Pushback Against CDC Claim That Ebola-Infected Nurse Breached Protocol
You mean, it’s possible the protocol is not perfect? Thoughtcrime!
Some healthcare experts are bristling at the assertion by a top U.S. health official that a “protocol breach” caused a Dallas nurse to be infected with Ebola while caring for a dying patient, saying the case instead shows how far the nation’s hospitals are from adequately training staff to deal with the deadly virus.
. . . .
Some experts also question the CDC’s assertion that any U.S. hospital should be prepared to treat an Ebola patient as the outbreak ravaging West Africa begins to spread globally. Given the level of training required to do the job safely, U.S. health authorities should consider designating a hospital in each region as the go-to facility for Ebola, they said.
“You don’t scapegoat and blame when you have a disease outbreak,” said Bonnie Castillo, a registered nurse and a disaster relief expert at National Nurses United, which serves as both a union and a professional association for U.S. nurses. “We have a system failure. That is what we have to correct.”
Well. “You” don’t scapegoat and blame. But members of the federal government do that as easily and naturally as they breathe. Scapegoating and blaming is currently classified as a part of bureaucrats’ autonomic nervous system.
Dr. Gavin Macgregor-Skinner, an expert on public health preparedness at Pennsylvania State University, also disagreed with the talk of a breach of protocol, saying it just puts the onus on the nurse.
“I think that is just wrong,” said Macgregor-Skinner, who helped the Nigerian government train healthcare workers when a traveler from Liberia touched off an outbreak of Ebola this past summer.
“We haven’t provided them with a national training program. We haven’t provided them with the necessary experts that have actually worked in hospitals with Ebola,” he added in reference to U.S. hospital staff.
Always trust content from Patterico.
Thanks to CardioNP for the link to the story.
Ding.
Patterico (9c670f) — 10/13/2014 @ 10:43 amI expect a “best practices” protocol will be developed rather quickly in the case of an outbreak. The CDC is the epitome of REMFs and the talent on the front lines in regional medical centers will be both smart enough and motivated enough to figure it out.
Despite the CDC.
Kevin M (b357ee) — 10/13/2014 @ 10:46 amYou will note that McCoy never asked Starfleet for help.
Kevin M (b357ee) — 10/13/2014 @ 10:47 amI expect the US strain of this disease to be renamed “obola” after our cic who said it wouldn’t spread to the US. Apparently, upon his invitation obola is here.
I just wish he told us if we liked our obola we could keep our obola. Then I might feel safe.
Jim (84e66d) — 10/13/2014 @ 10:55 amHey, that blaming the victim for mysterious protocol breaches thing is not working out so well.
New and always reliable smarttake, blaming Republican budget cuts. ROFLCOPTER!!!!!!!!!
daleyrocks (bf33e9) — 10/13/2014 @ 10:58 amNext post deals with that, daley.
Patterico (9c670f) — 10/13/2014 @ 10:59 amit’s so sad what America’s become
happyfeet (a785d5) — 10/13/2014 @ 10:59 amNurses strikes in the middle of an ebola scare would be interesting.
Update—-University of Illinois Hospital System nurses voted overwhelmingly to strike if they can’t come to an agreement with the West Side hospital system. The 1,150 nurses represented by the Illinois Nurses Association had a three-year contract with the hospital system that has been extended twice already. The three-day vote was tallied late Thursday night, with 94 percent, 609 nurses, in favor of a strike. The one-day strike could take place as soon as Oct. 21, the day the current contract expires.
http://www.suntimes.com/news/metro/29514614-418/u-of-i-nurses-vote-to-authorize-strike.html
elissa (04e1fa) — 10/13/2014 @ 11:07 amWhat’s going on? Didn’t Obama assure us that Ebola was not a big deal?
AZ Bob (34bb80) — 10/13/2014 @ 11:14 amUnless and until they can tell us what this supposed protocol breach was, they should STFU about the protocol breach.
Dave (in MA) (037445) — 10/13/2014 @ 11:24 amI wonder what the CDC swells actually discussed at their Ebola meetings.
Regional expert centers? Nope.
How to decontaminate affected residences? Nope.
Where to dispose of contaminated personal items? Nope.
How to train millions of health care workers to treat patients? Nope.
How to limit sick people coming into the US? Nope.
Symptoms that warrant hospitalization and/or quarantine? Nope.
Where to quarantine? Nope.
How to control those who break quarantine, like the execrable Nancy Snyderman? Nope.
What did they talk about?
Patricia (5fc097) — 10/13/2014 @ 11:26 amIn the press (UK mail) is info the patient both underwent dialysis and was on a vent.
