Los Alamos Medical Center Conducts Full Scale Ebola Drill

During LAMC’s full scale Ebola Drill Tuesday, Emergency Department Director Lori Coffelt, RN, left, plays the role of ‘primary nurse’ and Med-Surgery Unit Director Holly Kinney, RN plays the ‘second nurse.’ Photo by Carol A. Clark/ladailypost.com

 

By CAROL A. CLARK
Los Alamos Daily Post

Following weeks of training, table top exercises and daily conference calls with the Centers for Disease Control and Prevention (CDC), the core team at Los Alamos Medical Center launched a full scale Ebola Drill Tuesday.

The premise being a patient walks into the Emergency Department complaining of a fever and confirms that he recently returned from a trip to Liberia. Springing into action, the receptionist calmly instructs the patient to put on a mask and wait for a triage nurse who will escort him to a room to be checked out. The receptionist calls back to the ER and states “fever triage”, which means the nurse will arrive with a certain level of protective clothing, take the patient through the ED door to the outside and walk him over to the decontamination room. 

The New Mexico Department of Health (NMDOH) is called, which in turn notifies the CDC. LAMC will draw a blood sample while awaiting further instructions from NMDOH. It is likely that the NMDOH will make arrangements for the patient to be transported to another facility for care if the Ebola virus is confirmed.

A qualified outside company trained LAMC’s plant operations staff in the proper containment processes by erecting plastic walls that are sealed tight to create a “doffing” room to remove protective clothing after treating the patient and being exposed to patient containment. 

Once Tuesday’s exercise was completed, the core team held a debriefing meeting to review the entire process. The team will hold similar drills on a weekly basis and continue to participate in calls as they are scheduled by the NMDOH or the CDC.

“Los Alamos Medical Center (LAMC) is working closely with the New Mexico Department of Health and the Epidemiology Office and the Centers for Disease Control and Prevention (CDC) to ensure our hospital is prepared with the appropriate plans to detect, protect and respond should anyone in our community contract or be exposed to the Ebola virus,” Chief Nursing Officer Tracie Stratton said.

Stratton explained that while LAMC has not treated any patients with Ebola, and there have been no confirmed cases in New Mexico, out of an abundance of caution LAMC has taken the following measures to prepare:

  • Triage and admission assessments have been revised to include questions regarding travel to high risk areas, as well as recent contact with people from those areas;
  • Stop signs have been placed at entrances asking anyone who has a fever and has traveled outside the country, or who has had exposure to an international traveler to notify staff; and 
  • Dedicated isolation rooms have been designated for patients who may have been exposed to Ebola and protective gear has been provided for LAMC employees.  

“LAMC staff is trained and prepared to manage outbreaks of viruses and infectious diseases, including Ebola,” Stratton said. “We want to assure the community that we are taking the appropriate precautionary measures to keep our employees, visitors and community safe and prevent the spread of this virus.”

The core team that took part in Tuesday’s drill included:

  • Chief Nursing Officer Tracie Stratton, RN (Role: Coordinator)
  • Emergency Services Director Kevin Vigil (Role: Patient)
  • Emergency Department Director Lori Coffelt, RN (Role: Primary Nurse)
  • Med-Surgery Unit Director Holly Kinney, RN (Role: Second nurse)
  • Erica Hudson, RN (Role: House Supervisor)
  • Laboratory Services Director Brent Butler (Role: Lab Supervisor)
  • Environmental Services Manager Thomas Harvey 

Observers:

  • Human Resources Director Jacqui Carroll
  • Infection Control Director Andrea Gurley, RN
  • Plant Operations Director Carlos Branch

Other resources involved:

  • Chief Executive Officer Feliciano Jiron
  • Chief Medical Officer Barbara VanEeckhout, MD
  • Chief Financial Officer Emma Canlas
  • Ancillary Support Services Director Marc Witkowski
  • Marketing Manager Mary Beth Maassen

Los Alamos Medical Center at 3917 West Road is a regional hospital providing compassionate care close to home to the people of north central New Mexico. LAMC is part of LifePoint Hospitals, a leading hospital system that operates 68 community hospitals in 21 states. With a mission of Making Communities Healthier, LifePoint is the sole hospital in a majority of the communities it serves. More information about the company, which is headquartered in Brentwood, Tenn., can be found on its website: lifepointhospitals.com and information about LAMC can be found at 505.662.4201 www.losalamosmedicalcenter.com.

