Policy and procedure

Ebola Management of Care of Patients Presenting With the Ebola Virus in the Emergency Department Scope: This policy applies to all hospitals
Level: Specialty
Definitions
EVDEbola viral disease
ED Emergency Department
HICPHospital Infection Control Program
EMSEmergency Medical Services
Supportive Data
According to Peters & LeDuc (1999) and CDC (2015) Ebola has an incubation period of between 2 days and 21 days for the signs to be visible.
Individuals can only become infectious once the signs start showing. In the case of Ebola, signs of one being infected include the sudden onset of fever, headache and muscle pain (Centre for Health Protection, 2014).
In advanced stages, bleeding from both internal as well as external organs may be witnessed. Normally, the bleeding will normally be from most of the body openings such as the mouth, nose, anus and even eyes. It treatment is delayed, the affected individual may lose a lot of body fluids and sometimes, may bleed to death.
PROCEDUREKEY POINTS
ContactAll contacts with the patient’s fluids such as blood, saliva and sweat should be avoided. This is because the virus is easily transmitted through the body fluids.
IdentifyTake the exposure history of the patient; ask the patient whether he/she has recently travelled or resided in a country experiencing widespread transmission of Ebola.

Confirm whether the patient has had contact with an individual with EVDin the last 21 days.
In the event that the patient cannot provide history due to any reason, then
the information should be elicited from a reliable source such as family or
EMS provider or a clinical judgment may be applied.
Isolate In the event exposure history is confirmed and the symptoms are consistent with EVD, the patient should immediately be isolated.
The patient should be isolated in an enclosed area such as a room with a private bathroom.
Measures should be taken to prevent transmission through either direct or indirect contact. Such measures includes having equipment dedicated to the patient, frequently washing hands with soap and restricting the movement of the patient (Sanchez, Geisbert& Feldman, 2007).
In the event the patient is being brought in via EMS transport, then the emergency department should ensure that the patient is received in a designated area away from other patients. Besides, the patient should be transferred to the isolated area/ room without bringing him/her in contact with either the public of non-essential healthcare staff.
A log should be maintained of all staff providing care to the patient and healthcare workers who come in contact with the patient put of appropriate PPE.
InformThe following should be notified about the patient with an EVD exposure history regardless of symptoms being presented.
HICP
Appropriate staff
Relevant local health department
ProtectionOnly essential healthcare workers should provide care to the patient.
Healthcare workers attending to the patients exposed to EVD, should wear the following safety clothing:
Face shield
Surgical face mask
Impermeable gown
Two pairs of gloves.
All equipment used for care of the patients should not be shared with their patients unless decontaminated or appropriate evaluations undertaken.
References
Centre for Disease and Control. (2015, March 24). Outbreaks Chronology: Ebola Virus Disease. Retrieved from http://www. cdc. gov/vhf/ebola/outbreaks/history/chronology. html
Centre for Health Protection. (2014, March 24). Ebola virus disease. Retrieved from http://www. chp. gov. hk/en/content/9/24/34397. html
Peters, C., & LeDuc, J. (1999). An introduction to Ebola: the virus and the disease. Journal of Infectious Diseases, 179-81.
Sanchez, A., Geisbert, C., & Feldman, K. (2007). Filoviridae: Marburg and Ebola. In W. Knipe, & K. Howley, Fields virology, 5th ed (pp. 1409-48). Philadelphia: Williams & Wilkins