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re: Ebola Nurse in Maine Takes a Bike Ride - Cops Follow
Posted on 10/31/14 at 12:37 pm to BamaAtl
Posted on 10/31/14 at 12:37 pm to BamaAtl
She never had a fever. They used a forehand scanner type thermometer on her. Those aren't the most accurate if your face is flushed and warm from that. It read 101 when her face was flushed....oral temp was 98.6. Any ER will go with the oral temp readout over the forehead one if they are not the same (unless she just drank something cold or hot).
I know cause I see it at work. I'll use forehead scanner in a child and it read high....I take a oral temp to double check (which that is the most accurate besides a rectal or core temp) and it reads fine.
Also....If you aren't using the thermometer properly you won't get an accurate temp.
I know cause I see it at work. I'll use forehead scanner in a child and it read high....I take a oral temp to double check (which that is the most accurate besides a rectal or core temp) and it reads fine.
Also....If you aren't using the thermometer properly you won't get an accurate temp.
1
Posted on 10/31/14 at 12:52 pm to BamaAtl
quote:How are Ebola screening temps normally done at airports? Are they not done in exactly the same manner?
As I'm sure you know, increased increased blood flow to the face and forehead can increase locally the temperature of the skin of the face and forehead
She registered a 101°.
Period!
From that point she was done traveling for the day.
As a CDC worker she should have respected that.
The temp measuring technique identifying her as febrile is identical to the process that would strand anyone in Monrovia, Liberia given the same recording. The Liberian temperature screening process is something of which the CDC approves, is it not?
quote:Is that protocol?
which is why she should have been checked with an oral thermometer immediately.
A registered fever in a potential Ebola carrier means don't worry. Simply change the thermometer. Then change the measuring site, and try again. If no fever is noted using the latter, then ignore the higher number, and geaux with the lower recording. Really?
quote:
And I wasn't on the phone call with Vinson - there are perfectly acceptable circumstances where she could have been told it was low/no risk, then after more facts came out it was deemed too much a risk.
So that's it! Got it.
We find out if the person turns up with Ebola a couple of days later, and if they do, they were too much a risk to travel wherever they traveled.
By chance, do you work for the CDC?
quote:Well let's see. First there was the ""paranoid"" accusation, and now I seem to have a ""personal vendetta"" against someone I've not met. Frieden is incompetent. It is nothing personal. It's not a "personal vendetta". He may be a really good guy at home. He has been awful in his role as CDC Director though. Just awful.
I know you have some personal vendetta against Frieden, but he personally had nothing to do with that phone call, either.
As a result, the Ebola saga is a leaderless quagmire.
Vinson is criticized for traveling.
Spencer is criticized for bowling.
Pham is criticized for caring.
THP is criticized as being subpar.
Duncan is criticized for lying.
And the public is criticized for being paranoid.
All points back to the simple fact of a leadership void.
This post was edited on 10/31/14 at 1:10 pm
Posted on 10/31/14 at 12:57 pm to NC_Tigah
Well they need to train people in how to properly use them. At the infection control meeting I attended at work about Ebola one of the nurses was saying at some of the airports in Africa....the temp screening they do is just aim the thermometer at forehead or arm and look at reading. They only are on alert if reading is high. She said they showed staff getting readings of 93 degrees and just waving those passengers on. Ummm....no person walking around alive is gonna have a temp that low Just goes to show how reliable the temp readings are if staff isnt trained.
Just goes to show how reliable the temp readings are if staff isnt trained.This post was edited on 10/31/14 at 12:58 pm
Posted on 10/31/14 at 1:04 pm to lsunurse
quote:This was not an ER.
Any ER will go with the oral temp readout over the forehead one if they are not the same (unless she just drank something cold or hot).
Neither is it a race to the bottom to see if we can find a reason to let a potential Ebola carrier board a crowded aircraft.
It is a screening process.
