Could your hospital handle Ebola? CDC has a checklist

Protective gear is key, expert says

Some experts estimate that there is as much as an 18% chance that the United States will report an Ebola case this month. CDC has released a checklist outlining how hospitals should prepare for a possible case.

"While we are not aware of any domestic [Ebola] cases…now is the time to prepare," officials wrote in a statement released Monday. According to the latest data from the World Health Organization (WHO), at least 5,357 people have been infected with the deadly virus since March and 2,630 people have died.

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How hospitals can prepare

Per its new checklist, CDC urges hospitals to train workers to identify Ebola symptoms, which include high fever, headache, muscle pain, vomiting, and diarrhea. Should patients exhibit these symptoms, workers should ask if they have traveled to Africa within the past three weeks or been in contact with someone who has.

If patients answer affirmatively, they should be isolated in a private room. Anyone who enters that room should wear gowns, impermeable gloves, eye protection, and a face mask.

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This is particularly important because improper use of protective equipment—or lack of it altogether—has enabled the spread of the virus in West Africa, according to Michael Anne Preas, director of infection control and epidemiology at the University of Maryland Medical Center.

"The physical exhaustion and emotional fatigue that come with caring for patients infected with Ebola may further increase the chance of an inadvertent exposure to bodily fluids on the outside of the personal protective equipment, leading to unwanted contact when the gear is removed," Preas wrote in the Annals of Internal Medicine last month.

He added that the "impulse to wipe away sweat in the ever-present hot, humid environment during personal protective equipment removal may lead to inadvertent [exposure]."

If a hospital confirms an Ebola case, it should follow "supportive care" guidelines, which include continuing to isolate the patient, providing the patient with intravenous fluids, balancing the patient's electrolytes, and maintaining oxygen status and blood pressure.

Emory University Hospital used similar guidelines while treating two American medical volunteers who were infected with Ebola. They have since been released from the facility.

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Generally, experts recommend common-sense, evidence-based preparations. "As health care professionals, we strive to provide evidence-based care driven by science rather than by the media or mass hysteria," says Michael Klompas of Harvard Medical School, adding, "We need to apply these principles to planning for Ebola as well” (CDC checklist, Sept. 2014; Caldwell, Atlanta Business Chronicle, 9/16; Dance, Baltimore Sun, 9/17).

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