Posted on 10/13/2014 5:53:44 AM PDT by Innovative
Some healthcare experts have criticized the head of the Centers for Disease Control and Prevention for saying that a "protocol breach" was responsible for the infection of a Dallas nurse with the Ebola virus, claming that the description scapegoats the nurse in a case that shows how unprepared nursing staffs are for dealing with a potential outbreak.
Texas and CDC officials say that the nurse was wearing the recommended personal protective gear for handling an Ebola patient, including a gown, gloves, mask, and eye shield. However, one expert told Reuters that gear only offers a minimum amount of protection, especially when the disease enters its final phases.
Sean Kaufman, president of an Atlanta-based firm that helps train hospital staff said that caregivers may need to add more layers of protection in the patient's final days, such as double gloves, a respirator, or even a full bodysuit.
(Excerpt) Read more at foxnews.com ...
That was a different strain...
http://www.freerepublic.com/focus/news/3214475/posts?page=49#49
The hair has no protection..... that’s the probable means by which the nurse got the virus.
All y’all, ping to this pic!
You are correct except that it is 416 infected and 233 dead medical professionals in Africa. The procedures are inadequate. Even if 416 people who knew their lives depended on it violated procedures. The procedures should be designed so that a non-specialist working long hours and with a real-world level of training can follow them well enough to survive. Otherwise, the procedures are by definition defective.
Well, 233 is more than 100. ;-)
But I agree.
A link to this thread has been posted on the Ebola Surveillance Thread
Hopefully only upset stomach.
If you can’t analyze what went wrong without such analysis being criticized as “blame”, then it will be really difficult to prevent other health care workers from getting sick.
Whenever something goes wrong, people who deal with safety and risk management analyze the situation, determine where the problem occurred, take steps to mitigate the problem, and very often use the incident as an example of how failure to follow standard procedures leads to trouble.
We have protocols for dealing with Ebola. We have been dealing with Ebola for decades. If those protocols are not followed to the letter, we need to know how and why they were bypassed, so as to prevent those lapses in the future.
Ebola did not suddenly become more contagious because someone did not use PPE properly.
‘Airborne particles’ are the key words in this definition. Folks need to start paying attention.
Ebola is not, never has been, and never will be an airborne transmissible disease. Apparently, that nurse was protected against an airborne disease... the problem is that she was not protected against a direct-contact disease like Ebola.
“If you can’t analyze what went wrong without such analysis being criticized as “blame”,”
Unfortunately this is NOT the case — the CDC is making the UNSUBSTANTIATED statement that the nurse breached protocol, without any evidence of whether or not she did and without them being able to say what the breach was.
If she was following prescribed protocols to the letter, then she could not have gotten Ebola. So it is pretty clear that either the PPE was breached (which she would have noticed) or she was *not* following standard protocols as described by CDC and others. It could be that the hospital did not properly teach her--in that case, she would not have been using proper procedure, but a portion of blame would fall on the hospital.
As someone mentioned earlier in the thread, the descriptions of her PPE indicates that she was wearing level 2 PPE, not level 4. That is a breach of standard protocol.
Understanding what went wrong is crucial to preventing similar incidents in the future. Accident analysis is not done to "blame the victim"--rather, it is a crucial component of accident avoidance. People who work in safety and risk management do these analyses all the time. There are whole websites devoted to them.
You are working on the assumption that the CDC protocol is correct. I, for one, question that assumption.
If it were one incident, then perhaps the protocol was correct and somebody really screwed up. Two incidents in less than two weeks, indicates the screw-up is the CDC author(s) of the protocol. A protocol which requires people to be perfect and make zero mistakes, is a bad protocol.
The CDC protocol, in this case, was that Level-2 procedures would be OK in a hospital setting when dealing with Ebola patients. It is looking increasingly likely that this is incorrect, and that more rigorous protection procedures need to be used, involving full-body coverage with no skin or hair exposed, probably two or more layers of protection, and thorough washing and spraying of the suit with disinfectant before removal.
“If she was following prescribed protocols to the letter, then she could not have gotten Ebola.”
The point is that you do NOT know that. And neither does the CDC and for them to make such a statement based on ASSUMPTIONS, NOT fact is highly disturbing. There could be flaws in the protocol.
“As someone mentioned earlier in the thread, the descriptions of her PPE indicates that she was wearing level 2 PPE, not level 4. That is a breach of standard protocol.”
Except that on the CDC page:
Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Virus Disease in U.S. Hospitals
http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html
They describe Level 2 protocol, NOT level 4.
See my post 37 and PapaBear3625’s post 61 on this thread.
You seem very sure of this. There is "airborne" (dry virus particles floating through the air), and then there is droplet/aerosol transmission, which IS an area of concern. Real live patients cough and sneeze. Hard vomiting may send droplets though the air.
I am absolutely sure of this. Ebola has never been documented to transmit by aerosols (which are not droplets). All cases of Ebola have been traced to direct contact transmission. One paper mentioned the possibility of fomite transmission, but it was inconclusive.
Droplets, by definition, are 5 micrometers or larger in diameter, and fall to the ground quickly. Patients *might* generate droplets, but those droplets would only be infectious if they are contaminated by blood. The cells that produce mucus are not infected by Ebola.
Aerosols are particles smaller than 5 micrometers, that are capable of hovering in the air for prolonged periods, or can travel on breezes. The majority of aerosol particles emitted by humans are less than 1 micrometer in diameter. These particles dry quickly, making them inhospitable for Ebola viruses. They would also expose virus to UV light, which destroys them. Furthermore, since the virus is fairly large, it is questionable whether such small particles could contain enough virus to cause an infection.
The laboratory aerosolization experiments do NOT represent a natural transmission of virus. In those, the virus was atomized directly into animals' faces, in a manner that is not analogous to a biological process at all.
For Ebola to become airborne, it would have to change the cells it infects. It has no reason to do this--it transmits well enough the way it is. Plus, according to top virologists, no virus has ever changed its mode of transmission.
Post to me or FReep mail to be on/off the Bring Out Your Dead ping list.
The purpose of the “Bring Out Your Dead” ping list (formerly the “Ebola” ping list) is very early warning of emerging pandemics, as such it has a high false positive rate.
So far the false positive rate is 100%.
At some point we may well have a high mortality pandemic, and likely as not the “Bring Out Your Dead” threads will miss the beginning entirely.
*sigh* Such is life, and death...
Thanks for the ping!
You’re Welcome, Alamo-Girl!
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