In this case, judgement was made by customs, and then medical personnel, that the woman should be held in quarantine until she was determined to be symptom-free. Sounds like they kept her until they got the Ebola test back, and they could make plans for her transportation.
Frankly, she's acting like a bit of a self-important head case. Those actions have brought her at least 24hrs of further forced quarantine at her home.
Posted on 10/31/14 at 1:06 pm to lsunurse
quote:In some instances, 89° and just waving those passengers on
She said they showed staff getting readings of 93 degrees and just waving those passengers on.
Posted on 10/31/14 at 1:12 pm to NC_Tigah
I have mixed feelings about the whole thing. I agree she is maybe not acting in the best manner about all of it. But could understand her frustrations by the way she was treated at the airport(not being kept informed, only giving her water and a granola bar when she had been held for several hours there).
I just got an email today. Several nursing unions are planning a massive nationwide strike next month about ebola (hospitals not providing proper PPE). Obviously only in states that have nursing unions. That should be interesting to follow.
I just got an email today. Several nursing unions are planning a massive nationwide strike next month about ebola (hospitals not providing proper PPE). Obviously only in states that have nursing unions. That should be interesting to follow.
Posted on 10/31/14 at 1:13 pm to lsunurse
quote:
I have mixed feelings about the whole thing.
This judge doesn't:
Judge issues order enforcing Ebola isolation of defiant Maine nurse
Posted on 10/31/14 at 1:39 pm to idlewatcher
quote:Ironically the order doesn't prevent her from taking a bike ride.
This judge doesn't:
Judge issues order enforcing Ebola isolation of defiant Maine nurse
But it will likely be overturned on the 3 foot rule as well.
Posted on 10/31/14 at 1:41 pm to NC_Tigah
quote:
In this case, judgement was made by customs, and then medical personnel, that the woman should be held in quarantine until she was determined to be symptom-free.
Their initial reading (with an oral thermometer) showed a temperature of 98 degrees. She was then held for 4 hours and re-measured with a more inefficient method, which showed a slightly elevated skin temperature on her forehead. Surely you understand why that second reading never should have happened - that is, if they're following proper CDC protocol.
She never had symptoms, period. She had one inaccurate reading which is known to be inaccurate and should have been checked against a more reliable method. I guarantee you nobody gets admitted to our SCDU (or any) based on one forehead temp reading.
She's acting like someone who is having her rights taken away for no reason. She is zero risk to the public, but is being treated as if she is.
Posted on 10/31/14 at 1:45 pm to lsunurse
quote:
Several nursing unions are planning a massive nationwide strike next month about ebola (hospitals not providing proper PPE).
They still don't have proper PPE, even after what happened in Dallas? Crazy.
It isn't that expensive to get some PAPRs and Tyvek suits like we have, tbh. Lab capabilities are another matter, but aren't really PPE in that context.
Posted on 10/31/14 at 1:56 pm to BamaAtl
No idea. I don't live in a state with unionized nurses. My hospital has the gear though. They didn't before all this, but have ordered the appropriate gear for staff to care for an Ebola patient if one was here.
But....the gear isn't hazmat suits...which I think is what the unions are demanding. It's impermeable gowns, aprons, boot covers, hoods and face shields/masks(likely N95 unless that changes) with a couple layers of gloves that go up your arm more than regular gloves. All of your skin will be covered with this though(unlike some of those nurses in Dallas).
I actually start special training next week on how to properly put on and take off all the gear. 3 hours of training. Not yet for all staff...we are just the ones that volunteered to be trained first. Then we will help train others.
But....the gear isn't hazmat suits...which I think is what the unions are demanding. It's impermeable gowns, aprons, boot covers, hoods and face shields/masks(likely N95 unless that changes) with a couple layers of gloves that go up your arm more than regular gloves. All of your skin will be covered with this though(unlike some of those nurses in Dallas).
I actually start special training next week on how to properly put on and take off all the gear. 3 hours of training. Not yet for all staff...we are just the ones that volunteered to be trained first. Then we will help train others.
