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kurtster

kurtster Avatar

Location: where fear is not a virtue
Gender: Male


Posted: Oct 15, 2014 - 9:59am

 islander wrote:

Having recently been through a few audits I'd have to ask - who is asking and who are they asking?  

I was recently presented with a report that my staff were woefully under-prepared. After a bit of digging, we found they were asking contract security people about starting the emergency generators, and were counting clarification questions like "do you mean the red book" when asked about first responder documentation as "did not know about relevant policies and procedures". 

So do you need a specific ebola procedure, or is a procedure for highly infectious deadly disease enough?  because I bet that is present in every hospital around since the days of AIDS and before. 

 
Please take this reply at face value and nothing more.

This is why we have drills and audits.  Time passes between policy creation / implementation and new developments.  The audits should show where or where not policies are relevant, understood and current.  My most recent experience in manufacturing was with Swagelok back in the mid 90's.  Every aspect of this company was micro managed and safety was a paramount concern, at least officially.  As an equipment provider for nuclear power generation and microchip manufacturers, they were and had to be at cutting edge levels in order to keep there certifications and credibility.  There were countless meetings and drills on every procedure imaginable within their scope of operation.  It is where I really learned about OSHA and all that goes with it, including the good old MSDS, ISO certification, ANSI, even clean rooms as we had one for parts fabrication for the microchip industry.  Granted, it was over 20 years ago, but it gave me first hand knowledge and a reasonable foundation for keeping up with and having a rudimentary understanding of developments since then.  My current profession is all about ANSI as well as medical.

On to healthcare. 

Again at face value ...

In the 20 years since I left Swagelok, I have been a licensed medical professional.  Plus a Stage IV blood cancer survivor with the 5 year anniversary of my stem cell transplant this past April.  It by no means make me an expert on medicine, but it does give me first hand access to doctors, nurses and cutting edge medical treatments and procedures.  I have been picking the brains of nearly everyone I've met within this sphere for both personal and professional curiosity as well as saving my own ass.

Since Obamacare came along ... this is not about Obamacare but just the changes it has brought about since its passage within the biz and specifically about what I see as pertinent to this Ebola thing we are discussing. 

Obamacare has changed the drivers and priorities of healthcare and its delivery, without consulting with those responsible for delivering healthcare to the consumer, namely doctors and nurses.  Is what it is.  We have to accept it and move on.  Policy is now driving healthcare, not healthcare driving policy.  That brings about the situation of out of sight, out of mind with so much change to digest and focus on and implement.  What I have witnessed in and participated in is the introduction of IT and data management into the biz.  The industry as a whole is overwhelmed with this change.  Bear in mind, Cleveland has 3 world class hospital networks, with the county hospital being one of the 3, so I'm not in a medical backwater.  As a patient of the Cleveland Clinic for the past 6 years, I have witnessed its implementation first hand and witnessed the challenges and the changes it has brought, again first hand.  The CCF is where this stuff is being modeled after, not just using it.  The other hospital in town CWRU, has been about 2 years behind in introducing IT to its biz.  The wife uses it for her medical needs, in which she has been the beneficiary of cutting edge technology, to the point of being a case study subject in one of her doctor's presentations.  And now with her full tilt back fusion this past July, again cutting edge technology with artificial flesh wraps around her spine to using an electro magnetic field generator around her surgical location to spur bone growth.  Thank you Tesla, thank you very much !

About 15 years ago, there was a major migration of doctors between the 3 hospitals in town for a host of reasons, but mainly policy and other HR concerns.  Regardless of where I went, I could say that I know this doctor and the doctor I spoke with would say, yeah, I know him or her, we used to work together.  Within a couple of years, the dust settled and everything was hunky dory.  Now, once again, there is a new migration underway, again as hospitals are changing their missions to adapt to Obamacare.  So again I am witnessing this as both a provider and patient and seeing it implemented in two world class hospital systems, simultaneously and independently.  The CCF, is the pioneer while CWRU is the follower.  The pioneer is the first to encounter the bugs and has to develop the work arounds.  The follower has the benefit of seeing it in use and adapting, avoiding the growing pains.  With the bonus of Case being a world renowned engineering school, their solutions are even better.  we all win.  Case in point, when CCF built their new stem cell unit, they did a spectacular job.  Along the way, the apheresis unit, where stem cells are harvested, refused to move to new digs as the doctor in charge had strongly concluded that the operation would suffer because it was such a finely tuned operation, that any change, no matter how small would have a potential undesirable outcome in their operation and efficiency.  Newer is not always better.  But what CWRU did with its new cancer wing is mindblowing.  The wife did her post op for several surgeries there because her doctor had pull.  So I have witnessed it first hand.  They put the CCF to shame with just a two year lag time.

