Local hospitals prepare for the possibility of Ebola
The mishandling of an Ebola patient at a Texas hospital has health care institutions across the country on alert, and that includes central New York. Local hospitals and health care providers have stiffened protocols when it comes to dealing with a patient who could have the deadly disease.
Soon after walking into the emergency room at St. Joseph's Hospital in Syracuse, prospective patients are asked about more than their symptoms. They’re quizzed on where they have been.
"The triage nurses know what to look for, in terms of which countries are of concern for Ebola, what the incubation period is, so they have a pretty good idea which patients were at risk of having Ebola,” said Dr. Helen Jacoby, medical director of infectious diseases at St. Joseph's. “If we were to get a patient who fit that category, they know to put that patient in isolation and they know to call me or one of my colleagues, as well as the infection control department. Then we would go from there and contact the public health authorities.”
Jacoby says she was concerned after hearing about a Dallas hospital that released an Ebola patient.
“It’s more of a 'there but for the grace of God go I' situation," Jacoby explained. "We are, we think, well prepared, but it made me think okay, we have to double check our preparedness and see if it is as good as we think it is. So we sent people down to the emergency room today to make sure the correct questions are being asked, and they are.”
Jacoby says St. Joe’s has been talking about being prepared for Ebola for a couple of weeks now, and are armed with guidelines from the Centers for Disease Control and the New York State Department of Health. Upstate Medical University and Crouse Hospital are doing the same. Upstate has developed an Ebola-specific emergency preparedness plan, and Crouse says its infection control team has been working to raise awareness and education among staff, particularly in the emergency department. And it is not just hospitals.
"Really what we’re doing is being a little bit more aware of our surroundings and our environment, and knowing these patients may present with symptoms that are similar to other things we see every day," said Melissa Fleischmann, a spokeswoman for Rural/Metro Medical Services, which provides ambulance service for much of Central New York.
Fleischmann says the same state and federal guidelines hospitals are using have been installed in a new dispatch protocol, and are based on guidelines from the Centers for Disease Control and the state Health Department.
“So when someone calls 911 for an ambulance, they’re always getting questions about things like what's wrong with the patients, what they’re presenting with," Fleischmann said. "Now if they present with certain symptoms, we’re asking other questions about where have you traveled to try and identify possible exposures.”
If that travel includes countries ravaged by Ebola within a certain incubation period, that means emergency workers know before going on a call that there is a potential Ebola patient and will take steps to protect themselves.
"In addition to regular things like gloves that we wear for every patient, they would wear an approved respiratory mask, that is a higher end respiratory mask that blocks things in addition to regular viruses," Fleishmann explained. "It’s more of a protective gear. They would also wear a gown. They would also wear additional protection on the outside as well."
Dr. Joe Domachowske, an infectious disease specialist in pediatrics at Upstate, says isolating potential victims is really the key to shutting down Ebola, noting that Nigeria and Senegal have been able to corral the virus through education and making sure people stay away from bodily fluids that can transmit the disease.
"So we already know that in developing countries, where resources are extremely limited, that containment is possible," Domachowske said. "With our existing health care system here, even a single case is unlikely to spread further."
While Jakoby says she believes St. Joe’s is ready, what happened in Dallas shook her up. At one point, she was double-checking with staffers and patients to make sure everyone was following the new rules.
"We haven’t found that there’s been any lapse, we think we’re ready if that would come up," Jakoby said. "But you know when you hear about a good hospital where this happened, you think, I don’t want that to happen at my institution."