Dallas Hospital Staff Had No Ebola Training, Official Says

[UpInArms]

Source: ABC News

Health care workers in the Dallas hospital that treated a patient who died from Ebola and then treated two nurses who contracted the disease never received in-person training on how to treat Ebola patients and avoid spreading the highly contagious disease, a top hospital official said at a Congressional hearing today.

Dr. Daniel Varga said that, even though guidelines from the Centers for Disease Control and Prevention were sent to the emergency department at Texas Health Presbyterian Hospital in late July, there was no follow-up training ordered for the staff. Less than two months later, the hospital staff sent a man with Ebola home with a fever even though he was likely contagious at the time.

Varga is one of the panel of top American health officials testifying in Congress as part of a hearing on the federal government's response to Ebola cases in the United States.

Read more: http://abcnews.go.com/Health/dallas-hospital-staff-ebola-training-official/story?id=26240790

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[uppityperson]

1. Texas Health Presbyterian Hospital lawyers and administrators continue to huddle attempting CYA

and screaming at each other.

[In_The_Wind]

2. That was obvious from the beginning.

They all tried to the best job they could given their lack of training.

[magical thyme]

4. yup. that includes the doctor(s).

a lot of times, "training" doesn't filter down to the people who need it.

And as far as removing biohazard suits, Dr. Sacra just gave an interview in which he talked about how it's not enough to get a few slides or a poster. You have to drill it, practice it with somebody watching. He called it "quite tricky."

It died down pretty quickly, but I even saw at one point the CDC criticizing the doctors for ventilating and dialysis because that hasn't been done on any Ebola patients before. Yet, one of the things they'd bragged about when bringing Brantly and Writebol back was that in the US we'd be able to provide support for any failing organs through those very techniques, to buy time for the immune system to kick in.

That staff was forced to wing it from day one with a deadly disease they had zero training on, and yet hospital administration and the CDC couldn't start the finger-pointing fast enough.

I'm glad the reality is coming out now. Apparently the Dr. at Emory that headed the treatment for Brantly and Writebol blasted the CDC for their irresponsibly lax protocols too.

[In_The_Wind]

7. Training should have been started when Ebola showed signs of being uncontrolled.

I feel so bad for everyone.

[magical thyme]

13. training, and massive support for the countries impacted

my concern is that the aid finally being sent may be too little, too late to truly contain it. They are playing a massive game of catch-up. WHO believes they need to isolate 70% of infected patients to stop the spread. We're talking about building hundreds of beds within some number of weeks, when there are already thousands of sick people not accounted for. By the time those facilities are set up, we'll be even more thousands behind.

The scientist who is saying it will burn itself out is assuming it will be confined to Guinea, Liberia and Sierra Leone, and that there won't be people crossing back roads and trails into neighboring countries desperate to escape or to find food and/or work.

And he writes about "changing behavior." Well, some villages have changed their behavior and implemented no-touch protocol, etc. But others with great distrust of their government and strangers in biohazard suits have attacked and murdered the aides trying to help them because they thought they were spraying their villages with ebola.

There are a lot of countries in Africa who's health care systems would be overwhelmed if it gets into them. And heaven forbid it should get into Asia.

[valerief]

3. The important thing is we were told they did. It's politics. Nothing is done, everything

is promised.

http://www.cdc.gov/media/releases/2014/t1004-ebola-confirmed-case.html

Everything we've seen until now reinforces what we've known for the past 40 years. We know how to stop outbreaks of Ebola. In this country, we have health care infection control and public health systems that are tried and true and will stop before there's any widespread transmission.

[magical thyme]

5. the sad thing is that one patient died and two are at great risk

due to those assurances that everybody in the trenches knew were a pack of lies.

[Cryptoad]

6. Come on People,,,,

we all know Gov Perry has been way too busy fighting Obama to have time for any Health Care workers continuing Education funding!

[jwirr]

8. This then is why all the other hospitals are not having a crisis. Even my granddaughter who runs

a small rural clinic said she received materials from CDC and passed them on to the staff. So the CDC did provide info.

[magical thyme]

14. it varies from one hospital to the next.

we are just now going to get training at my rural hospital.

Smaller sometimes is actually better. Fewer layers of administration and management, and real connection to the community.

[jwirr]

22. Yes Jen said that they will be notified by the hospitals down in the Twin Cities and then they will

know that there are cases coming out way.

[Little Star]

9. No shit Sherlock says the whole world who witnessed that fact...

in real time.

[Feral Child]

10. Nonsense.

I'm sure they have had MRSA training and there are protocols for isolation-type illnesses.


They just didn't follow procedure.

