Friday, October 03, 2014

guess what? you have been assigned to care for an ebola patient...

It would be interesting to see how the nurses caring for the ebola patient in Dallas are doing it.  Just practically speaking.

It appears from what I have seen, people in West Africa caring for patients are dressing in what is essentially a hazmat suit. Well lets assume that here the outfit consists of: gown, double gloves, hairnet,  foot covers, googles, mask.  I assume our mask we are fitted for with TB doesn't have to be worn since apparently this is not airborne.

The nurse(s) spends the shift in all of this.  I assume they never leave the room because of the situation and the impracticality of putting this stuff off and on over and over.  To say wearing this gear for hours is uncomfortable is to understate it.

The machinery involved in caring for a critically ill patient like this is complicated.  Just trying to manage the practical care of the patient with the gear on would be very difficult.

So keep in mind everybody who comes into the room: xray, various docs, respiratory therapy has to don the gear. This kind of patient has a lot of tests: xrays, CTs. How is this done?  Is there one xray machine dedicated to them?  Do you take them through the halls to CT?

This patient may be on dialysis.  They may be intubated.  What if they arrest?  Is someone in this situation resusitated?

The practical side of caring for this patient is mind boggling.  Its something the general public has no concept of.  The cost is staggering. Now imagine just ten cases of this across the country.

One last thing: Can a nurse refuse to take care of this patient? Imagine being a new mother with a few months old baby at home.  Would you want to chance bringing something home?  Now I can hear all of you saying: If you use all of the gear, take the necessary precautions, you will be fine.  What about those 2 doctors who used all the precautions in Africa and ending up getting ebola anyway? What about the cameraman who surely had no physical contact with an ebola patient and has now developed the disease?

For healthcare personnel in hospitals, the reality of this hits home.  Chances are almost nonexistent that we as individuals will ever deal with it. It certainly makes you think.


Anonymous said...

The west is arrogant and assume the feeling that the nanny state knows how to protect them no matter what the problem is. The truth is the world is a few inches from distaster and authorities in the west think this disease won't hit us. No one gives a shit about the other side of the world because they are seen as less valuable.

Anonymous said...

These suits are more than hazmat as hazmat suits are usually a variation of the PAPPR units in most hospitals. The Ebola suits are completely contained, breathing recycled air and not outside air. Despite that, 240 healthcare workers were infected, 120 have died. The PAPPR units in the hospital are useless. None of my area hospitals seem to have the true biohazard suits.
Think of all the disposables as well, covered in blood and how do you get that out of the hospital with minimal risk of contamination?
And this is a hemorrhagic disease where most patients are going to be vented. How many vents can your hospital come up with?
This has the potential to be a nightmare we could never have imagined.