When Do We Panic?Follow

Following are our priorities:
1. Our highest priority is to rapidly identify potentially infected individuals, quickly isolate them without panic then calmly make a decision about next steps in collaboration with institutional and local authorities. Patients with Ebola virus infection are not contagious until after they develop symptoms of the disease. All body fluids may be infectious, and risk of transmission increases as the disease progresses over a period of several days. Once identified as high-risk, these individuals can be isolated — for instance, frontline staff are being trained to place such a person in a room with minimal human contact and close the door. Once identification and isolation occur, staff are being instructed to contact the Administrator on Duty through the OHSU Operator (4-9000) and Infection Prevention and Control (4-6694). Appropriate public health authorities will then be contacted. If they determine the individual to be at sufficient risk to warrant ongoing isolation and testing, a team of physicians, nurses and staff who have been specially trained to safely evaluate and transport a patient suspected of having Ebola virus disease will be dispatched. Local clinic staff should not enter the room where the patient has been isolated unless absolutely necessary, and then only if appropriate personal protective equipment is worn.
2. Remember, when an individual who is at risk presents or when our screening identifies a potentially infected individual, simply not touching them further, doing hand hygiene, and placing the individual into a regular room with the door closed and without direct contact is the optimal process. If or when a patient with suspected Ebola virus disease is identified, OHSU will deploy a highly trained and experienced team to care for the patient, thereby limiting exposure to others.
3. NO ONE will be asked to care for a patient with suspected Ebola before he/she has been trained and feels comfortable with the process. Emergency Department staff have been trained to put up an isolation tent, and the suspected Ebola patient will be held there until trained personnel are ready to receive him/her. The guiding principle is safety first. Infection Prevention and Control personnel and other authorities will provide guidance on site.
4. We have identified and are in the process of training OHSU physicians, nurses and staff who will serve as an Ebola Response Team. We feel confident that we will have the necessary knowledge, skills, supplies and equipment needed to deliver appropriate care safely.
5. We anticipate the number of staff who would come in contact with a potentially infected individual and the risk to any caregiver who might initially identify a potentially infected individual to be small. That should not make us less vigilant in our planning and training.
6. Trainees (students and residents) will not participate in the care of potentially infected individuals. Residents and fellows will be exempt from caring for patients with suspected or confirmed Ebola infection (with rare exceptions for adult critical care fellows, to be determined in specific cases).
7. We are working very closely with other area health systems, as well as local and state public health authorities to ensure an organized response across the community.
8. Intensified training has begun and will continue over the weekend, into next week and as long as is necessary to ensure full training of: 1) a primary Ebola Response Team to manage each situation, and 2) frontline staff to perform appropriate screening and patient isolation protocols, if necessary.