Download FHCW Ebola Virus Disease Triage Specialists (list as of 10/20/2014

FHCW Ebola Check-In Triage Process
Ebola Preparedness Guideline Appendix B
Check-in staff asks: Have you or any members of your household traveled out of the United States in the last 4 weeks or
had contact with a recently returned traveler? If YES, ask to what countries and check against current affected country list.
If patient or contact traveled to an area where Ebola Virus Disease (EVD) transmission is active in last 4 weeks:
 Give patient a surgical mask and offer a wheelchair if the patient appears weak.
 Calmly call a team nurse to report to check-in desk for EVD evaluation. Team nurse will quietly move patient to designated private
triage area and CONTACT EVD Nurse Triage Specialist for Ebola Virus Disease Risk Assessment.
NOTE: Recent travelers (to any country outside of United States) with fever should undergo careful medical evaluation, to
rule out other potentially serious travel-related infectious causes.
Travel but No Known Exposure:
Travel and Some Risk of Exposure:
Travel and High Risk Exposure:
• Had no exposures to ill individuals or their
body fluids
• Was a household contact with an EVD
patient
• Did not handle bats, rodents, or primates
• Had other close contact with an EVD patient
• Needle stick (or other percutaneous
exposure) or mucous membrane exposure to
blood or body fluids of EVD patient
OR
• Direct skin contact with, or exposure to blood
or body fluids of, an EVD patient without
appropriate personal protective equipment
(PPE)
OR
• Processing blood or body fluids of a
confirmed EVD patient without appropriate
PPE or standard biosafety precautions
OR
Asymptomatic
(NO FEVER)
• If during EVD triage
FEVER is noted, patient
triage should continue
per boxes to the right.
• CONTACT/DROPLET
PRECAUTIONS
NEEDED
• Give patient mask
and call nurse to bring
patient to private area
for EVD triage
(including vital signs)
• EVD Nurse Triage
Specialist will review
and provide patient with
“Instructions for SelfMonitoring and
Reporting of Ebola
Symptoms”
• EVD Nurse Triage
Specialist will precept
case with EVD Provider
Triage Specialist
• EVD Nurse Triage
Specialist or EVD
Provider Triage
Specialist will check in
with patient regularly
(via phone) during 4
week monitoring period
FEVER WITH or
WITHOUT other
symptoms (severe
Asymptomatic
(NO FEVER)
headache, muscle pain,
vomiting, diarrhea,
abdominal pain, or
unexplained bleeding)
FEVER WITH or
WITHOUT other
symptoms (severe
• Direct contact with a dead body without
appropriate PPE in a country where an EVD
outbreak is occurring
Asymptomatic
FEVER OR other
(NO FEVER)
symptoms (severe
headache, muscle pain,
vomiting, diarrhea,
abdominal pain, or
unexplained bleeding)
headache, muscle pain,
vomiting, diarrhea,
abdominal pain, or
unexplained bleeding)
• EBOLA
PRECAUTIONS AND
PPE NEEDED, CALL
FHCW INFECTION
CONTROL NURSE
• EBOLA
PRECAUTIONS AND
PPE NEEDED, CALL
FHCW INFECTION
CONTROL NURSE
• EBOLA
PRECAUTIONS AND
PPE NEEDED, CALL
FHCW INFECTION
CONTROL NURSE
• EBOLA
PRECAUTIONS AND
PPE NEEDED, CALL
FHCW INFECTION
CONTROL NURSE
• EBOLA
PRECAUTIONS AND
PPE NEEDED, CALL
FHCW INFECTION
CONTROL NURSE
• CALL EVD Provider
Triage Specialist for
medical evaluation and
consultation with public
health officials to
determine need for
evaluation vs. transfer
to UMass Memorial
Medical Center ED
• CALL EVD Provider
Triage Specialist for
medical evaluation and
consultation with public
health officials to
determine selfmonitoring vs. transfer
to UMass Memorial
Medical Center ED
• CALL EVD Provider
Triage Specialist for
medical evaluation and
consultation with public
health officials to
determine need for
transfer to UMass
Memorial Medical
Center ED
• CALL EVD Provider
Triage Specialist for
medical evaluation and
consultation with public
health officials to
