Ebola Virus is Here in Dallas!
Yes... the unthinkable has happened! The first case of ebola to develop in our country happened right here in Dallas, Texas. Ebola is a frightening, deadly disease that is spread through contact with body secretions as opposed to casual contact.
I can tell you that it was just a matter of time. With air travel today, we are only hours away from whatever epidemic might be happening anywhere in this world and to think otherwise would be foolhardy. We are not immune from these things being brought into our country. It is virtually impossible to check every passenger adequately to be sure they are not harboring some dreadful disease.
Please know, that my heart goes out to Thomas Duncan and his family and friends. Right now he lays in critical condition at Presbyterian Hospital of Dallas, a well respected hospital in the area. From the news reports, they say that he is on life support (as, on a ventilator), in a coma (I am assuming perhaps a drug-induced coma) and undergoing kidney dialysis and has liver failure. These are all ominous signs but these are medical interventions that many there in Africa do not have at their disposal. He has also been started on an experimental drug in hopes of turning this around; however, we have no idea if this will help and there is a very good possibility that he may die as a result of the disease. Sometimes even the best of care cannot change the course of a deadly virus such as this.
The initial snafu at the hospital occurred when the nurse did not pick up on the link between his symptoms and his travel history; although, she did illicit that information but evidently it did not get passed on to the doctor and the doctor evidently did not pick up on that fact when doing his history and physical. You see... I was a critical care nurse for 45 years, and very few times do I remember a doctor actually reading my notes. There is much repetition in medicine. The nurse asks her questions and the doctor asks his questions and many will overlap. Communication is vital.
As far as a computerized program is concerned, it would be ideal if a ringing bell would go off questioning ebola when in a history and physical the words "recent travel", "Africa", "Liberia", "diarrhea", "vomiting", "abdominal pain", or "fever" were typed in the computer but we are not there yet! And I can only imagine that both the nurse and doctor involved would wish they could go back and do it all again, knowing what they know now. So... based on his symptoms, he was sent home. I cannot tell you how many patients are seen with mild non-specific symptoms who show up in the ER simply because they feel badly... or they may show up at their doctor's office with similar complaints.
The CDC travels to Dallas and helps disperse information to the public in hopes of not causing panic. The family and those who had been in close contact with the patient were to not leave their apartment or come in contact with others until the allotted time to be sure that they had not contracted the disease but evidently these instructions were not followed causing the need for an armed guard outside of the apartment. All potential contacts were being tracked. And interestingly enough, you are not considered contagious until you start to show symptoms which may take up to 21 days.
From what I have read. everything in the apartment was discarded and the occupants were relocated. The apartment was thoroughly cleaned and disinfected. I saw a news clip today with someone on the cleaning crew in his hazmat suit holding onto the metal bannister with gloved hands and I did wonder if those gloves were clean or contaminated. The discarded items were being stored in a truck in an undisclosed location with an armed guard until they could be incinerated.
Every medical worker must know universal precautions (protecting yourself from body secretions) and must wear PPE (Personal Protective Equipment) when deemed appropriate. For ebola, this consists of a non-permeable gown, boots, gloves, and hood. All of this is very hot to wear and requires frequent breaks and each time, everything must be thrown away to be incinerated. And just today I was hearing that there is a shortage of supplies, not to mention a severe shortage in west Africa.
And if all of that isn't enough... Jesse Jackson is on the scene in Dallas talking with the patient's family as they feel the patient is not getting proper treatment. And then Jesse Jackson starts fanning the flames with the suggestion that Thomas Duncan was initially sent home from the ER because he did not have medical insurance or perhaps due to a racial bias. Quite frankly... I think he needs to butt out and let the doctors and nurses do their job.
Late this afternoon he led a prayer vigil outside of the hospital. He can pray all he wants but he better respect science as the doctors try to cure the patient and the CDC tries to prevent the spread of disease in our community, state and country. Exactly why did God let this disease happen anyway and why is God not curing these people afflicted with this deadly disease? I'm sure the preachers will come up with an answer for that one!
And now another case of ebola in Spain. This time a healthcare worker and not only that, but they are fearing that her dog may also carry the disease and have euthanized the dog before proving that the dog was infected.
I worry about our healthcare workers as well. All it takes is a break in technique or a needlestick to have someone exposed. The stress of working under these conditions is tremendous and the importance of adequate staffing at a time like this is essential!
So where all of this will lead, we do not know. We take it a day at a time. I certainly hope that Thomas Duncan survives this ordeal and the drug companies soon find a cure. I would also hope that everyone be vigilant and supportive of those dealing with this horrible disease.
Educate yourself about ebola: http://www.cdc.gov/vhf/ebola/
An update: Sadly, Thomas Duncan died today 10/08/14. I extend my sympathy to the family and all of those whose lives have been impacted by this catastrophic disease. A cure cannot come soon enough!
Keywords: Dallas, PPE, Presbyterian of Dallas Hospital, Spanish nurse, Texas, Thomas Duncan, West Africa, ebola, science, virus
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