About the Ebola Virus:

Ebola Virus Disease (EVD) is a rare and deadly disease that is native to several African countries. It is caused by infection with Ebola virus, which is contracted through direct contact with a sick person’s blood or body fluids, contact with contaminated objects (such as needles), or contact with infected animals.

Those at risk for contracting Ebola include:

  • People who have resided in or travelled internationally to countries where cases of Ebola have been reported (West African countries of Guinea, Liberia, Sierra Leone)
  • People who have been in close contact with a person who is ill with Ebola
  • People who have handled bats, rodents or primates from areas where Ebola transmission is active
  • Healthcare workers who have treated patients with Ebola

Symptoms include fever (greater than 100.4 degrees Fahrenheit), severe headache, joint and muscle pain, sore throat, weakness, diarrhea, vomiting, stomach pain and unexplained bruising or bleeding. Some patients also experience skin rashes, red eyes and internal bleeding.

  • You can only get Ebola from:
    • Touching the blood or body fluids of a person who is sick with or has died from Ebola.
    • Touching contaminated objects, like needles.
    • Touching infected animals, their blood or other body fluids, or their meat.
  • You cannot get Ebola through water, the air, or food.

Community Risk and Hospital Preparedness:

The threat of a widespread outbreak of Ebola in the United States is very low. The CDC and the Federal Government are taking many measures to help prevent spread of Ebola in the U.S.

LAMC is committed to protecting the health of the Los Alamos community.

LAMC follows infection control procedures as recommended by the CDC and the state health department. Routine infection control procedures that are used to prevent the spread of any viral illness also can control and manage Ebola cases and ensure the safety of other patients in the hospital.

While LAMC does not anticipate Ebola impacting the local community, out of an abundance of caution the hospital has:

  • Implemented new screening processes to identify patients who have traveled to countries affected by Ebola, or who have had contact with someone who has traveled to those countries;
  • Practiced appropriate isolation procedures and crisis response procedures in the event a patient presents with symptoms;
  • Evaluated our supply of personal protective equipment (PPE) and practiced usage; and
  • Distributed detailed guidance to all hospital staff regarding the appropriate steps to prevent the spread of infection and the proper procedures for handling a patient who has, or is suspected to have, an EVD infection.

Infection Prevention:

Basic infection control procedures and good hygiene can prevent infection. Just like any other virus, EVD can be prevented by:

  • Avoiding contact with people who are sick or display signs and symptoms that indicate illness, including sharing food, cups or eating utensils;
  • Washing your hands frequently – or, if soap and water aren’t available, using an alcohol-based hand sanitizer with at least 60% alcohol;
  • Avoiding touching your eyes, nose, and mouth with unwashed hands;
  • Disinfecting your home and belongings regularly; and
  • Covering your mouth and nose when coughing or sneezing, using a tissue or your sleeve or elbow (not your hands).

An annual flu vaccine can help prevent the flu, making diagnosis of Ebola easier. The flu vaccine is the number one way to prevent the flu.

FAQ About Ebola

What is Ebola?

Ebola Virus Disease (EVD), previously known as Ebola hemorrhagic fever, is a rare and deadly disease that is native to several African countries. It is caused by infection with Ebola virus, which is contracted through direct contact with a sick person’s blood or body fluids, contact with contaminated objects (such as needles), or contact with infected animals.

Who is at risk?

Those at risk for EVD include:

  • People who have resided in or travelled internationally to countries where cases of EVD have been reported (West African countries of Guinea, Liberia, Sierra Leone);
  • People who have been in close contact with a person who is ill with EVD;
  • People who have handled bats, rodents or primates from areas where EVD transmission is active; and
  • Healthcare workers who have treated patients with EVD.

What are the symptoms?

Symptoms include fever (greater than 100.4 degrees Fahrenheit), severe headache, joint and muscle pain, sore throat, weakness, diarrhea, vomiting, stomach pain, and unexplained bruising or bleeding. Some patients also experience skin rashes, red eyes and internal bleeding.

