Yes. And it makes you feel damn stupid. Let’s hope she survives.
I agree with Broomstick because I’ve never seen a medical person take their gloves off properly. Sure, they wash their hands before they glove up, but after they are done doing whatever they need to with me, they just kinda pull their gloves off and toss them in the trash.
I’d guess they think they are trying to protect their patients from other patients, and not thinking that they really need to protect themselves from the patients.
As for the advice about nuking Dallas from orbit…I’m totally up for that if only because of their traffic. I used to think that Houston sucked…then I tried to drive in Dallas.
I’m sorry, but the answer to Chicken Little is not Pollyanna. Comparing this to “HIV and hepatits and so on” is rather instructive. So far, out of some 10 - 20 Ebola patients treated in Western countries, 2 have transmitted the disease to health care workers. I don’t care to look up the exact numbers, but that must be at least 5 or 6 orders of magnitude higher than the transmission rate of HIV or hepatitis. It’s not even vaguely comparable.
Meanwhile, the CDC has a rather complicated set of instructions for use of protective equipment when treating Ebola patients. You can see it here, with commentary. Speaking as a resident MD who works in busy overstaffed public hospitals, including ICU settings, the idea that these protocols can be easily followed in any hospital (as opposed to specialized designated treatment centers) is frankly laughable.
Oops… that should have been “understaffed”, of course.
How does one remove the protective gear without being exposed? Who carries it off and burns it?
In Liberia and Sierra Leone on average every Ebola patient is infecting 2 other people - hence the outbreak grows there.
This, compared to Dallas were 48 people participated in the card of Mr. Duncan and only one it seems has contracted the disease. Sure, it’s easier to catch Ebola than HIV, but it also seems that Ebola doesn’t spread nearly as easily in the Americas or Europe as in Africa… hmmm… could it be that the protective protocols actually work? Despite, yes, the fact that they don’t work perfectly.
Funny, I don’t recall anyone saying those protocols are "easy’. I keep hearing over and over how damn careful you have to be. If, as you say, they are difficult to get right every single time is it that surprising 1 person out of 48 didn’t quite get it right and got sick?
I don’t know all the details, but I gather it involves cleaning the exterior, then carefully removing everything in a particular order so as to never contact the exterior with your flesh while having a buddy (also in protective gear) help you do it, then taking a long, full body shower. The contaminated gear is then bagged and disposed of as biohazard.
I have some concerns with the military personnel being sent over to Africa to help with them. I’m assuming they are folks trained in NBC warfare who have had some training already with protective gear but I don’t know for sure - anyone have more information on that?
The protective gear is removed with a flame thrower. When performed, there is almost no chance of infection, but there are other issues with this technique.
Cool!
Hot!
*Very *carefully.
The University of Nebraska Medical Center protocol for donning and doffing gear can be downloaded from this page.
First, note that the protective equipment requires two layers of gloves. Additional layer(s) may be added once in the patient treatment room. These instructions assume only two layers to start.
Doffing:[ol]
[li]Wipe outer gloves with bleach before opening door to exit patient room.[/li][li]Step out of room onto pre-positioned doffing pad (think specialized non-absorbent tarp) with pre-positioned trash can with liner.[/li][li]Once on doffing pad, carefully remove duct tape which you used to tape outer gloves to sleeves of gown. Gently discard tape in trash can.[/li][li]Pinch left* hand glove on the inner wrist with thumb and forefinger of right hand. Pull gently towards fingertips of left hand until pinched glove starts to roll inside-out off the hand. Remove left glove inside-out, wadding it into a ball. Hold discarded glove in right hand. Slide forefinger of left hand inside right glove at the inner wrist. Pull right glove away from wrist slightly and towards fingertips of right hand until right glove starts to roll inside-out. Continue pulling right glove off inside-out leaving left glove inside the right. Gently discard gloves in trash can.**[/li][li]Gently untie the gown closures. As much as possible pull your hands up inside the sleeves of the gown. Gently start to gather the gown keeping the dirty surfaces to the inside, rolling it up as it slides off. [/li][li]Gently discard gown in trash can.[/li][li]Remove leg boot covers one at a time. Roll them inside out as you remove them, if possible. Minimize contact between hands and clothing.[/li][li]Step into new clean area of doffing pad. Gently discard leg boot covers in the trash. Refrain from returning to the soiled part of the doffing pad from this point forward.[/li][li]Remove inner standard patient care gloves using previous technique and place them in the trash.[/li][li]Wash hands using pre-positioned hand sanitizer. Do not leave doffing pad.[/li][li]Put on a new pair of clean gloves.[/li][li]Grab rear strap of face shield. Tip head so chin is down. Lift face shield strap up at rear of head, Allow face shield to fall away from face. [/li][li]Discard face shield in trash.[/li][li]Untie strap for head and neck covers. Gently, pull off head and neck cover and discard in trash.[/li][li]Hold lower corners of face respirator mask with fingers of left* hand without touching skin. Expose as little of the mask’s dirty surface as possible to your gloves hands. Use right hand to lift each strap of the respirator mask over the back of your head. [/li][li]Discard respirator mask in trash can. The surgical cap may move with the respirator mask straps as they are moved. [/li][li]Gently remove surgical cap while minimizing contact with its contaminated surfaces. [/li][li]Discard surgical cap in trash can.[/li][li]Disinfect top and bottom of shoes by wiping with bleach. Discard wipes in trash can.[/li][li]Step off doffing pad. Gather up the pad, rolling contaminated surface towards the inside.[/li][li]Place rolled doffing pad in trash can.[/li][li]Remove gloves using above described glove-in-glove technique.[/li][li]Discard gloves in trash can.[/li][li]Wash hands with hand sanitizer.[/li][li]Take a full body shower.[/li][li]Take your vital signs.[/li][li]Rehydrate.[/li][/ol]
Simple, eh?
Somewhere along the line someone with exposure protection on comes along and seals all the discarded stuff in biohazard bags for proper moving and disposal.
*Doesn’t really matter if you start with left or right. It’s just easier to describe if I specify.
** If inner layer of glove is accidentally removed as you peel off the outer glove inside-out, then stop and put a fresh new glove on the affected hand.
Thanks, Iggy!
A second health care worker at the same hospital is testing positive for Ebola.
Apparently, the hospital was NOT properly following protocols for dealing with Ebola. Well, that makes everything less puzzling.
“Officials said they expect to see more cases.”
:mad:
Shouldn’t the CDC be sending experts to any hospital with an ebola case to make sure all training and protocol is strictly followed?
Yes. They even conceded this morning that that is what they should have done.
Let’s get real here - the US hasn’t had a serious outbreak of a high contagious and lethal disease since the last US smallpox outbreak in 1949. We’re a little out of practice.
I just hope we learn something from these initial screw ups.
seems to be a constant
I find one person infecting two others to be a remarkably small ratio. Perhaps in third world areas patients die quickly.