determine selfmonitoring vs. transfer
to UMass Memorial
Medical Center ED
• CALL EVD Provider
Triage Specialist for
medical evaluation and
consultation with public
health officials to
determine need for
transfer to UMass
Memorial Medical
Center ED
• If patient requires
transport to UMass
Memorial Medical
Center ED, FHCW
provider must call Care
Connection Center and
notify EMS are
requesting transport of
suspected EVD patient
• If patient requires
transport to UMass
Memorial Medical
Center ED, provider
must call Care
Connection Center and
notify EMS are
requesting transport of
suspected EVD patient
• If patient requires
transport to UMass
Memorial Medical
Center ED, provider
must call Care
Connection Center and
notify EMS are
requesting transport of
suspected EVD patient
• If patient requires
transport to UMass
Memorial Medical
Center ED, provider
must call Care
Connection Center and
notify EMS are
requesting transport of
suspected EVD patient
• If patient requires
transport to UMass
Memorial Medical
Center ED, provider
must call Care
Connection Center and
notify EMS are
requesting transport of
suspected EVD patient
FHCW Ebola Check-In Triage Process
Ebola Preparedness Guideline Appendix B
Countries with known Ebola Disease Cases (list as of 10/20/2014):
Guinea
Liberia
Sierra Leone
Democratic Republic of the Congo (separate outbreak from West African outbreak)
FHCW Ebola Virus Disease Triage Specialists (list as of 10/20/2014):
Ebola Virus Disease Nurse Triage Specialists:
Employee Health: XXXX
Call Center: XXXX
Walk-In Center: XXXX
Team 1: XXXX
Team 2 and 3: XXXX
Team 4: XXXX
Ebola Virus Disease Provider Triage Specialists:
Walk-In Center: XXXX
Team 1: XXXX
Team 2: XXXX
Team 3: XXXX
Team 4: XXXX
Public Health Offices to contact in case of suspected Ebola Virus Disease case:
Massachusetts Department of Public Health: 617-983-6800
UMass Memorial Medical Center Infection Control: 508-856-3293
City of Worcester Division of Public Health: http://www.worcesterma.gov/e-services/online-submit-forms/disease-reporting
If transporting patient to UMass Memorial Medical Center ED, FHCW medical provider must call:
UMass Care Connection Center: 508-334-4111
NOTE: NOTIFY the EMS dispatcher that you are requesting transport of a patient suspected to have EVD
If suspect case of Ebola Virus Disease (i.e. travel and any fever or symptoms), FHCW staff who need to interact with the patient
should:
• Maintain a distance of 3 feet from the patient when triaging, if at all possible
• Maintain a log of all personnel and others who interact with the patient
• Use following PPE:
 Double gloves (nitrile with extended cuffs)
 Boot covers that are waterproof and go to at least mid-calf or leg covers
 Single-use fluid resistant or impermeable gown that extends to at least mid-calf or coverall without integrated hood.
 Respirators, including either N95 respirators or powered air purifying respirator (PAPR)
 Single-use, full-face shield that is disposable
 Surgical hoods to ensure complete coverage of the head and neck
 Apron that is waterproof and covers the torso to the level of the mid-calf (and that covers the top of the boots or boot
covers) should be used if Ebola patients have vomiting or diarrhea
Disclaimer
The Family Health Center of Worcester (FHCW) prepared the materials for Ebola Preparedness. This
document is designed to provide accurate and authoritative information in regard to the subject matter
covered. However, it is being made available with the understanding that neither FHCW nor the Authors
are engaged in rendering legal or other professional advice and that the information presented does not
constitute, and is not a substitute for, specific legal, professional or other expert advice. If legal advice or
other expert assistance is required, the services of a competent professional should be sought.