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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.