Wednesday, October 01, 2014

are we ready for something like ebola? Of course not.

You know what I love?  When officials get on TV and say things like the medical profession and hospitals have been "practicing for years how to deal with something like ebola".  Really?  What does that really mean?  I haven't been doing any practicing and I have been working in the ER for years.  I am on the front lines of medicine where those patients will show up first.

I always feel like we are not prepared for any disaster, let alone some hemmorhagic fever.

If they mean, if you came in with vomitting, fever, muscle pain, etc and said you had travelled to West Africa, would I put a mask on you?  Sure.  I would put you in one of the two isolation rooms we have in the ER.  We would put you on contact precautions.  contact precautions mean we wear gloves and a gown.  Is this enough?

When you see somebody on TV in West Africa treating people for ebola they are dressed from head to toe in an outfit.  They have a hood over there head.  They have things over their shoes. They have people there whose only job is to dress those people to care for them.  The way they are dressed reminds me how we used to dress for chemical warfare training.

Do we have access to these kind of outfits?  Not that I know of.

What would we do with their family members accompanying them? There are many questions that arise.   No one has said ANYTHING to us except saying we should ask people at triage whether they have travelled outside the country.

You probably think I am overreacting.  Come on....its never going to happen at your local ER.  You are probably right.  It is scary nonetheless. It brings this fact front and center: Most ERs are not ready to deal with something like this and they should be.

Tuesday, September 30, 2014

ebola is here

A couple of months ago we started asking people if they have travelled out of the country.  This was around the ebola outbreak in Africa.

Today there is a report that the first ebola case has been confirmed in Dallas.  This is really scary for
those of us who work in emergency rooms. We're literally at the front lines. If someone slips by and we are exposed we take it home to our family and they are exposed.

Shit just got real.  The symptoms of ebola are fever, headache, muscle aches, weakness, vomiting. Symptoms we see every day of the week in the emergency room. Symptoms may appear anywhere from 2 to 21 days after exposure, average being 8-10 days.

I wonder how this patient came into the hospital  No doubt it was through the emergency room, exposing lots of ER staff.  The question is did they have any idea this could have been ebola when the person came in or did it take a couple of days for the hospital to figure it out?  Did those staff go home to their families before it was known?

We live under the illusion that somehow this won't get here.  We will stop it at the airport.  There are CDC quarantine stations at airports around the country that deal with those ill from other countries.  They determine whether they can enter the country.  Here's the thing:  They may not yet be manifesting the symptoms at the time they enter the country.

So what's the solution?  I don't know. You can ban people from coming here. The on
ly solution lies in Africa, stopping the spread there. That's being worked on.  In the mean time we're sitting ducks.

Sunday, September 28, 2014

I been robbed

Here are the top ten things stolen from our emergency room:

1) syringes - before drawers were locked

2) linen - sheets, towels and wash cloths

3) phones off the wall

4) fetal doppler

5) lap top

6) bandaids, bandages

7) box lunches

8) gowns

9) oximeter

10) staff purse

11) thermometers

12) TV remotes

13) box lunches

14) scrubs

15) wheelchair

exta added bonus points: Christmas ornaments in the lobby