Ebola: CDC Tightens Protection Rules

Published: Oct 21, 2014/By Michael Smith, North American Correspondent, MedPage Today/Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

Faced with dismay over the Ebola infection of two nurses, the CDC has tightened its guidance for personal protective equipment.

The major change in the new guidance is an insistence that no skin be exposed during the care of an Ebola patient.

But the CDC is also insisting that people likely to treat Ebola patients need to practice putting on and taking off the equipment safely, and that hospitals have a trained monitor to observe both procedures.

“There’s no alternative to hands-on training,” Frieden said, adding that “it’s an important message for healthcare workers that these are three comprehensive aspects.”

The CDC now says personal protective equipment should consist of:

  • Double gloves
  • Boot covers that are waterproof and go to at least mid-calf or leg covers
  • Single-use, fluid-resistant or impermeable gowns that extend to at least mid-calf or a coverall without integrated hood
  • Either N95 respirators or powered air purifying respirators
  • Disposable single-use full-face shield
  • Surgical hoods to ensure complete coverage of the head and neck
  • A waterproof apron that covers the torso to the level of the mid-calf in the event Ebola patients have vomiting or diarrhea

The guidance no longer recommends goggles, arguing they might leave skin exposed, are not disposable, and might fog up, tempting healthcare workers to manipulate them with gloved — and possibly contaminated — hands.

Screening and Triage

While a great deal of attention has been paid to protective equipment, it’s “just one aspect of infection control,” Frieden said, and such things as screening and triage are also “critically important.”

“Every healthcare worker needs to learn how to screen a patient who may have Ebola,” he said, including making sure to ask about a travel history.

For Full Article, see Medpage Today.

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