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magical thyme

(14,881 posts)
Wed Oct 15, 2014, 10:46 PM Oct 2014

here are the PPEs worn in the Ebola ward at Emory and Nebraska



?resize=760%2C507

Can anybody explain to me why BSL-4 hospitals believe they need years of training, specially designed facilities and biohazard suits to treat Ebola patients?

Whereas nurses at regular hospitals only need droplet/contact precautions?

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uppityperson

(115,674 posts)
1. These sound more like what they used in Dallas. They are not necessarily what they used, but
Wed Oct 15, 2014, 10:50 PM
Oct 2014

more along the line of normal isolation gear.


picture above is from http://www.jsonline.com/news/health/wisconsin-health-officials-gather-as-ebola-concerns-rise-b99370560z1-279083301.html

This photo needs gloves and goggles, but this is a basic isolation gown, shoe covers, hair covers, mask.

Recursion

(56,582 posts)
2. "Funny" story: the first Ebola (or maybe Marburg?) samples that came to CDC were mislabeled
Wed Oct 15, 2014, 10:55 PM
Oct 2014

(Marburg is a close Ebola relative that was discovered first.) Anyways, the CDC got a cooler like it often does, but the label was mistyped so they thought it was a known low-danger pathogen, and the processing crew was wearing those outfits when they did the intake. Even "funnier": the vial inside the cooler had broken, and blood and tissue were just sitting there on the ice.

That said, they handled it for a couple of days before anybody realized what was happening, and nobody got sick...

Also, the goggles are a crucial part that isn't in the photo but is in the drawing. The first known patient-to-doctor transmission seemed to have been from vomit hitting his eye.

uppityperson

(115,674 posts)
3. I edited to add another graphic but indeed. A high percentage of people catching this are caregivers
Wed Oct 15, 2014, 10:56 PM
Oct 2014

they need protection, caregivers all over the world.

Recursion

(56,582 posts)
5. Yeah, the type sample of Ebola Zaire comes from a Congolese nurse who died
Wed Oct 15, 2014, 11:00 PM
Oct 2014

A doctor in the hospital caught it in the same outbreak, though he survived (and is now one of Africa's top authorities on rotoviruses like Ebola).

I haven't heard of a case where the transmission occurred outside of a hospital or health clinic, except for Case 0 back in 1981 (WHO has still never been able to figure out how he got it).

 

magical thyme

(14,881 posts)
7. the "wash hands immediately after removing all PPE" is problematic at my little hospital
Wed Oct 15, 2014, 11:02 PM
Oct 2014

the disposal for gowns, etc. for MRSA patients on droplet/contact precautions are in the doorway.

the sinks are well inside the rooms, often right by the bed.

If you're to wash your hands immediately, you'll have to remove the PPEs by the bedside, leaving you exposed to any projectile vomit that heads your way.

Luckily, we won't be admitting any I'm sure. Our doctors mostly have an abundance of caution. Any suspicious patients will be headed to the big hospital to our south as quickly as possible.

 

kestrel91316

(51,666 posts)
6. What the "cowboys" of virology got away with back in the day
Wed Oct 15, 2014, 11:02 PM
Oct 2014

never fails to give me heart failure when I read about it.

 

pugetres

(507 posts)
8. Fancy!
Wed Oct 15, 2014, 11:55 PM
Oct 2014

At times, the OR crew would be wearing head coverings when bringing a patient. A sterile field is important.

I cannot recall ever having anything to cover my hair in the ICU. I can recall standing there pumping out alcohol foam and rubbing it through my hair after particularly ugly episodes involving bodily fluids. That wasn't because of protocol saying to do so. It was because that protocol didn't address that sort of thing. Hair coverings cost money!

 

kestrel91316

(51,666 posts)
4. BPCUs are not specifically designed for Ebola,
Wed Oct 15, 2014, 11:00 PM
Oct 2014

but rather for the next big unknown infectious disease that comes along that we don't understand or know for sure how it spreads. There is no particular reason Ebola patients should HAVE to be treated there. Ebola can be treated in far less specialized facilities with little or no fancy equipment and without infecting staff. And training for biosafety can be done anywhere by people with brains.

I'm sure glad we have these units, though, for the hospitals that just aren't up to the task to turn their patients over to. TH Pres would be one of those. They need to decommission their iso ward altogether, IMHO, until and unless they agree to follow established federal safety guidelines instead of winging it Texass-style.

Barack_America

(28,876 posts)
9. I'm wondering if that first pic is supposed to be smallpox?
Thu Oct 16, 2014, 12:02 AM
Oct 2014

And hoping that someone needs to be commended on their makeup job.

 

kestrel91316

(51,666 posts)
10. Yep, fake smallpox. I see a little light reflecting off the clear plastic
Thu Oct 16, 2014, 12:34 AM
Oct 2014

stuff all the spots are attached to - in just a few places.

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