Posted on 10/14/2014 5:52:48 PM PDT by Carry_Okie
This is the CDC procedure for donning and doffing personal protective equipment (PPE) specifically for ebola found here.
This is basic isolation gear on a cart outside the patient’s room - disposable gowns, masks, gloves. You’re supposed to stuff the discarded clothing into a bin just inside the door and step out of the room. You’re supposed to take gloves off first, then with your supposedly clean hands, tear off the strings of the mask and gown and remove them so that only the inside surface touches you. Supposedly the string at the back of the gown and mask are clean because you never turned your back to the patient or brushed your back against any contaminated surface.
A lot of nurses before driving home remove their shoes outside the car, drop them in a plastic bag, use hand sanitizer, put on clean shoes, and then start the car.
I’d risk that for MRSA, not Ebola.
It requires a second person in the exit area to do this properly.
There is no safe way to remove PPE without a bleach rinse first.
Aerosols must be limited as much as possible. They can remain infectious for up to 90 minutes if the humidity is high. Air jets or pressure washes can stir them up.
Low humidity, ozone, or UV light will kill aerosols quickly.
The reported procedures in the hospitals are totally inadequate for a BL-4 hazard.
That was one recommendation. The other had the person touching their gown with bare hands. In both methods, the person is touching their mask, respirator, face shield with bare hands and told to wash them with hand sanitizer “if” they get contaminated.
Read this and be comforted:
http://www.umc.edu/News_and_Publications/Press_Release/2014-08-07-00_UMMC_ready_for_Ebola.aspx
You are right, and as CarrieOkie said, they should be double-gloving.
Even with double gloves I would be nervous. So many times I have had gloves break.
They do stress not to touch the front of the mask, I guess that’s something. s/
Frieden has no sense of the fact that these nurses and doctors, resp therapists are going home to their families at night essentially as vectors of ebola.
“Hey honey, what’s that in your hair?”
Mrs. AV
So I take off my infected shoes before I get into the car. Am I now infected because I came in contact with some body fluid on my contaminated shoes?
I know I’d feel safer with the rinse or “spritz” if I was a health care worker. The CDC is quite unprepared to give adequate advice, it seems.
Make sure my will is up to date, I guess.
Dr Frieden sure wouldn’t be answering my calls, I can tell you that.
Mrs. AV
Yes, I know what they’re dealing with. But do the nurses? Or DID the nurses. They were lied to by the CDC and their bosses. Nurse Pham has said she did not breach protocol. That tells me she did exactly as she was told. So there’s no telling what she was told about the gear.
Now all those who had contact with Duncan are afraid for their lives because I’m sure they, too, did what they were told and they’re now finding out it probably wasn’t enough.
Incompetent political appointees are running the show but we’re just now finding that out.
The CDC poster is pure fantasy.
Gowning up needs to be a two person operation.
There should be no exposed skin. Not neck or forehead or anything.
Booties need to be duct taped to the suit’s legs.
Sleeves need to be duct taped to the outer pair of gloves.
Removal is even harder. Buddy needs to hose you down with bleach. Then wait 7 to 10 minutes for the bleach to kill the pathogens, then hose down with clean water, then your buddy needs to help you remove the protective gear. You can’t do it by yourself without compromising and possibly contaminating yourself.
If you’re not gloved so that the virus can’t come into contact with your skin it’s certainly a good possibility. Then, you’ve got to exercise caution with the gloves because they touched the potentially contaminated shoes because they came into contact with some bodily fluid from an infected person. This sort of thing is why a sort of buddy system arose in Africa, two people suited up so each can spray the other down with chlorine bleach solution to kill the virus before taking them off.
I still cannot get the comparison out of my mind: the nurse working with the patient in a cotton gown will in contact with his body fluids while the guy cleaning out her apartment is wearing a full hazmat spacesuit. I hope the nurses and doctors can put a stop to this lunacy.
Did you track the gross infected fluids all over the hospital on your way to the car?
That’s the question I’d be asking the hospital lawyers.
Yeesh.
I would never touch the gown with bare hands. And double gloving is a must. The truth is that gloves often tear, both at the fingertip and when pulling them on, at the cuff.
Even double-gloving is not enough for something like this, which is probably why they are wearing the thicker rubber gloves in Africa.
Hand sanitizer is really overused, and is basically useless. The main thing that removes bacteria and viruses from your hands is the friction of washing your hands with soap and water.
Mrs AV
Thanks for the procedure write-up BuffaloJack. Excellent. You should send your procedure to the CDC.
That sounds like standard procedure, though, when treating patients in isolation. All nurses, paramedics, etc., know how to handle gloves and so on to avoid contamination.
But, one would expect them to be given hazmat suits when treating Ebola patients.
I hope and pray the nurse will be all right.
Next to your body being completely covered the washdown by you buddy is almost as important. The washdown is not even being done now.
Yep, he should.
I hope that we as Americans support our nurses, and this conversation here is one way to do it.
Call your reps and senators. Insist the CDC rewrite the protocols for isolation garb for these contagious diseases.
Better yet, call your local hospital. Ask to speak to the head of Infection Control - ask them how their nurses and other personnel will be protected in the event of an ebola patient strolling into the ER.
Because that’s what they do - they stroll in. You get no warning that they are coming. This isn’t like Kent Brantly flying in on a special isolation airplane. All of the sudden, there they are - and you have to deal with them. You have to start their IV(blood exposure), hold the basin for them to vomit into(body fluid exposure), test their stool for blood(blood and body fluid exposure)etc,etc.
We had best be prepared.
Mrs. AV
Excellent post Heartwood. The gear for dealing with ebola is available off-the-shelf. Now the question is: Why isn’t it and the bleach washdown part of the CDC protocol? Any thoughts?
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