[magical thyme]

15. 1. MRSA precautions didn't stop the spread of MRSA, and 2.

The CDC has finally admitted that standard droplet/contact precautions are insufficient, after the Dr. the headed Brantly and Writebol's treatment ripped him one for incredibly lax protocols.

Droplet precautions are not sufficient for somebody who is spewing projectile vomit and explosive diahrrea. Every inch of your body needs to be covered -- including your neck -- and you need drill training and a spotter to help in removing the coverings without accidental contact.

[Feral Child]

18. Thanks for the information.

I stand corrected.

[herding cats]

11. I'm confused. Initially it was claimed the hospital had just held a drill for Ebola

This was before Mr Duncan arrived, granted, but it was claimed they'd held a drill for a potential traveler with Ebola arriving at the hospital. Later it was claimed the hospital had "prepped and drilled front line personnel involved with treating Mr. Duncan in protective protocols during his inpatient care."

Now it's being said they had never received any in-person training on treating Ebola patients. So, which is it? They knew nothing about dealing with an infectious disease such as Ebola, or their facility made sure they were properly trained and prepared? Because they can't have it both ways, they were either prepped and drilled or they weren't.

[magical thyme]

16. training by handouts and slides doesn't cut it, and the CDC protocol was inadequate.

Dr. Sacra explained it in an interview today. The BSL-4 hospital staffs drill for days -- actually practice removing their biohazard suits. He called it "quite tricky" to remove contaminated coverings without any accidental exposure.

And the CDC has admitted their recommended protocol was inadequate and increased it to complete head to toe coverings, with hood protecting the head neck and shoulders. Certain workers are also recommended to have filtered air supplies under their hoods.

The CDC has also admitted that their threshold temperature of 101.5F was too high, and lowered it to 100.4 (which was Duncan's intake temp). And based on the latest nurse, who's temp was only 99.5, they are considering lowering still further.

[herding cats]

19. So, the hospital didn't prep and drill their healthcare workers?

They gave them handouts and slides and said that was a prep and drill, is that what you're saying took place? If it is, then that's not even close to properly preparing and drilling their front line care providers.

As for Mr Duncan's temp, I've read it was 103 during his first visit to the ER.

[magical thyme]

20. his intake was 100.4, which is why the triage nurse didn't freak when he came in

It spiked to 103 while he was there.

He spent several hours there and underwent quite a bit of testing on his first visit. That's why I don't buy the "uninsured, so dump him" argument. His fever and pain initially like appendicitis and that's what they were looking for. I forget which kind of scans they did. (I'm a lab tech so more versed on the lab tests. They probably ran CBC, CMP, Lipase in case of pancreatitis, CRP for nonspecific inflammation.) I also don't blame him for prescribing antibiotics with dx of possible virus. EDs are not diagnostic specialists; they separate you into admit versus treat/release. They brought his fever back down while he was there and the antibiotics were probably "jic" is bacterial and not viral. Without extensive testing that they aren't able to perform in an ED visit, they can't be sure. The CBC can point a bit toward viral vs bacterial, but in the case of Ebola, which attacks your monocytes first, who knows that that looks like. To my knowledge, we don't have any real data on that, like we do more common diseases that we've been able to study.

I don't know for a fact that's what took place (slides, posters), but that's what passes as training where I'm at. Even when I was in clinical training, we didn't practice removing anything except gloves. Basically a demo and a try, and move on.

The protocols the CDC was recommended was for droplet precautions, the same as for things like MRSA. It wasn't even close to adequate for something like Ebola, where patients have massive quantities of highly infectious projectile vomit and explosive diarrhea, which even Frieden now admits and has apologized for...and changed to biohazard-type coverings.

The hospital absolutely failed their staff, but that strikes me as pretty common. I hold it against them, but against all of them. Some are better than others, but I can tell you if he'd walked into my hospital, we wouldn't have been any better prepared. We are only going to get Ebola training soon -- my lab manager got hers yesterday.

[Habibi]

12. Once guidelines are received, who is responsible for providing the training?

[magical thyme]

17. the hospital is. the problem is that "training" usually consists of a bunch of slides and maybe

posters or handouts.

They needed better protocols from the CDC, and you need to actually practice removing the contaminated coverings. At the BSL-4 hospitals they drill for days, with helpers watching them both when they practice and irl.

[Habibi]

23. Thanks, magical. Your perspective on this issue is really helpful.

[blkmusclmachine]

21. TX hospitals have Freedumb. They don't need no stinkin' DC laws and regulations!!!

[KeepItReal]

24. The CEO had to get his $5.7 million...who's got money for training?