Not a single mention anywhere by anyone that respirators were used by the careworkers or recommended to the hospital or included in the protocols of infection control.
Did CDC not give the hospital advice consistent with it’s own published guidelines?
“Guidance from the CDC and WHO recommends the use of facemasks for healthcare workers providing routine care to patients with Ebola virus disease and respirators when aerosol-generating procedures are performed. (Interestingly, the 1998 WHO and CDC infection-control guidance for viral hemorrhagic fevers in Africa, still available on the CDC Web site, recommends the use of respirators.)”
http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola
SarahW (267b14) — 10/13/2014 @ 11:41 amWhy is no one noting that this is an attack on a woman!
CDC: It is a female nurse who is reported to have contracted the illness although fully gowned. Supposedly it was her breach of protocol that caused her to contract the disease. In other words, she screwed up!
#Waronwomen??
John (5d295e) — 10/13/2014 @ 11:47 amSarah W reported in the other thread that the nurse’s name is Nina Pham. That sounds like a Chinese name, and they tend to be on the small side. Maybe the protective gear, made for American nurse sizes, XL to XXXL, could not be adjusted to fit her properly?
nk (dbc370) — 10/13/2014 @ 1:42 pmVietnamese. But your point about potentially ill-fitting protective gear still stands.
Steve57 (4d34f4) — 10/13/2014 @ 1:44 pmVietnamese.
I know. I was going to do a takeoff on a King of the Hill riff. “Are you Chinese or Japanese?” “We’re from Laos”. “Welcome to Arlen. But are you Chinese or Japanese”? It being Texas and all. But maybe it’s not all that funny, in this situation.
nk (dbc370) — 10/13/2014 @ 1:51 pmMaybe not all that funny. I may know her family. I know quite a few Phams around here. I might even have met her, if she was active in the local Vietnamese community and her Church.
Steve57 (4d34f4) — 10/13/2014 @ 2:06 pmPresident Obama hit a sporting milestone Sunday — his 200th round of golf since moving into the White House!
happyfeet (a785d5) — 10/13/2014 @ 2:16 pmI was involved in occupational safety for over 30 years. My experience suggests that in instances such as the exposure in Texas either 1) training was inadequate; or, 2) the protective devices are too complicated and impractical to consistently utilize safely. I would not assume that we just had a careless worker.
Paige (5b1395) — 10/13/2014 @ 2:31 pmAnother factor is that the hospital Thomas Duncan picked at random doesn’t specialize in treating these kinds of diseases. So the hospital workers had to basically read the CDC instructions about how to implement the protocol. Then implement the protocol.
As MD in Philly and others have pointed out that we need to designate regional medical centers where these patients can be treated by experts who are trained in best practices. Not generalists who need to go from zero to 60 in nothing flat when learning how to deal with Ebola on the fly.
Steve57 (4d34f4) — 10/13/2014 @ 2:45 pmwe have to ramp up cause of it’s spreading exponentially the cases have already doubled once
what’s the protocol kenneth
happyfeet (a785d5) — 10/13/2014 @ 2:48 pmThe protocol is to give the infantrymen of the 101st Airborne Division brief familiarization training on the HAZMAT gear that’s supposed to keep them from becoming infected. Then send them to West Africa.
What could go wrong?
Steve57 (4d34f4) — 10/13/2014 @ 3:12 pmWorking as I do at the Los Angeles Department of Water and Power, I get sent to regular safety training sessions. One covered an electrical worker who had made contact with a falling object and been electrocuted.
It was a hot day and he had removed his leather gloves to cool off. When he saw something falling toward him, he instinctively reached up to deflect it.
One lesson, and the obvious one, was that he should have been wearing his protective equipment. So bad on him for violating protocol.
However, a less obvious lesson was that every piece of worker protection has holes in it — gaps in the safety barrier which can allow injury to happen. The removal of the gloves would not have been a problem had the falling object remained properly secured. In other words, the injury under consideration did not happen because of only one failure, but because of multiple failures that happened to line up the wrong way.
Think of each element of a safety program — each piece of equipment, each procedure, each habit, and so on — as a shield with holes in it. If something gets through one of those holes, you get an injury. If it bounces off the shield, you’re OK. In a well designed safety program, the holes will not overlap. Ideally, none of the holes should overlap even if one of the shields is missing for some reason.
I suspect a thorough incident analysis would find that multiple balls were dropped and multiple protocols were violated. The nurse may have some blame, but so will a lot of other people.
IMAO, YMMV
Karl Lembke (e37f42) — 10/14/2014 @ 12:09 pm