understand is that in the U.S. at this point, there have only been eight people treated, out of 300 million. That's a very low number.
"They just need to measure their own risk profile for the amount of travel that they do and having an understanding of the symptoms of the disease, and be aware of risks that they would (have) by going to areas that have Ebola. And of course, if they have concerns, they certainly should follow up with public health and the CDC."
Brogneaux said in actuality, people should worry more about the flu.
"We have a lot of panic over this and more people die of the flu every year than Ebola has killed, I think, over the last 30 years," he said.
Attempting to keep things in perspective, he agreed it is a big issue but believes local preparations will be effective.
"I feel very confident that if it does happen right now, we could take care of a patient," he said.
Health Director Davin Madden agreed.
"Even though we're focusing on Ebola, (this) is allowing us to focus on the protocol," he said. "But in a case like this where Ebola is on American soil, we haven't really had to deal with those on a potentially mass scale.
"This has really heightened our response on how to respond."