As the Ebola outbreak continues in West Africa, area hospitals made preparations to deal with possible cases, should they present.
"When the news about the Ebola case in Texas broke, we got together internally with our hospital staff and also with Sylacauga Ambulance," said Jeff Wood, facility infection preventionist for Coosa Valley Medical Center, whose sole focus is on ensuring the hospital is prepared to treat whatever infection presents itself. "Including the ambulance service was important to us, because they would be the first ones treating a potential Ebola patient."
Quincy Leach, CVMC nursing director for the emergency room and intensive care unit, said the hospital conducted an internal drill with external components (the ambulance service).
"The disease could come into the hospital in many ways, and our concern is catching it as early as possible so we can isolate the patient from the get-go," he said.
Leach said when a person comes to the CVMC emergency room, each is asked if they have traveled to Liberia, Sierra Leone or Guinea in the past 21 days or has been in contact with someone who has traveled to those countries in the past 21 days.
Wood said CVMC uses the Centers for Disease Control and Prevention Ebola algorithm for evaluation, which helps determine high-risk, low-risk and no known exposure to Ebola.
"The CDC first recommended we use contact precautions and droplet precautions," he said. "The CDC's personal protective equipment (PPE) recommendation was gown, mask, gloves and goggles (eye protection).
“We put that on a health care worker and there was a lot of skin exposed. We saw on the news that people in West Africa were covered from head-to-toe, so we did the same even before the CDC revised their guidelines, which now recommend no skin exposure."
Wood said Ebola is transmitted through contact with body fluid, not casual exposure.
"The symptoms are fever, nausea, vomiting, diarrhea, body aches, severe headache — symptoms very much like the flu," he said. "Since we are coming into the flu season, we need to be able to properly diagnose whether a person has Ebola or the flu."
Leach said at this time, travel history is the deciding factor.
"We have an isolation room in the E.R. with its own bathroom," he said. "It also has an ante-room for the nurse to don the PPE in."
Wood said CVMC has four additional isolation rooms in the hospital and two bubbles that allow health care workers to provide care without being in the same space as the patient.
"If we have a suspected case of Ebola, we would house the patient in the E.R. at the time and contact the CDC for a response team," he said. "Then the patient would be transported to a regional care facility equipped to treat Ebola."
Wood said the E.R. would be in lockdown during that time until cleared by the CDC to reopen.
Leach said the drill was a great learning experience that helped identify gaps in the learning process.
"When a patient presents as infectious, it took the nurse several minutes to collect the equipment for PPE," said Amy Price, chief nursing officer and chief operating officer for CVMC. "So we developed an Ebola bag, a duffle with all the PPE needed to protect against Ebola, which is kept in the ante-room of the isolation room in the E.R."
Price said the PPE items are numbered in the order they are put on in, which they believe will help decrease the chance of exposure. Additional nurses from other departments will be trained as observers, to ensure the person donning the PPE does every step correctly and that there are no gaps which might result in exposure.
"The PPE is above and beyond the CDC recommendations," she said. "Also, the PPE is very hot, so we have implemented a two-hour limit on the time a nurse will spend in PPE inside the isolation room with the patient. We don't want to exhaust our health care providers."
Price said PPE is also now on backorder, so the hospital will use what it has judiciously and not go in and out of the isolation room unnecessarily.
"We also felt getting the ambulance service involved really created a health care team, a united front in preparation," she said.
Wood emphasized that identifying the patients is the key to protecting both health care workers and the public at large.
"We also looked at this from the community perspective," Leach said. "Even if Ebola strikes here, we will do our best to provide the best care possible and protect the community. These drills help us with that."
In addition to the drills, Wood will be speaking at Community Links about CVMC's Ebola plan at the B.B. Comer Library on Monday.
A football tailgate lunch begins at 11 a.m., provided by CVMC. The presentation "Is it the FLU?" will begin at noon in the Harry I. Brown Auditorium. CVMC will also provide free flu shots to the first 25 people and flu shots for $15 after that. For more information about the event call 256-401-4070.
Beth Bourg, manager of marketing and communications for St. Vincent's Health System, said all St. Vincent's Health System facilities are following the CDC's guidelines for infectious diseases.
Kate Darden, vice president of marketing and communications for Baptist Health System, released the following statement, "The Baptist Health System Hospitals and clinics are adhering to the Centers for Disease Control and Prevention and the Alabama Department of Public Health's guidelines for the screening and identification of potential patients who are at risk for or may have Ebola.
“On Oct. 20, the CDC released updated recommendations for the personal protective equipment (PPE) that U.S. health care workers should wear when caring for suspected or confirmed Ebola patients. Baptist Health System's clinical leaders have adopted these recommendations and implemented actions to ensure that all recommended PPE and recommended CDC protocols will be followed.
“Additional training is being provided to individuals that may be involved in the treatment teams for any patient with a suspected or confirmed case of Ebola.
"As always, patient safety and privacy are a top priority for Baptist Health System. We are deeply committed to maintaining the highest standards and most current protocols and training to minimize the risk of anyone contracting an infectious disease like Ebola."
Contact Elsie Hodnett at email@example.com.