Ebola in the states???

[DSynger]

I heard one health-care group asking for a buddy to help assist with ppe removal. It sounds like that is where the failure occurred.

[kf7mjf]

Maybe it's not Ebola, maybe the projectile vomiting means demons.

[root]

[glockgirl]

...to help assist with PPE removal...

Actually, the CDC PPE/decontamination protocol allows for assistance in removing the contaminated PPE (by another person also wearing PPE). There is a right way and a wrong way to go about it. At this point, it doesn't really matter if the nurse at Texas Presbyterian removed her PPE herself and accidentally self-inoculated, or whether she had assistance in removing the PPE and accidentally self-inoculated.

To address the concerns of Anzac: Yes, most if not all hospitals are woefully underprepared to handle an Ebola patient, and yes, the PPE/decontamination protocol training of close or direct contact health care providers is lagging far behind what it should be. Still, the hospital dropped the ball, and still, the nurse violated, albeit accidentally and definitely unknowingly, the PPE/decontamination protocol.

As root and I have both said, this is not some super virus that can penetrate nitrile gloves, and if there was some overall failure in the PPE itself, then we would see several, if not all, of the providers who attended to Mr. Duncan fall ill themselves. Occam's Razor dictates that the simplest answer is usually the correct one, and the simplest answer here is accidental self-inoculation with the virus during the removal of the PPE.

[rayjax82]

Anzac doesn't trust the government, but is voting for I-594.

Mind = blown.

[ANZAC]

As root and I have both said, this is not some super virus that can penetrate nitrile gloves, and if there was some overall failure in the PPE itself, then we would see several, if not all, of the providers who attended to Mr. Duncan fall ill themselves.

That's two big assumptions right there. Maybe the patient projectile vomited on one of them, and not the others. Who knows? Maybe the CDC PPE procedure increases the risk 10% of infection, not 100%? You either get infected or you don't, you don't get partially infected. So it is possible some carers do and others don't.

Occam's Razor dictates that the simplest answer is usually the correct one, and the simplest answer here is accidental self-inoculation with the virus during the removal of the PPE.

Actually, Occam's Razor doesn't say that, it says the answer relying on the fewest assumptions is probably correct. You're making a lot of assumptions about the disease, and the protocols.

By your logic, the Space Shuttle Challenger was safe to fly on January 28 1986 because none of the other shuttle missions had previously exploded. It must have been something the astronauts did, because none of the other shuttles exploded.

Did you read any of the articles I posted by citing health care professionals saying it was irresponsible of the CDC to blame the nurse when they actually and no clue how she was infected?

I don't know that she did or did not make a mistake. But the CDC itself has said they don't know either.

[powder]

Anzac doesn't trust the government, but is voting for I-594.

Mind = blown.

[glockgirl]

Did you read any of the articles I posted by citing health care professionals saying it was irresponsible of the CDC to blame the nurse when they actually and no clue how she was infected?

Yes, I did read your carefully selected articles. As it stands, though, the ANA (American Nurses Association) and the AACCN (American Association of Critical Care Nurses) both have posted statements indicating that the virus was transmitted during PPE removal after a high-risk procedure was performed on the patient (intubation and dialysis being the most likely culprits, both of which the patient underwent in his final days).

I really don't understand why, exactly, you seem to want this to prove to be some super virus capable of defeating proper PPE donning and removal protocol. The following is a link to the ANA statement regarding the infection of the nurse at Texas Presbyterian: http://www.nursingworld.org/HomepageCat ... Ebola.html

[lamrith]

Did you read any of the articles I posted by citing health care professionals saying it was irresponsible of the CDC to blame the nurse when they actually and no clue how she was infected?

Yes, I did read your carefully selected articles. As it stands, though, the ANA (American Nurses Association) and the AACCN (American Association of Critical Care Nurses) both have posted statements indicating that the virus was transmitted during PPE removal after a high-risk procedure was performed on the patient (intubation and dialysis being the most likely culprits, both of which the patient underwent in his final days).

I really don't understand why, exactly, you seem to want this to prove to be some super virus capable of defeating proper PPE donning and removal protocol. The following is a link to the ANA statement regarding the infection of the nurse at Texas Presbyterian: http://www.nursingworld.org/HomepageCat ... Ebola.html

As much as I hate to side with Anzac, no offence man, but I don't see eye to eye on you with anything else.. He has valid points.
I see no conclusive evidence that they know a breach happened, just assumptions merely on the fact she got infected. Just because everyone in that hospital is not infected is not a way to prove she screwed up.

CDC officials report that a breach in protocol may have occurred at some point.

What gear did she have on every time she worked with the patient, I mean EVERY TIME, not just the "high risk procedures"? I have seen apron, mask etc. That does not sound like an air tight, or full containment suit. With a guy projectile vomiting nothing less than a containment suit is enough. Did they screen everyone in the waiting room the day he initially came in? and all the staff that were working at the time? How did they decon the rooms he was in that 1st day? When did they decon? HAve they tested every person that entered any of those rooms he was in between that 1st visit and when the deconned?

