Wednesday, October 8, 2014

This. Right Here.


In case anyone thinks this is just my non-stop rant that nobody's doing anything right, a counter-example:

http://online.wsj.com/articles/new-york-hospitals-prep-for-ebola-1412730058?mod=WSJ_hpp_sections_newyork

Public and private hospitals around New York are quietly conducting Ebola drills, sending fake patients to test emergency-room staff in the proper methods to identify and safely isolate a person suspected of having the virus.
Key to the protocol is one simple question: Have you traveled recently?
The move to prepare area hospitals and educate health-care workers is largely in response to the increased chance that a patient will arrive in New York infected with Ebola, said Ross Wilson, the chief medical officer at the New York City Health and Hospitals Corporation.
“If a patient does not get identified early, you have what happened in Dallas,” said Dr. Wilson. “The first thing is that you get more people in the community in contact with Ebola. The second thing is that you can increase the risk to health-care workers.”
On Monday, New York City Mayor Bill de Blasio said the city has a “much more aggressive and coherent game plan” to respond to suspected Ebola patients than what played out in Texas.
“We know that if we have even the possibility that someone may have Ebola that they’re going to be handled in a very careful and aggressive manner. So I feel very, very confident. All New Yorkers should feel confident,” he said.
Over the past two to three weeks, said Dr. Wilson, trained hospital staff members pretending to be patients have entered the city’s 11 public emergency rooms complaining of fever, headaches and abdominal pain. With anyone who presents just those symptoms, a nurse is then supposed to ask about any recent travel to West Africa—specifically, to Sierra Leone, Guinea and Liberia.
If the fake patient answers yes to travel to or from those countries—or to contact with any person who has had Ebola—emergency protocols would be implemented. Health-care workers would put on protective equipment and the patient would be isolated, said Dr. Wilson. Over the next 45 minutes or so, staff, still unaware of the pretense, process the patient as if he or she were really sick.
At some point, said Dr. Wilson, a doctor reveals that the patient is part of a drill, after which senior medical staff take time to review what happened and fine-tune their protocols.
The response to the training has been “very positive,” said Dr. Wilson. “We’re getting it right with pretty much every step.”

Kudos and a hearty "Bravo!" to Dr. Wilson and the staffers in NYC hospitals.

One or two bitches, though. (I know, act surprised.)
If you're waiting to don the gear once the patient triggers threshold criteria, both the interviewing staff member and anyone in the same waiting area have already been exposed.
That's needlessly expanding the risk pool, in a way that's still wrong for bystanders, and a foolish risk of trained clinical staff.
Yeah, the damned gear is uncomfortable. And it might frighten people away.
So let's evaluate the pros and cons:
Scary hot clothes vs. agonizing horrible death...
Scary hot clothes vs. agonizing horrible death...

Yeah, that's a poser, that is.

How about having someone(s) take a 2-3 hour shift outside geared up to ask the million dollar questions before arrival inside, with a separate handling tent/whatever right there to immediately divert patients into before they infect anyone else, like your nurses, your waiting area, and your other patients, and inside which you could further process them in such a way that their privacy is respected, and a contagious condition isn't passed along to 2-50 more people while you play the ER clinical edition of 20 Questions?

Do that, Dr. Wilson, and you'll be getting it all "right with every step".

Keep up the good work.
And don't just depend on the media to tell folks about it.
Put your process on YouTube (and update it as needed), and give it to the whole world, for free, at the speed of electrons. That way, you control your message, and the Truth gets out rapidly.
By the time the government figures it out, we'll either be drawing Social Security, or all be quarantined amidst a biblical pandemic.

Put it on the Internet - TODAY.

This is what should be going on right now in every hospital in every major city, and no small number of smaller ones.

2 comments:

  1. Not happening where I work. I just sat for an hour with 2 people from our infection control department. They complained about people at my hospital feeling uncomfortable caring for Ebola patients and that these same people complained that they have not received proper training. I asked them if they thought our hospital was properly prepared to take care of such patients, and the response was: "Doctors should know how to take care of infections" and "They have a system in place". Since I am a doctor at this hospital and know of no system, I asked - How do we isolate such patients from the rest of the hospital? Where is my decontamination area? Will I put on a Hazmat suit in a busy hallway and take off the dirty suit and stuff it into a trashcan?

    Here is the response from my infection control department representative : "No you will put on this suit and remove it inside the patient's room." We are talking about a relatively small room which is meant for use by a single patient and when you open the door, you will already be 5 feet from the patient's bed.

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  2. Your infection control department are morons who're going to kill people.

    Your options are to light them up in a memo and fight like hell for your very life, or understand that if an Ebola patient ever walks in the door, you can either quit, or die.

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