Emergency Department Processes for the Evaluation and Management of Persons Under Investigation for Ebola Virus Disease - 24/08/15

Doi : 10.1016/j.annemergmed.2015.04.020

Michael C. Wadman, MD ^a,^⁎ , Shelly S. Schwedhelm, RN, MSN ^e,^f, Suzanne Watson, RN, BSN ^g, John Swanhorst, RN, BSN ^f,^g, Shawn G. Gibbs, PhD ^b,^f, John J. Lowe, PhD ^b,^f, Peter C. Iwen, PhD, MS ^c, A. Kim Hayes, RN, BSN ^h, Susie Needham, RN, BSN ^g, Daniel W. Johnson, MD ^d, Daniel J. Kalin, MD ^a, Wesley G. Zeger, DO ^a,^f, Robert L. Muelleman, MD ^a
^a Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE
^b Department of Environmental, Agricultural, and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE
^c Department of Pathology and Microbiology, Nebraska Public Health Laboratory, University of Nebraska Medical Center, Omaha, NE
^d Department of Anesthesiology, Division of Critical Care, University of Nebraska Medical Center, Omaha, NE
^e Emergency Department, Trauma, Emergency Preparedness Services, Nebraska Medicine, Omaha, NE
^f Nebraska Biocontainment Unit, Nebraska Medicine, Omaha, NE
^g Emergency Services, Nebraska Medicine, Omaha, NE
^h Division of Infection Control and Epidemiology, Nebraska Medicine, Omaha, NE

^∗Corresponding Author.

Abstract

Introduction

Due to the recent Ebola virus outbreak in West Africa, patients with epidemiologic risk for Ebola virus disease and symptoms consistent with Ebola virus disease are presenting to emergency departments (EDs) and clinics in the United States. These individuals, identified as a person under investigation for Ebola virus disease, are initially screened using a molecular assay for Ebola virus. If this initial test is negative and the person under investigation has been symptomatic for < 3 days, a repeat test is required after 3 days of symptoms to verify the negative result. In the time interval before the second test result is available, manifestations of the underlying disease process for the person under investigation, whether due to Ebola virus disease or some other etiology, may require further investigation to direct appropriate therapy.

Materials and Methods

ED administrators, physicians, and nurses proposed processes to provide care that is consistent with other ED patients. Biocontainment unit administrators, industrial hygienists, laboratory directors, physicians, and other medical personnel examined the ED processes and offered biocontainment unit personal protective equipment and process strategies designed to ensure safety for providers and patients.

Conclusion

ED processes for the safe and timely evaluation and management of the person under investigation for Ebola virus disease are presented with the ultimate goals of protecting providers and ensuring a consistent level of care while confirmatory testing is pending.

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Plan

Introduction

Background

Materials and Methods

	Please see page 307 for the Editor’s Capsule Summary of this article.
	Supervising editor: Gregory J. Moran, MD
	Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist.
	A podcast for this article is available at www.annemergmed.com.

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Vol 66 - N° 3

P. 306-314 - septembre 2015 Retour au numéro

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Emergency Department Processes for the Evaluation and Management of Persons Under Investigation for Ebola Virus Disease - 24/08/15

Abstract

Introduction

Materials and Methods

Conclusion

Plan

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