They have taken infection control to the highest levels.  Each room is private and about 400 sq feet.  each room can basically be hosed down between patients.  Each room has its own staff computer terminal, personal refrigerator and other controls and features designed to eliminate cross contamination between rooms and patients.  Everything removable in the room is changed between patients, including the curtains on the windows and around the bed.  Curtains in hospital rooms are one of the biggest contamination vectors and one of the least addressed as they are rarely changed between patients.

So here we are.  My humble opinion ... Healthcare has been fighting to maintain its status quo, while having to add the burden of reorganizing to address the new administrative drivers of policy, IT and HR.  The eye has been taken off the ball.  The biz has relied on the policy makers for guidance as opposed to the providers.  The policy makers are political in nature, not professional.  There lies the disconnect.  The policy makers neglected to equally focus on the medical aspects.  They just make policy and don't worry about implementing it.  What is the mantra ... unintended consequences ? or incompetency ?  How about just plain willful ignorance ?

It is up to the government to formulate the measures required for safety as it has effectively taken over the health care system.  But it cannot, because politics drives government, not reality.  We are bearing the brunt now with this Ebola thing because of the assumption, based upon reassurances from the politicians, that the bases were covered in the most important areas by such orgs as the CDC.  While the head of the CDC is indeed an MD, he is a political appointment.  Politics has left us without a Surgeon General for over 11 months now.  Isn't that a key medical position we direly need to have filled right now ?  Perhaps we would not be in the mess we are in now with that position having been filled rather than left vacant.  But politics and government has let us down at the worst time possible.

The truth of the matter is, with Ebola, we really can't say how it is transmitted.  The assurances of that "we know how it is transmitted" have become more vague.  Can animals transmit it ?  Yes, absolutely as the fruit bat is the source of transmission to humans.  So a victim's pet would likely be a possible carrier.  They say it cannot be airborne, yet when viewing videos of the nurse in Dallas home, we see her grounds outside being sprayed.  Yet there is a debate over whether her pet should or should not be euthanized because of the risk involved.  Now with the poll you I posted that you responded to, we see an apparent state of unpreparedness.  While Obamacare is not responsible for this lapse in preparedness, it is.  It brought about such drastic changes to a system that it forced it to rely upon government instead of from within.  And here we are with the weaknesses of the system being exposed.

That's all I got for now, I'm out of gas.  Hope it made some kind of sense. and provides some worthwhile insight for others.

And answers you questions, at least at some level. 

Edit ... Our healthcare biz has changed form a proactive posture to a reactionary posture, directly because of Obamacare, imho ...


islander

islander Avatar

Location: Seattle
Gender: Male


Posted: Oct 15, 2014 - 8:49am

 meower wrote:


well, people who treat patients with HIV aren't wearing Hazmat suits, so I can't help but feel that they're not.  

EDIT: maybe you didnt mean what I thought you meant?

 
I meant that although not labeled 'in case of ebola', that every hospital has a procedure for dealing with people that come in with highly infectious diseases. I imagine it goes something like:
is patient presenting symptoms of any highly infectious disease?
N-stop,
Y- is the disease airborne"
Y- isolate patient and quarantine area already exposed
N- is the patient expelling any contaminated body fluids
Y- isolate area, don protective gear, quarantine patient, collect and isolate any contaminated materials,  
...

I have a similar script in my head for my staff during flu season.  I'm admittedly more into preparedness than most, but I don't have a 'plan for dealing with ebola'. So when some one says "76 percent still say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola" with a flurry of panic in their voice, I kind of wonder if they are just asking the wrong question.  I bet there is already a policy for how to handle highly infectious patients, it's probably used often in flu season.  Just because there isn't "a policy regarding the potential admission of patients infected with ebola" does not mean that even reasonably well trained staff can deal with it.

I only mentioned HIV/AIDS because that was the last time people got all in a tizzy over 'scary not well understood disease wiping us out' that comes to mind. 


meower

meower Avatar

Location: i believe, i believe, it's silly, but I believe
Gender: Female


Posted: Oct 15, 2014 - 8:13am

 islander wrote:

Having recently been through a few audits I'd have to ask - who is asking and who are they asking?  

