Ebola is on everyone’s mind right now. But once this is contained and wiped out, it still remains a very good lesson on how the slightest error in technique can get you or your co-workers or even you family in the center of a medical emergency.
It was so sad to hear that a nurse, caring for the initial Ebola patient has contracted the disease. It must be terrifying for her, her family and friends.
I have no doubt that the CDC among other agencies reviewed isolation techniques before allowing anyone to begin care, so I imagine it was a very minor breach of protocol. Unfortunately, that is all it takes.
In the several hospitals I have been in over the years, technique appears less stringently followed by staff. Unfortunately, I have seen it too often, careless removal of gowns, lack of hand hygiene, or forgetting to use all the PPE (Personal Protective Equipment) available.
Why? Probably because the illnesses for which we normally use isolation precautions aren’t quite as deadly as ebola. The process is taken too cavalierly, probably with the thought, “It will never happen to me.”
When suddenly your life is on the line, you realize the importance of being correct in the process you use. The protocol only works if you do it 100% correctly 100% of the time. Take a minimal amount of virus out of the patient care room with you and it can turn into an epidemic.
So let’s review how to put on and even more importantly how to take off the PPE for droplet precautions and ebola without contaminating yourself.
Ebola is not airborne but it can be transmitted by droplets, which are larger particles of moisture carrying the virus which can travel through the air as when someone sneezes or coughs or if body fluids splash.
So in this case, Droplet precautions are appropriate.
Once you are gowned and gloved and enter the room, you SHOULD NOT reach under your gown to get anything from your pockets. It seems like a no brainer to me, but I’ve seen it happen too many times. Reaching for a pen or your notes in your pocket will contaminate you.
When removing the gear, touching the outside of the front of the gown, the outside of the gloves or facemask will contaminate your bare hands. When you begin to roll up the gown in order to dispose of it, make sure your hands only touch the INSIDE of the gown. NEVER take the rolled up gown and push it down into the trash receptacle. You are bound to accidently touch some contaminated material in the trash container.
Obviously, with something as dangerous as Ebola, the droplet precautions will be carried out with suits much more sturdy and with more coverage than the normal yellow gown used by most hospitals.