While the government came out last week proclaiming that healthcare workers are prepared for an Enola outbreak, the majority of us do not feel this is the case. Virtually no one in the US has seen, or treated, a case of Ebola virus in the past. Now, not only are we expected to recognize patients that may be infected with this deadly virus, we need to be prepared to prevent the spread of this highly contagious pathogen if we were to encounter it.
The CDC has done an excellent job passing its guidelines to ER’s and local health departments across the nation. But, these simply have not trickled down to those of us on the front lines: doctors and healthcare workers in outpatient settings, nurses, EMT’s paramedics, and all those who may be the first to encounter an Ebola patient. This represents a very significant gap in the system. There is no one to blame for this gap. Everyone is working hard to get a handle on it, but it simply is an enemy we have never seen before and are forced to develop guidelines for it as we are under attack.
The CDC advises that if you have a suspect patient in your practice, place him/her in an exam room, close the door, and the local health department. I work evening hours. The health department closes at 5PM. I cannot keep my patient locked in the exam room until they open up again in the morning. Of course, a breach of the suggested protocols will have to be made to get this patient to the emergency room where they belong. And I would have to worry about those transporting the patient. Without the guidance of the health department, will the EMT’s know the proper way to transport that patient? Will they be properly protected? And while this person is being transferred, the trail of possible exposures will not be started immediately in such a situation. This is just one example of where there is a gap in the guidelines. I am sure every healthcare worker can give their own.
The CDC has done an excellent job developing their guidelines and getting them to ER’s. But, for many patients, they would rather come to their primary care providers first. No one has sent us these guidelines. Sure, they are available by an internet search. Many of us do that to be prepared. But many doctors don’t have time to do this research on their own. And they will be left scrambling for information if they are thrust into a situation where they have a suspected patient. This is a way that surely errors will seep in.
Primary care providers, all doctors in hospitals and outpatient settings, nurses, and anyone who works in the healthcare field needs to have these guidelines brought to their attention. Everyone needs to understand the deadliness and infectivity of this virus. And the gaps in the system need to be addressed. Unless these gaps are filled, people will be exposed who should not be. All of us need to come together and explore these cracks and ensure no one falls through. Because even if just one patient does, it can have quite deadly consequences.
While we all need to be prepared, the truth is probably the grand majority of us will ever see or treat a case of Ebola. Patients are starting to ask questions, and we need to give them answers. And we need to be on heightened alert for those traveling from an infected area. With that being said, preparation is important, but we should not be paranoid about it. We should trust in the CDC and look to them for guidance. If we all work together, we can keep this disease at bay.
How prepared do you feel if a patient with a potential Ebola infection shows up in the exam room?
Dr. Linda Girgis MD, FAAFP, is a family physician in South River, New Jersey. She holds board certification from the American Board of Family Medicine and is affiliated with St. Peter’s University Hospital and Raritan Bay Hospital. Dr. Girgis earned her medical degree from St. George’s University School of Medicine. She completed her internship and residency at Sacred Heart Hospital, through Temple University and she was recognized as intern of the year. Over the course of her practice, Dr. Girgis has continued to earn awards and recognition from her peers and a variety of industry bodies, including: Patients’ Choice Award, 2011-2012, Compassionate Doctor Recognition, 2011-2012. Dr. Girgis’ primary goal as a physician remains ensuring that each of her patients receives the highest available standard of medical care.