When do symptoms appear after infection?

Symptoms can appear anywhere from two to 21 days after infection. The incubation period for EVD – the time from exposure to when signs or symptoms appear – is usually eight to10 days, but can range from two to 21 days. The risk for transmission is greatest during the later stages of the illness. Ebola can only be transmitted when the ill person has symptoms.

Is there a vaccine for EVD?

No vaccine currently exists for EVD.

However, the Department of Health and Human Services, including the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH) and the Food and Drug Administration (FDA) are leading the effort to develop and test vaccines and new treatments. Some investigational vaccines have been developed. The NIH recently announced that initial human testing of an investigational vaccine to treat Ebola began in September, and a vaccine developed through the U.S. Department of Defense also will start testing in humans later this year.

How is EVD treated?

EVD symptoms are treated with supportive care, including providing intravenous fluids and balancing electrolytes, maintaining oxygen status and blood pressure, and treating other infections that may occur.

What are the potential complications of EVD infection?

Data gathered on patients who have recovered from EVD show long-term complications ranging from joint and muscle pain to vision problems. EVD can potentially be fatal. Recovery depends on early diagnosis, good clinical care, and the patient’s immune response. Evidence shows that people who recover from EVD infection develop antibodies that last for at least 10 years.

How can I prevent transmission?

Basic infection control procedures and good hygiene can prevent infection. Just like any other virus, EVD can be prevented by:

  • Avoiding contact with people who are sick or display signs and symptoms that indicate illness, including sharing food, cups or eating utensils;
  • Washing your hands frequently – or, if soap and water aren’t available, using an alcohol-based hand sanitizer with at least 60 percent alcohol;
  • Avoiding touching your eyes, nose, and mouth with unwashed hands;
  • Disinfecting your home and belongings regularly; and
  • Covering your mouth and nose when coughing or sneezing, using a tissue or your sleeve or elbow (not your hands).
  • An annual flu vaccine can help prevent the flu, making diagnosis of Ebola easier. The flu vaccine is the number one way to prevent the flu.

What procedures is LAMC following to keep patients and the community safe?

LAMC follows infection control procedures as recommended by the CDC and the state health department. Routine infection control procedures that are used to prevent the spread of any viral illness also can control and manage Ebola cases and ensure the safety of other patients in the hospital.

While LAMC does not anticipate Ebola impacting the Los Alamos community, out of an abundance of caution, it has:

  • Implemented new screening processes to identify patients who have traveled to countries affected by Ebola, or who have had contact with someone who has traveled to those countries;
  • Practiced appropriate isolation procedures in the event a patient presents with symptoms;
  • Evaluated our supply of personal protective equipment (PPE); and
  • Distributed detailed guidance to all hospital staff regarding the appropriate steps to prevent the spread of infection and the proper procedures for handling a patient who has, or is suspected to have, an EVD infection.

Is EVD a threat to my community?

The threat of a widespread outbreak of Ebola in the United States is very low.

Hasn’t EVD spread to the United States?

On Sept. 30, 2014, the CDC confirmed the first case of Ebola to be diagnosed in the United States in a person who had travelled from Liberia to Dallas, Texas. The patient had no symptoms when leaving West Africa but developed symptoms approximately four days after arriving in the United States. The patient sought medical care at Texas Health Presbyterian Hospital of Dallas, was evaluated and discharged, and later readmitted and tested for Ebola infection. His diagnosis was confirmed and attempts to control his infection, which was quite progressed, began. He died on Oct. 8.

Two additional secondary cases of EVD were identified when two nurses who cared for the patient at Texas Health Presbyterian Hospital of Dallas developed symptoms. Both nurses were quickly identified and isolated.

In addition, a medical aid worker who volunteered in Guinea, one of the three West African nations experiencing an Ebola epidemic, and since returned to the United States tested positive for Ebola on Oct. 23, according to the New York City Health Department laboratory, which is part of the Laboratory Response Network overseen by the CDC.

The patient has been notified of the test results and remains in isolation at Bellevue Hospital in New York City, one of eight New York State hospitals that has been designated to treat Ebola patients. A specially trained CDC team determined earlier this week that the hospital has been trained in proper protocols and is well prepared to treat Ebola patients.