I was recently presented with a report that my staff were woefully under-prepared. After a bit of digging, we found they were asking contract security people about starting the emergency generators, and were counting clarification questions like "do you mean the red book" when asked about first responder documentation as "did not know about relevant policies and procedures". 

So do you need a specific ebola procedure, or is a procedure for highly infectious deadly disease enough?  because I bet that is present in every hospital around since the days of AIDS and before. 

 

well, people who treat patients with HIV aren't wearing Hazmat suits, so I can't help but feel that they're not.  

EDIT: maybe you didnt mean what I thought you meant?
ScottFromWyoming

ScottFromWyoming Avatar

Location: Powell
Gender: Male


Posted: Oct 15, 2014 - 7:55am

 islander wrote:

Well conspiracy aside, I am surprised at the lack of preparedness. Your glove thing is a perfect example - I know how to do that from long ago first aid training and infrequent practice when working on the car/boat (oil from a diesel could be a good virus analog).  How is it that people working in the field don't know these protocols? it's not like ebola is the only scary thing around. They are many other things that should be taken just as serious.

 
I was surprised that a patient diagnosed overseas was being treated in Nebraska. I'm sure the Omaha facility is up to snuff but it seems logical that anyone flying to this country for treatment should go only to one facility, designated in advance. Now the CDC is onto the idea that all patients should be funneled to one of a handful of hospitals nationwide. 
 
I agree that it's weird that nurses are freaking about no training... I know they get it and got it, but we have a lot of nurses in this country so I'm sure 20% of them thought to themselves "I'm going to work in pediatrics so I don't need to really pay attention here" *checks messages*
 
I totally agree with the complaints that the gear simply does not exist and/or it hasn't been updated or maintained. Top-heavy administration salaries don't leave much room for preparedness. 
islander

islander Avatar

Location: Seattle
Gender: Male


Posted: Oct 15, 2014 - 7:33am

 kurtster wrote:


Ebola–RNs Call for Highest Standards for Protective Equipment, including Hazmat Suits and Training

National Nurses United Press Release, 10/12/14

As of Sunday mid-day, 2,000 RNs at more 750 facilities in 46 states and the District of Columbia have responded to the NNU national survey.

Current findings show:

76 percent still say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola

85 percent say their hospital has not provided education on Ebola with the ability for the nurses to interact and ask questions

37 percent say their hospital has insufficient current supplies of eye protection (face shields or side shields with goggles) for daily use on their unit; 

36 percent say there are insufficient supplies of fluid resistant/impermeable gowns in their hospital


39 percent say their hospital does not have plans to equip isolation rooms with plastic covered mattresses and pillows and discard all linens after use; 

only 8 percent said they were aware their hospital does have such a plan in place



 
Having recently been through a few audits I'd have to ask - who is asking and who are they asking?  

I was recently presented with a report that my staff were woefully under-prepared. After a bit of digging, we found they were asking contract security people about starting the emergency generators, and were counting clarification questions like "do you mean the red book" when asked about first responder documentation as "did not know about relevant policies and procedures". 

So do you need a specific ebola procedure, or is a procedure for highly infectious deadly disease enough?  because I bet that is present in every hospital around since the days of AIDS and before. 
islander

islander Avatar

Location: Seattle
Gender: Male


Posted: Oct 15, 2014 - 7:27am

 ScottFromWyoming wrote:

I just spotted the Obama thread where Kurt loses both the taco and the Pepsi.

 
Well conspiracy aside, I am surprised at the lack of preparedness. Your glove thing is a perfect example - I know how to do that from long ago first aid training and infrequent practice when working on the car/boat (oil from a diesel could be a good virus analog).  How is it that people working in the field don't know these protocols? it's not like ebola is the only scary thing around. They are many other things that should be taken just as serious.
kurtster

kurtster Avatar

Location: where fear is not a virtue
Gender: Male


Posted: Oct 15, 2014 - 7:16am

 helenofjoy wrote:

This is what I was talkin' about down there!  A disagreement doesn't not mean your post is under attack!  Referral to a poster as "Mr. expert" seems defensive and offensive imho.  I'm not saying you are the only person guilty of this kind of "discussion." I'm pointing it out because I like you although I do not agree with many of your interpretations and assumptions.  If this was a mature, polite discussion with someone you respected would you do that?

 
Simple answer, no, I would take a different tone to be sure.

