Saturday, November 17, 2018 -
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Rose ‘ready for Ebola’

Dr. John HammerDENVER’S Rose Medical Center started implementing Ebola protocols before John Eric Duncan presented symptoms of the hemorrhagic disease last month in Dallas.

“But like many hospitals across the country, we went into high gear” after the chaos in Dallas, says infectious disease specialist Dr. John Hammer, chair of infection control at RMC.

Rose currently has one dedicated Ebola bed in the ICU and the capacity to care for two adult patients inflicted with the deadly virus.

Due to nurses’ concerns about inadequate protocol, personal protective equipment (PPE) and procedural missteps, RMC has instituted measures designed to protect both healthcare workers and patients.

“Repeated instruction, practices and drills, and feeling comfortable with PPE in case we do have a patient exposed to Ebola are key,” Hammer says.

RMC nurses untrained in Ebola protocol are not allowed to fill in as volunteers, which allegedly occurred at Texas Health Presbyterian.

“We train special ER staff members in Ebola and ask them if they would feel comfortable working in the ICU setting,” Hammer says. “They can accept or refuse.

“We have not experienced any push back from our nurses because of Dallas, and believe we have taken extra steps to ensure those problems won’t happen here.”

Read previous IJN coverage of the Ebola scare, “Ebola in US no surprise to local expert

RMC’s PPE requirements exceed CDC requirements, Hammer says. No areas of the body are exposed. “Our PPE is more aggressive than what has been proposed by the CDC.”

He adds that new CDC requirements for PPE (scheduled to be released two hours after this interview) probably will insist that all skin is covered. “I don’t try to read the CDC’s mind,” Hammer says. “But my guess is that the PPE we’ve been using will be in accordance with any new regulations.

“It’s a moving target,” he says of the agency’s constantly fluctuating protocols. “Still, it’s hard to imagine that ours would be considered less than ideal.”

(He was right. CDC guidelines issued Oct. 20 included intensive training for healthcare workers, competency exams and proper PPE control practices, all of which Rose utilizes.)

Colorado hospitals immediately contact the Colorado Dept. of Public Health and Environment (CDPHE) about suspected cases of Ebola.

The state-run CDPHE functions as an arm of the CDC.

PERTINENT information is collected and documented the moment an ill person arrives at RMC’s ER intake center. “You will be questioned about fever, related symptoms and your travel history,” Hammer says. “Travel history is crucial.

“If the answers are yes, you will be masked and wheeled to a secure ER room with negative air flow that is staffed by trained employees.”

A separate containment area is connected to the secure ER room. This is where employees put on and remove (“don and doff”) PPE to protect themselves and others.

ER personnel contact CDPHE at that time. “We would then move you to a dedicated ICU room, mobilize our team and resume care,” Hammer says.

If a patient’s symptoms are severe, the RMC team of physicians consults with CDPHE and Children’s Hospital, Denver Health and Children’s Hospital, the three designated “centers of excellence” in treating Ebola.

“It’s a collaborative decision making process involving Rose physicians, the receiving facility and CDPHE,” Hammer says.

Transportation is an important factor. The three designated health centers have special ambulances and personnel, while symptomatic patients may arrive at RMC’s ER in unprotected ambulances.

Should sick people with a travel history to the affected West African countries bypass RMC and go directly to Children’s, University or Denver Health?

“Those facilities are well equipped to handle Ebola,” Hammer prefaces. “That said, Rose is prepared to safely admit and care for patients for as long as necessary.”

Hammer advises people who feel ill and spent time in Liberia, Sierra Leone or Guinea to first call their primary physician. Doctors will in turn contact state health authorities.

“We wouldn’t want you showing up here if it’s avoidable,” he says. “As with any infectious disease like the flu, we want to minimize contagion to anyone waiting to be admitted to the ER.

“This helps us reduce the risk of infection to others and expedite care in a safe manner.”

AMERICA is relaxing its grip on Ebola, at least this week. Public health officials are now urging reason-based calm over unsupported Ebola rumors circulating in the media.

Hammer agrees with Dr. Daniel Mogyoros, an infectious disease specialist at Kaiser Permanente, that influenza is an infinitely greater threat than Ebola in the US.

The death of John Eric Duncan in Dallas and two nurses who tested positive for the disease after treating him brought home an improbable scenario in a very palpable way, Hammer says.

“We believe that the antidote to fear is information,” he stresses. “For the Rose staff, this entails repeatedly practicing protocols, drills, and acquiring a thorough understanding of Ebola.

“Nothing is perfect. Things can go wrong in the heat of the moment. But we feel we’ve taken extra precautions to prevent this from happening.

“We have a plan in place, and we’re confident it will work.”

Copyright © 2014 by the Intermountain Jewish News



Andrea Jacobs

IJN Senior Writer | andrea@ijn.com


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