The 2014 Ebola
epidemic is the largest in history and has spread to multiple
countries in West Africa. The first
confirmed case in North America was recently reported in
Dallas, Texas, where the 9-1-1 system was used to treat and
transport the patient to the hospital. The patient has since died.
The ambulance crew - all
members of Dallas, TX Local 58 - have been taken off duty
with pay and are under continuous medical observation at their
homes. For more information on what you need to know about Ebola, click
here.
It
is highly likely that more individuals infected with Ebola will seek
assistance from emergency response personnel as the disease spreads.
The IAFF is urging every affiliate
to conduct a "safety stand down" with their employer and review all
infectious exposure policies, procedures and guidelines. You should
assess your department's preparedness for responding to and caring
for patients with possible symptoms of the Ebola virus and whether
you have the equipment and training needed for safely responding to
worst-case scenarios in potential Ebola exposures should this virus
spread in the United States and Canada.
All policies, procedures and guidelines should at a minimum address
the following:
·
Use standard precautions,
including fluid resistant and or impermeable long-sleeved gowns,
single or double gloves, eye protections, leg coverings, and
disposable shoe covers. The IAFF recommends N95 respirators for all
patients with respiratory symptoms.
·
If there is a potential
exposure, or the crew thinks they have been affected, DO NOT return
to the firehouse. After transport, remove the unit from service
while at the hospital. If an engine and EMS unit both respond, they
should stay together throughout the call to keep other fire fighters
from potential contamination. Exposure reporting should be activated
from the hospital or while in route to the hospital with the
patient.
·
Establish follow-up and
reporting measures after caring for a suspected or confirmed Ebola
patient.
·
Develop policies for monitoring
and management of EMS personnel potentially exposed to Ebola.
Policies should be flexible in terms of the amount of time required
for monitoring and potential isolation of exposed personnel.
·
Establish sick leave policies
for personnel that are non-punitive, flexible and consistent with
public health guidance.
·
Ensure that all personnel,
including staff who are not directly employed to provide patient
care but provide essential daily services, are also aware of the
sick leave policies.
·
Ensure that fire and EMS
personnel exposed to blood, bodily fluid, secretions or excretions
from a patientwith
a suspected or confirmed Ebola virus immediately:
1) Stop working and wash the affected skin surfaces with soap and
water and irrigate with a large amount of water or eyewash solution.
2) Contact an occupational health supervisor for assessment and
access to post-exposure management services.
3) Receive medical evaluation and follow-up care as appropriate.
Medical evaluations should include fever monitoring twice daily
throughout the Ebola incubation period, which is two to 21 days.
·
Establish return-to-work
protocols according to EMS agency policy and discussions with local,
state and federal public health authorities.
·
Fire and EMS personnel who
develop sudden onset of fever, intense weakness or muscle pains,
vomiting, diarrhea, abdominal pains or any other symptoms after an
unprotected exposure should NOT report to work or, if at work,
immediately stop working, isolate themselves, notify their
supervisor (who should notify local and state health departments as
appropriate), contact an occupational health supervisor for
assessment and post-exposure management service and comply with work
exclusions until they are considered no longer infectious to
others.
·
Identify a single occupational
health representative for reporting exposures.
·
Fit
test all personnel for use of N95 masks and provide them, as well
as appropriate eye protection.
The transmission of
the Ebola virus occurs through direct contact with blood and bodily
fluids of an infected person. It can also be transmitted through
exposure to objects that are contaminated by the bodily fluids, such
as needles. Healthcare workers, including
fire fighters and EMS personnel, are at the highest risk of becoming
sick because they are exposed daily to many patients with common
symptoms of Ebola and other infectious diseases.
The IAFF stresses the importance of consistently using standard precautions during
every patient encounter and having the proper training and
equipment to safely respond to and care for individuals exhibiting
signs of Ebola.
The Centers for Disease Control (CDC) provides important guidance
documents, most notably the Interim
Guidance for Emergency Medical Services (EMS) Systems and 9-1-1
Public Safety Answering Points (PSAPs) for Management of Patients
With Known or Suspected Ebola Virus Disease and EMS
Checklist for Ebola Preparedness. For
more CDC infection control guidelines, click
here.
For more information on what you need to know about Ebola, click
here.