His handle is expertTextpert so it wasn't a slam, just using his handle in shortened form.  If I had used his entire handle what would it have changed in tone ?  Nothing as far as I can figure.  It would only appear to be an irony.

Based upon previous interactions with him, I have concluded, maybe wrongly, that he is not interested in serious discussions and have taken that into consideration with my tone.

 


helenofjoy

helenofjoy Avatar

Location: Lincoln, Nebraska
Gender: Female


Posted: Oct 15, 2014 - 6:37am

 kurtster wrote:


"I did address that to the best of my ability in my post that has come under attack in the Obama thread.  Unfortunately it has been discredited by our latest arrival, Mr. expert."



 
This is what I was talkin' about down there!  A disagreement doesn't not mean your post is under attack!  Referral to a poster as "Mr. expert" seems defensive and offensive imho.  I'm not saying you are the only person guilty of this kind of "discussion." I'm pointing it out because I like you although I do not agree with many of your interpretations and assumptions.  If this was a mature, polite discussion with someone you respected would you do that?
kurtster

kurtster Avatar

Location: where fear is not a virtue
Gender: Male


Posted: Oct 15, 2014 - 6:30am

 ScottFromWyoming wrote:
As a kind of first responder, I was interested in the case in Spain and now the case in Dallas, where nurses doing everything by the book contracted the disease. Now several representatives of nurses groups are saying that they're not getting adequate training in how to use (and most important: remove) the hazmat suits. I believe it; I can just imagine some hospital admin saying "okay I ordered the suits, now I need to book myself a trip to The Hellouta Here."

It's my assumption (now) that no one will go into an isolation ward without proper gear and training. Someone hands me a hazmat suit and says "go clean that up," I'm not about to do it until I know I'm doing everything right. Now. Maybe last week, I would have assumed I could get it right the first time. 

 
So you are curious about Ebola based upon your first responder status ?  I would be as well if I was one.

I did address that to the best of my ability in my post that has come under attack in the Obama thread.  Unfortunately it has been discredited by our latest arrival, Mr. expert.

But if this is where you would like to begin discussing Ebola, take a second look at the suspect info.  Maybe someone will come up with more concrete information shortly.  But for now if this information is correct, if the nurses are ill prepared from a lack of leadership, guidance and training, first responders have to be just as much in the dark factually as the nurses are.  In your case though, you live far enough from any major danger to really worry much.  Two things you can consider.

A) by the time it gets to be a threat in your neck of the woods, there should be some answers

or

B)  if it does present itself as a real and grave danger in your neck of the woods, then it doesn't matter cuz its probably out of control by then.

Finally, winter would be your friend.  It would seem that a tropical virus would have a difficult time in cold weather.  But that is just a stab in the dark. 

 Here again is my discredited information ...

Ebola–RNs Call for Highest Standards for Protective Equipment, including Hazmat Suits and Training

National Nurses United Press Release, 10/12/14

As of Sunday mid-day, 2,000 RNs at more 750 facilities in 46 states and the District of Columbia have responded to the NNU national survey.

Current findings show:

76 percent still say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola

85 percent say their hospital has not provided education on Ebola with the ability for the nurses to interact and ask questions

37 percent say their hospital has insufficient current supplies of eye protection (face shields or side shields with goggles) for daily use on their unit; 

36 percent say there are insufficient supplies of fluid resistant/impermeable gowns in their hospital


39 percent say their hospital does not have plans to equip isolation rooms with plastic covered mattresses and pillows and discard all linens after use; 

only 8 percent said they were aware their hospital does have such a plan in place


helenofjoy

helenofjoy Avatar

Location: Lincoln, Nebraska
Gender: Female


Posted: Oct 15, 2014 - 5:46am

 kurtster wrote:

Sure, taco's and Pepsi's, that's the ticket.  I'll have a taco, but I drink Coke.

Well go ahead, start a conversation.  This Ebola thing has been going on for some time.  No one has stopped you.  Have one and don't talk about Obama, who has put himself in charge.  I covered a lot of ground in the other thread.  All of it is dismissed as rubbish and hyperbole, as I will infer.

And I will refer you again to winter's journal.  He laid out the general view of the majority of RPeep's.  Is what it is.

OBTW, Go Giants ...
 
