Rader clinic staff rehearses for Ebola Virus Disease response

By Damien SalasNovember 5, 2014

Rader clinic staff rehearses for Ebola virus disease
The Andrew S. Rader Clinic performs a walk-through scenario Oct. 24., 2014, to prepare health care workers in the case of an Ebola patient on the Henderson Hall portion of Joint Base Myer-Henderson Hall, Va. The clinic, along with other local health ... (Photo Credit: U.S. Army) VIEW ORIGINAL

JOINT BASE MYER-HENDERSON HALL, Va. (Oct. 30, 2014) -- Doctors and nurses at Andrew Rader U.S. Army Health Clinic on Joint Base Myer-Henderson Hall performed a drill Oct. 24 to better prepare health care providers in the event a patient suspected of contracting the Ebola Virus Disease shows up at the clinic.

With heightened screenings for passengers flying to the U.S. from West African countries experiencing Ebola Virus Disease, known as EVD or simply Ebola, outbreaks set in place and an increasing number of service members deployed to Monrovia, Liberia, precautions are being taken by healthcare facilities across the U.S. to better prepare for the virus, according to Lt. Col. Ed Weinberg, Rader Clinic commander.

"We have to start talking about Ebola," said Weinberg. "We have to have real discussions about what we will do as the [registered nurse], as the [licensed practical nurse]. The transmission is not as easy as you would think, but we have to know how to treat the patient while also protecting our staff."

Though the chances of contracting EVD within the U.S. remains low, health care providers treating patients with EVD in West Africa and domestically run a higher risk of exposure to the virus from contact with blood or other bodily fluids, according to the Centers for Disease Control and Prevention.

Dr. Bazigha Hasan, the physician at Rader clinic tasked with donning personal protective equipment and evaluating the patient's simulated symptoms, noted the importance of stabilizing the patient while also avoiding contact with the deadly disease.

"It is usually the symptoms of the virus that kill patients, and not the virus itself," said Hasan. "The virus causes a loss of five to 10 liters of fluid per day, so an I.V. will be necessary in the quarantine room to stabilize the patient if they are observing severe symptoms."

Because Rader does not have the resources to treat or test for EVD, physicians on the installation should focus on preventing exposure to EVD by first quarantining suspected patients in a private room with their own bathroom, properly donning and doffing personal protective equipment, and disposing of any contaminated materials in leak-proof bags, once the patient has left the facility, according to Hasan.

A cooperative community effort is key to getting the patient to proper treatment facilities, according to Weinberg.

Arlington County Emergency Medical Services provided transport during the simulation, and discussed the "echo response" that is triggered when 9-1-1 callers report a temperature over 100.4 and a travel history to West Africa, or potential exposure to somebody infected with the virus.

"It is not always clear when someone calls 9-1-1 what exactly is going on," said a representative from Arlington County Emergency Medical Services, or EMS, present at the drill. "So it is especially important in these incidents for the health care provider making the call to have all of the information, because there is a heightened protocol."

"When we upgrade to an echo response, we call the battalion chief, EMS supervisor, the engine, medic and [hazardous materials] support units," said the EMS representative. "This lets the full chain of command know what is going, on so that the correct information can be reported to the public if necessary."

After a patients symptoms and exposure to the EVD are confirmed, the health care providers dealing with a patient on Myer-Henderson Hall, will consult with the infectious disease doctors at Walter Reed National Military Medical Center in Bethesda, Maryland, as part of their own echo response.

The call is made from a land line within the isolation room where the patient consultation takes place to limit the number of people exposed.

"We don't want more than two healthcare workers in the quarantine room unless absolutely necessary," said Weinberg.

"After we consult with Walter Reed, a decision is made whether or not to transport the patient," said Weinberg. "Patients on active-duty status quarantined at Rader will be transported by Fort Belvoir (Virginia) or Arlington County EMS to Walter Reed facilities, where they can receive proper treatment."

While exiting, the patient will don personal protective equipment to avoid potentially contaminating the facility. Once the patient has left Rader, the staff then is responsible for providing the Centers for Disease Control and Prevention with information necessary to begin tracing anyone who may have come in contact with the patient while observing symptoms.

More information on EVD protocol for health care workers can be found at www.cdc.gov/vhf/ebola/hcp/index.html.

General EVD guidelines can be found on the U.S. Army Public Health Command's website at http://phc.amedd.army.mil/topics/discond/diseases/pages/ebolavirusdisease.aspx.

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