I have also heard it said this is not airborne, but what is the "CDC approved" or medical definition of airborn? Does that mean transmit thru normal breathing IE lungs, airway saliva fluids carry it? Well consider that he is infected and projectile vomiting with will put the virus from his stomach contents in the air. That still puts the particles airborn, though not to the same degree, still a huge risk and easy way for that nurse to get infected. If it required such close and direct fluid contact how did the photographer in Africa get it, was he handling the bodies? I do not believe we know nearly as much about Ebola as we think we do, it has not had near the $$ or research put into it as cancer has and we are still a long long ways from fully understanding that, let alone curing it. What makes people think we have figured out ebola and know all it's secrets?

It is not that we WANT this to be a superbug, it is the fact that it already IS a VERY nasty bug, and with the way it is popping up all over the world, NOT just the US it is cause for concern. I see this morning that it is now showing up in Germany. The idea that every possible person infected is met and worked on by professionals that ALL are using the max protection gear is well, frankly ignorant and naive. It is exactly the attitude we are seeing from CDC, "As long as procedures are followed it is 100% safe". No procedure is 100% safe, and expecting every dr, nurse, urgent care staff member to know full protocol, let alone have the gear for themselves or proper isolation of a patient in every office in the US let alone the world is laughable at best. I hope that it is contained, but given how great people touted our medical procedures are the best there is and that it is no risk, sure seems like someone got infected pretty damn fast. EVERYBODY gets tired EVERYBODY makes mistakes, even the highly skilled Dr and Nurses with extensive training in these procedures. Relying on 100% perfection of every single suit up, suit down procedure as the means for stopping the spread is just not realistic.

Our Arrogance (which btw is why many other countries dislike the US) in thinking we know everything is a big problem. Am I out there buying Mop gear and building a Decon shower in my house, hell no, am I disappointed and concerned about how the CDC and govt is handling this problem, HELL YES.

[ANZAC]

I really don't understand why, exactly, you seem to want this to prove to be some super virus capable of defeating proper PPE donning and removal protocol.

I don't "want" this to be anything. If the nurse messed up somehow, well that's unfortunate and maybe there will be some change in training/process/monitoring. You still haven't acknowledged that there are different types of PPE and maybe the type of PPE required was not appropriate to the situation (e.g. the intubation etc).

However, what I do "want" is for health care professionals, and especially the CDC to not make assumptions (oh she just rubbed her hands in her eyes, next!) without any investigation. Obama ordered that they need to get that investigation done ASAP. Seems prudent to me.

Like this quote here from a local RN: ""I don't know what happened yet, and I'm a firm believer in that we need to find that out and learn from that," she said."

http://www.komonews.com/news/local/Loca ... 83661.html

The fact that health care professionals (like the CDC) make assumptions without knowing any of the details scares me. Everyone should be thinking critically and keeping an open mind (semen thing a great example of where they thought they knew something and were wrong). US hospitals and staff don't have any experience with ebola to speak of. They do with HIV and other bugs, but we shouldn't assume it is identical. The mortality rate has jumped in the latest outbreak in Africa. I know the conditions there are bad to begin with but we need to be prepared for more cases here.

[ANZAC]

Our Arrogance (which btw is why many other countries dislike the US) in thinking we know everything is a big problem. Am I out there buying Mop gear and building a Decon shower in my house, hell no, am I disappointed and concerned about how the CDC and govt is handling this problem, HELL YES.

[root]

GUNS ARE SCARY. LETS BAN THEM. I MIGHT SOME TIME MIGHT POSSIBLY MAY SEE A PERSON WHO HAS GUN LIKE SYMPTOMS.

[glockgirl]

For clarification, it is highly unlikely that Texas Presbyterian had the white full-body Tyvek suits that were seen in video footage of Ebola patients being transferred to hospitals in Atlanta. Standard isolation gear is a yellow splashproof tie-back gown, surgical mask, nitrile gloves that go over the cuffs of the gown, surgical booties, and, in the case of a patient who is likely to splash bodily fluids (as Duncan was), a full-face shield.

Ebola isn't the only virus that can cause explosive diarrhea and projectile vomiting, and I am sure that Nina Pham (the nurse who contracted Ebola at Texas Presbyterian) was familiar with isolation protocol. The thing is, treating a patient who is in isolation, keeping yourself from coming into unprotected contact, and donning the PPE gear correctly isn't the difficult part. The difficult part is removing the PPE gear after exiting the patient's room without accidentally touching the outside surface of any of the PPE. When I said that literally hours of classroom and clinical time is devoted to learning how to don and remove PPE, I wasn't kidding. All it takes is one tiny mistake--like touching the outside surface of your gown whilst untying it--and you have placed yourself and your other patients at risk of contracting whatever virus for which the patient is in isolation.

[BadKarma]

Anyone for setting Texas on fire?

[RENCORP]

Send Anzac to Texas.

They deserve each other.

And, he is an expert on both 594, and Ebola, so they need him down there in that diseased armed camp of unregulated gun owners.

i just solved three first world problems.

Send money, please.