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ebola

Sanford designated to treat Ebola

Protective gear for ebola treatment

Sanford Health infection prevention nurse Julie Jacobson models the personal protective equipment nurses will wear if called upon to treat patients with Ebola. Dr. Noe Mateo, right, said the protective covering will be worn by nurses and doctors for three to four hours before being disposed as hazardous waste. TOM STROMME/Tribune 

If a person in North Dakota contracts the Ebola virus, he or she would likely be transported to a Sanford Health facility in Bismarck or Fargo, according to the state Department of Health.

The state has designated Sanford to handle Ebola treatment in North Dakota.

“With Sanford’s position throughout the state, it made sense we would talk to the health department and collaborate,” said Dr. Craig Lambrecht, president of Sanford in Bismarck.

Colleen Reinke, public information officer for the health department, said the state has forwarded Sanford’s name to the Centers for Disease Control and Prevention. The federal agency seeks to certify at least one hospital in every state to handle Ebola cases, she said.

It’s unclear to Reinke when that certification will take place. She said the CDC plans to take a tiered approach, first certifying hospitals near the five U.S. airports receiving travelers from countries affected by the Ebola outbreak. Next will come hospitals in major cities with large immigrant populations before the CDC gets to facilities in lower-risk places such as North Dakota, she said.

Should someone in North Dakota develop Ebola in the meantime, the decision about where to send that person for treatment would be made on a case-by-base basis, said Reinke, adding that Sanford has indicated it is willing to take such a patient.

Meanwhile at the hospital, physicians and nurses continue Ebola training.

Dr. Noe Mateo, an infectious disease consultant at Sanford, said 500 of the hospital’s nurses have participated in training sessions. A select number of them routinely practice putting on and removing personal protective equipment, complete with fluid-resistant coveralls and shoes, a gown, two layers of gloves and a head covering connected to a device that filters air.

Mateo said at least 35 members of the nursing staff have volunteered to care for an Ebola patient.

Lessons learned

Watching what happened at the hospital in Dallas where a man recently died from Ebola and infected two nurses has shaped the way Sanford prepares for the virus.

“What everybody learned the hard way was that you can’t have any skin exposed,” Mateo said.

Sanford also is evaluating its rooms to determine which are best to handle Ebola patients, Mateo said.

Meanwhile, he said people who walk into the hospital for treatment can expect receptionists to ask them two questions:

  • Within the past 21 days, have you been to a part of west Africa affected by the Ebola outbreak?
  • Have you had any contact with someone who has Ebola?

If a patient answers yes to either of those questions, a nurse would step in for further screening, Mateo said.

So far, he has heard of two patients at Sanford whose responses to those questions raised a flag, but hospital workers ultimately ruled out the possibility of Ebola.

In those cases, it wasn’t a simple “yes” answer to either question. Rather, the patient provided a more ambiguous response, such as that they work with people from west Africa, he said.

Throughout the state, two people are considered at low risk for Ebola after having visited parts of Africa affected by the disease, state epidemiologist Tracy Miller said. The health department checks in with them daily, asking them to report their temperatures for up to 21 days.

“If they do have any change in health, we would work with them to make sure the medical community is prepared for them,” Miller said.

The health department asks that travelers concerned they have symptoms of Ebola call ahead before showing up at a medical facility so emergency responders and medical personnel know to use proper protective gear from the start and don’t miss a diagnosis. Ebola often present like a flu with symptoms that can include a fever, headache or muscle aches.

Proactive approach

The department receives travel manifests and contacts all passengers from Guinea, Sierra Leone and Liberia who come to North Dakota to go over screening information.

The state has established various protocols depending upon the risk a person presents. If someone is considered high risk, meaning he or she was likely exposed to the bodily fluids of someone with Ebola, the health department would ask that individual to avoid public transportation and public places, such as shopping centers, until the 21-day monitoring period has passed, Miller said.

The two people being monitored in North Dakota are not considered high-risk. Nevertheless, the health department has encouraged them to take certain precautions, such as avoiding places with a large number of people and not inviting a lot of visitors into their homes, Miller said.

“They are not in quarantine or anything like that,” she said.

The health department says it has a sufficient amount of personal protective equipment to handle Ebola patients, though it has placed an order for more.

Between the department’s own cache, hospitals and other medical facilities, there are 2,750 full-body suits in North Dakota considered appropriate for Ebola care, said Tim Wiedrich, section chief of the health department’s emergency preparedness and response section.

He said he would like to double that amount, but it could take months for an order to come in because the demand for personal protective equipment is high at hospitals and health departments throughout the country.

Wiedrich said the current supply in North Dakota would be more than enough to handle the number of Ebola cases seen so far in the United States.

“We still have way more personal protective equipment than would be necessary to care for those patients,” he said.

(Reach Amy R. Sisk at 701-250-8267 or amy.sisk@bismarcktribune.com.)

Reach Amy R. Sisk at 701-250-8267 or amy.sisk@bismarcktribune.com.

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