CDC and public health officials are taking precautions to identify people who had close personal contact with the infected persons.

How can I find out more information?

Contact LAMC or talk to your doctor or primary healthcare provider. LAMC staff has received extensive training and guidance on identifying, managing and treating EVD. Also, visit the CDC Ebola site at http://www.cdc.gov/vhf/ebola/, or the World Health Organization (WHO) Ebola virus disease (EVD) site: www.who.int/csr/disease/ebola/en.

LAMC’s Dr. Kevin Vigil in his role as the ‘patient’ in Tuesday’s Ebola Drill arrives in the Emergency Department and is asked to reach for a mask and put it on after telling the receptionist that he has a fever and recently returned from a trip to Liberia. Photo by Carol A. Clark/ladailypost.com

Emergency Services Director Dr. Kevin Vigil in his role as the patient in Tuesday’s Ebola Drill waits for a nurse to escort him to LAMC’s decontamination room. Photo by Carol A. Clark/ladailypost.com

Emergency Department Director Lori Coffelt, RN plays the role of ‘Primary Nurse’ and escorts ‘patient’ Dr. Kevin Vigil out of the Emergency Department and into the Decontamination Room during Tuesday’s Ebola Drill at LAMC. Photo by Carol A. Clark/ladailypost.com

The Primary Nurse in Tuesday’s Ebola Drill takes the patient into the decontamination room at LAMC. Photo by Carol A. Clark/ladailypost.com

LAMC’s negative air pressure decontamination room is where patients with infectious illnesses are cared for. Photo by Carol A. Clark/ladailypost.com

Scene from Tuesday’s Ebola Drll at LAMC. Photo by Carol A. Clark/ladailypost.com

Scene from Tuesday’s Ebola Drll at LAMC. Photo by Carol A. Clark/ladailypost.com

Infection Control Director Andrea Gurley, RN, observes as ‘Second Nurse’ Med-Surgery Unit Director Holly Kinney, RN, puts on protective clothing. Photo by Carol A. Clark/ladailypost.com

Playing various roles in LAMC’s Ebola Drill are Environmental Services Manager Thomas Harvey, Erica Hudson, RN as the House Supervisor, Human Resources Director Jacqui Carroll, Laboratory Services Director Brent Butler as the Lab Supervisor, Med-Surgery Unit Director Holly Kinney, RN as the Second Nurse and Infection Control Director Andrea Gurley, RN. Photo by Carol A. Clark/ladailypost.com

Photo by Carol A. Clark/ladailypost.com

Photo by Carol A. Clark/ladailypost.com

Photo by Carol A. Clark/ladailypost.com

Photo by Carol A. Clark/ladailypost.com

A crew begins the process of sealing off the area in front of the decontamination room that will allow medical personnel to remove their protective gear after caring for an infected patient. Photo by Carol A. Clark/ladailypost.com

Photo by Carol A. Clark/ladailypost.com

Barricades were set up to block access to the emergency department and decontamination entrance. The Los Alamos Fire Department was alerted to bring patients in through the front entrance during the training period. Photo by Carol A. Clark/ladailypost.com

Carefully untying shoe covers. Photo by Carol A. Clark/ladailypost.com

A nurse assists with the removal of shoe covers. Photo by Carol A. Clark/ladailypost.com

Two layers of gloves were worn and the nurse used disinfectant gel before removing each layer. Photo by Carol A. Clark/ladailypost.com

The process begins to remove the nurse’s protective gown. Photo by Carol A. Clark/ladailypost.com

The nurse slowly removes her protective gown ensuring that she folds it from the inside out. Photo by Carol A. Clark/ladailypost.com

The nurse makes sure she removes her mask slowly without snapping the elastic strap. Photo by Carol A. Clark/ladailypost.com

Ebola warning notices are placed at each entrances at LAMC. Photo by Carol A. Clark/ladailypost.com

At the end of Tuesday’s Ebola Drill, hospital employees gather the barricades used to block the entrance area to the decontamination entrance. Photo by Carol A. Clark/ladailypost.com

CSTsiteisloaded