Ebola Virus Disease (EVD) – Information for EMS and Healthcare Providers

by nageAdmin · October 9, 2014

The IAEP and NAGE EMS divisions of NAGE/SEIU Local 5000 provide this general information about the Ebola Virus as a public service to EMS professionals and healthcare providers who want more information about Ebola and related highly infectious diseases. The latest and most up-to-date information can be found at the Center for Disease Control and Prevention website HERE. Linked articles, documents, videos, photographs, and images are property of their respective owners.

See an informative CNN Interview of an EMS Professional who treated/transported an Ebola patient:

Video via Youtube courtesy of CNN

Here is a comprehensive article from JEMS: Journal of Emergency Medical Services titled:

Ebola Outbreak Not a Threat to U.S. Healthcare Workers

Click the link above to read more… Highlights include:

Patient Assessment

Travel history is important in today’s global society and should be a routine part of patient assessment. Assess patients who have had contact with blood or body fluids of a person known or suspected to have the disease, traveled to an area where there are cases of Ebola, or have handled bats, rodents, or primates from a disease area within the past three weeks.9,10 Assess for temperature greater than 101.5 degrees F, headache, muscle pain, vomiting, diarrhea, abdominal pain or unexplained hemorrhage.

What PPE is needed?

The World Health Organizations (WHO) and the CDC have published guidelines for the care of persons suspect for or diagnosed with Ebola:

>> Wear gloves when touching the patient and the patient’s immediate environment or belongings;

>> Wear a gown if substantial contact with the patient or their environment is anticipated;

>> Wear protective eyewear to protect from splash/splatter; and

>> Perform hand hygiene after removal of PPE. Use soap and water when hands are soiled with body fluids or after caring for patients with known or suspected infectious diarrhea.

There are three types of isolation precautions that should be used: standard, droplet and contact. Standard precautions are based on the principle that all blood, body fluids, secretions (except sweat), non-intact skin and mucous membranes may transmit infectious agents. Use gloves and wash hands when in contact with patient blood, non-intact skin, mucous membranes and contaminated surfaces. Alcohol-based foams and gels may be used if hands aren’t visibly covered with blood or body fluids.

To take droplet precautions, wear a surgical facemask when coming within three feet of an Ebola patient or upon entering the vehicle or home of a suspect patient, especially if he or she isn’t wearing a mask. Eyewear should be worn to protect from splash/splatter. If substantial spraying of respiratory fluids is anticipated, gloves and gown as well as goggles or face shield should be worn. Instruct the patient to wear a facemask when exiting the ambulance, avoid coming into close contact with other patients, and practice respiratory hygiene and cough etiquette.

For contact precautions, wear gloves and a cover gown when in direct contact with patient or contaminated equipment or surfaces. Perform adequate hand hygiene after removal of PPE, and dispose of medical waste as required by your state regulations.

Key prevention points include:

>> Avoid aerosol-generating procedures as these should be done in a hospital negative pressure isolation room;

>> Limit the use of and carefully handle sharps;

>> Cleaning can be conducted by using any EPA-registered disinfectant. No special solutions are required; and

>> Only routine laundry procedures are needed. No special washer or solutions are required.

Image courtesy of CNN

Also found in the article is an explanation of why there are media images of healthcare providers in “moon suits”, according to the article author:

Moon suits were shown on TV when the first two Ebola patients arrived in the U.S. and the media played it up big. But, here are some important points:

1. The unit at Emory University Hospital, where the first patient was taken, is just one of four in the U.S. designed to care for patients with an unknown disease. (There are also patients at the facility in Nebraska and at the National Institutes of Health in Maryland);

2. Written plans are in place for patient care and transport; and

3. Although Ebola is a familiar disease with a known method for transmission, this situation presented the perfect opportunity to put the university’s written plan into action and to practice real containment. However, in a more recent document, the CDC has made clear that any medical facility in this country should use the recommended precautions. This is now the case in Texas, where the first U.S. patients diagnosed with Ebola is hospitalized.

It’s also possible that the overuse of PPE was designed to lower public fear about spread of the disease. It’s not helpful that, in many media reports, the actual method for transmission hasn’t been made clear. Ebola is a disease transmitted by direct contact with blood and body fluids, so healthcare workers are protected as long as they practice basic infection control measures.

The U.S. Centers for Disease Control and Preparedness (CDC) has assembled a variety of resources to assist emergency medical services agencies and other healthcare providers in preparing to care for patients with known and suspected ebola virus disease. While this list is not all-inclusive, it contains relevant information from the CDC.