All of us need to try to remember that a large percentage of what is discussed here - the "facts" of the issues, are really only opinions and assumptions based on other people's opinions and assumptions, and rarely cover the real facts of the issue.  We seem reluctant to actually do real research in order to include it in the discussions (with a few exceptions) and instead look for "information" that backs up our own preconceived opinions.  I do find it distressing that we have to include insulting and disrespectful comments directed at people we perceive to be misinformed.  I like to think we are capable of outgrowing what seems to be a type of childish one-upmanship in the process of evolving and becoming more enlightened as a species.
kurtster

kurtster Avatar

Location: where fear is not a virtue
Gender: Male


Posted: Oct 14, 2014 - 9:31pm

 ScottFromWyoming wrote:

Well if it were possible to have a conversation —any conversation at all— without you or any of a handful of others turning it into a flaming condemnation of everything and everyone at RP. I mean, hell. I don't even need to be here to know where this will end up. I'll give you a free taco if you can discuss the ebola outbreak in any way without needing to indict Obama for some or all of it. I was going to throw in a packet of hot sauce if you could do it without dismissing everyone at RP who values thoughtful discussion but you've already blown that one. But I'll add in a Pepsi if you can do it without saying how you knew all along this would be the outcome since you've been following this issue so closely and so you're the only one here who really knows.

 
Sure, taco's and Pepsi's, that's the ticket.  I'll have a taco, but I drink Coke.

Well go ahead, start a conversation.  This Ebola thing has been going on for some time.  No one has stopped you.  Have one and don't talk about Obama, who has put himself in charge.  I covered a lot of ground in the other thread.  All of it is dismissed as rubbish and hyperbole, as I will infer.

And I will refer you again to winter's journal.  He laid out the general view of the majority of RPeep's.  Is what it is.

OBTW, Go Giants ...

Coaxial

Coaxial Avatar

Location: Comfortably numb in So Texas
Gender: Male


Posted: Oct 14, 2014 - 9:07pm

 ScottFromWyoming wrote:

I just spotted the Obama thread where Kurt loses both the taco and the Pepsi.

 
{#Yes}It's like Groundhog Day.


ScottFromWyoming

ScottFromWyoming Avatar

Location: Powell
Gender: Male


Posted: Oct 14, 2014 - 8:58pm

 Red_Dragon wrote:

{#Lol} Thank you.

 
I just spotted the Obama thread where Kurt loses both the taco and the Pepsi.
Red_Dragon

Red_Dragon Avatar

Location: Dumbf*ckistan


Posted: Oct 14, 2014 - 8:56pm

 ScottFromWyoming wrote:

Well if it were possible to have a conversation —any conversation at all— without you or any of a handful of others turning it into a flaming condemnation of everything and everyone at RP. I mean, hell. I don't even need to be here to know where this will end up. I'll give you a free taco if you can discuss the ebola outbreak in any way without needing to indict Obama for some or all of it. I was going to throw in a packet of hot sauce if you could do it without dismissing everyone at RP who values thoughtful discussion but you've already blown that one. But I'll add in a Pepsi if you can do it without saying how you knew all along this would be the outcome since you've been following this issue so closely and so you're the only one here who really knows.

 
{#Lol} Thank you.
Red_Dragon

Red_Dragon Avatar

Location: Dumbf*ckistan


Posted: Oct 14, 2014 - 8:56pm

 ScottFromWyoming wrote:

Well if it were possible to have a conversation —any conversation at all— without you or any of a handful of others turning it into a flaming condemnation of everything and everyone at RP. I mean, hell. I don't even need to be here to know where this will end up. I'll give you a free taco if you can discuss the ebola outbreak in any way without needing to indict Obama for some or all of it. I was going to throw in a packet of hot sauce if you could do it without dismissing everyone at RP who values thoughtful discussion but you've already blown that one. But I'll add in a Pepsi if you can do it without saying how you knew all along this would be the outcome since you've been following this issue so closely and so you're the only one here who really knows.

 
{#Lol} Thank you.
ScottFromWyoming

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Location: Powell
Gender: Male


Posted: Oct 14, 2014 - 8:55pm

 kurtster wrote:
Welcome to the new politically correct RP where serious conversations about serious subjects are no longer tolerated. 
 
Well if it were possible to have a conversation —any conversation at all— without you or any of a handful of others turning it into a flaming condemnation of everything and everyone at RP. I mean, hell. I don't even need to be here to know where this will end up. I'll give you a free taco if you can discuss the ebola outbreak in any way without needing to indict Obama for some or all of it. I was going to throw in a packet of hot sauce if you could do it without dismissing everyone at RP who values thoughtful discussion but you've already blown that one. But I'll add in a Pepsi if you can do it without saying how you knew all along this would be the outcome since you've been following this issue so closely and so you're the only one here who really knows.
Coaxial

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Location: Comfortably numb in So Texas
Gender: Male


Posted: Oct 14, 2014 - 8:04pm

 kurtster wrote:

Welcome to the new politically correct RP where serious conversations about serious subjects are no longer tolerated.  

