Since it seems the nationwide panic known as Ebola has overflowed into the EMS sphere I thought it a good time to step in and calm everyone down for a moment.
We’re experts at dealing with interventions based on a thorough assessment. Hemorrhagic Fever can’t be ruled out via ECG, stroke exam or any of our other tools.
To successfully deal with a patient exhibiting signs and symptoms of hemorrhagic fever in the pre-hospital environment, preparation is going to need to be solid.
- Contact your local Department of Public Health for an updated copy of their response policy and local resource deployment. Test the phone numbers in the plan and make sure they work now and that you know what information they want when you call in the possibility of an infected patient.
- Train and retrain on your PPE. This is not race for speed, but a checklist for proper donning and, more importantly, doffing. Improper removal of the best PPE negates all precautions.
- Ask direct questions when still at a fair distance. Monitor CDC bulletins for updated travel alerts at the beginning of each shift and ask questions that can rule out travel and contact with infected persons.
- Treat the scene like a Hazardous Materials scene. Isolate, identify, deny entry. Limit exposure using pre-existing structures like walls, doors, airplane lavatories, car interiors, etc.
- Ebola is still only in fluids, so limit contact with fluids using approved PPE barriers. This includes gloves, gown, goggles, booties and cap. It seems like an extreme measure, but think of all the things we touch with our gloves on. Push hair out of our face, adjust pants, replace goggles…all these movements could introduce a small bit of vomit on a glove to another portion of the body and eventually we rub our eye or nose and…poof…infected.
- Avoid unnecessary movement prior to Health Department assessment of the scene.
- We are the eyes and ears of the local Health Department and CDC. There is no treatment, no rapid transport, no EMS tool or technique that can help your patient more than making sure the system is in place and responding to what you see and hear.
The trick on a call you suspect to be Ebola (It’s likely not) is to treat it as such until you can reasonably determine the likelihood that I’m right. That means being a PPE expert, doffing properly and knowing who to call and how to keep people calm in the face of a perceived zombie apocalypse.
As the world panics, we will remain calm, gown up and get the job done.