The tribe has spoken.

We have reached a point where the very sight of a potentially controversial topic on the RAFT offends the "community".  The old axiom of don't click your mouse as in change the channel if you are or could be offended no longer applies.

All that is allowed is fluffy stuff and joking around.  But then see who is making the jokes about the serious stuff.  The same ones generally offended by the sight of the serious stuff. 

{#Meditate}

 
Now to me this is sinking thinking...You are free to post what you like, as long as it follows Bill's rules, and everyone here is free to tell what they think or not. Same as it ever was in that regard.
kurtster

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Location: where fear is not a virtue
Gender: Male


Posted: Oct 14, 2014 - 5:08pm

 helenofjoy wrote:
Well this seems to be the only place where Ebola has been mentioned on RP.  It's not just in Africa anymore.  I'm kind of flabbergasted at how this is playing out and by the apparent complacency being exhibited by most of us.  Should be more than just interesting!{#Eek}

 
Welcome to the new politically correct RP where serious conversations about serious subjects are no longer tolerated.  

The tribe has spoken.

We have reached a point where the very sight of a potentially controversial topic on the RAFT offends the "community".  The old axiom of don't click your mouse as in change the channel if you are or could be offended no longer applies.

All that is allowed is fluffy stuff and joking around.  But then see who is making the jokes about the serious stuff.  The same ones generally offended by the sight of the serious stuff. 

{#Meditate}
BlueHeronDruid

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Location: Заебани сме луѓе


Posted: Oct 14, 2014 - 3:27pm

 haresfur wrote:

I used to have hazmat and radiation worker certification. There is a right way and a wrong way to don and doff your kit. Doing it properly should reduce the risk by a huge factor. But I wouldn't say it is foolproof. Also, I don't know if there is a practical way to decontaminate the outside of the suits for ebola before taking them off.  I don't think I've ever seen a doctor or nurse take off gloves properly. (Grab a pinch of glove at the base of the palm and pull your hand out, turning the glove inside out.  Crumple that glove up in your gloved hand.  Slip fingers under the wrist of the second glove and pull your hand out turning the glove inside out and capturing the other glove and all the nasties inside.)

The trouble with chemical and biological contamination is that it is hard to tell it is there. Most rad contamination on the other hand is very easy to detect at low levels. They say the most common places they detect contamination on rad workers is the right index finger and the right nostril. 

 


My sister and BIL are nukers. (She's a health physicist. It's her job to keep the other workers safe and know their dose levels.) I'll have to ask them about that.
haresfur

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Location: The Golden Triangle
Gender: Male


Posted: Oct 14, 2014 - 3:15pm

 ScottFromWyoming wrote:
As a kind of first responder, I was interested in the case in Spain and now the case in Dallas, where nurses doing everything by the book contracted the disease. Now several representatives of nurses groups are saying that they're not getting adequate training in how to use (and most important: remove) the hazmat suits. I believe it; I can just imagine some hospital admin saying "okay I ordered the suits, now I need to book myself a trip to The Hellouta Here."

It's my assumption (now) that no one will go into an isolation ward without proper gear and training. Someone hands me a hazmat suit and says "go clean that up," I'm not about to do it until I know I'm doing everything right. Now. Maybe last week, I would have assumed I could get it right the first time. 

 
I used to have hazmat and radiation worker certification. There is a right way and a wrong way to don and doff your kit. Doing it properly should reduce the risk by a huge factor. But I wouldn't say it is foolproof. Also, I don't know if there is a practical way to decontaminate the outside of the suits for ebola before taking them off.  I don't think I've ever seen a doctor or nurse take off gloves properly. (Grab a pinch of glove at the base of the palm and pull your hand out, turning the glove inside out.  Crumple that glove up in your gloved hand.  Slip fingers under the wrist of the second glove and pull your hand out turning the glove inside out and capturing the other glove and all the nasties inside.)

The trouble with chemical and biological contamination is that it is hard to tell it is there. Most rad contamination on the other hand is very easy to detect at low levels. They say the most common places they detect contamination on rad workers is the right index finger and the right nostril. 
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