This post was edited on 10/31/14 at 2:00 pm
Posted on 10/31/14 at 2:03 pm to mmcgrath
quote:I don't think so. There is fairly broad range in these things.
But it will likely be overturned on the 3 foot rule as well.
Now whether it should be overturned is another issue.
I don't agree with the 3 foot restriction in the case of an asymptomatic and cooperative and reliable person. Whether a judge would view her as cooperative though is anyone's best guess. I'd have no qualms either way in her case. In general, the 3-ft rule should be unnecessary.
Posted on 10/31/14 at 2:17 pm to BamaAtl
quote:Slightly elevated? It was 101°!
showed a slightly elevated skin temperature on her forehead
What, in your opinion, is a normal forehead temp?
quote:Unfortunately, as with Amber Vinson, you seem to form your opinions retrospectively. I can tell you point blank she had "symptoms".
She never had symptoms, period.
She had traveled over 24hrs. I believe she even acknowledged she was "fatigued and flushed".
Attributable to travel?
Of course!
But if she was put on a passenger jet to Maine having admitted to fatigue, feeling flushed, and running a fever of 101°F, and subsequently developed Ebola, several folks would have their medical credentials yanked, at the least.
Posted on 10/31/14 at 2:47 pm to mmcgrath
quote:
This is ridiculous. Look at the video. Her house is in the middle of nowhere. There is zero chance she is going to infect someone while hiking or riding her bike.
yea heard on radio today her roomate was unknowingly infected with ebola before she came back.
you morons who think you're experts because you heard some govt lackey say "it can't be transmitted that way" are so cute, a shame you're incapable of thinking for yourself.
Posted on 10/31/14 at 3:00 pm to lsunurse
quote:Good to hear.
I actually start special training next week on how to properly put on and take off all the gear. 3 hours of training. Not yet for all staff...we are just the ones that volunteered to be trained first. Then we will help train others.
Posted on 10/31/14 at 3:02 pm to mmcgrath
Never Mind
This post was edited on 10/31/14 at 3:03 pm
Posted on 10/31/14 at 3:11 pm to NC_Tigah
quote:
Slightly elevated? It was 101°!
What, in your opinion, is a normal forehead temp?
As has been stated several times in this thread, forehead temps are as reliable as ones taken orally.
But you don't care. BamaAtl is telling you what I told you yesterday and you're still arguing about it.
Posted on 10/31/14 at 3:12 pm to idlewatcher
quote:
This judge doesn't:
That was from yesterday. Today the judge backed off it and she is free to interact with other people. The state police have been removed from the area of her home.
Posted on 10/31/14 at 3:52 pm to lsunurse
It's good to hear that they're taking the time to offer specialized training. A note, when we (Emory) initially started prepping for our patient(s) on July 31st, we quickly realized that N95 masks were not going to be comfortable for 8-12 hours in an isolation room setting. That's why we made the switch to PAPRs.
If you'd like to compare with what we're doing, we recently released all of our protocols surrounding Ebola and the SCDU, at Emory ebola protocols . We also included videos that show the proper method of donning/doffing this level of ppe.
If you'd like to compare with what we're doing, we recently released all of our protocols surrounding Ebola and the SCDU, at Emory ebola protocols . We also included videos that show the proper method of donning/doffing this level of ppe.
Posted on 10/31/14 at 4:05 pm to BamaAtl
Thanks!
I wouldn't be surprised if we saw some videos similar to that.
As for the N95, I'll have to ask in training about that.
I just cared for a rule out TB patient this week that required a sitter at bedside at all times due to her verbalizing suicidal thoughts. The poor sitter had to sit in there the entire 12 hours(with breaks of course) with the N95 on....I couldn't have done it(esp since I'm claustrophobic).
I wouldn't be surprised if we saw some videos similar to that.
As for the N95, I'll have to ask in training about that.
I just cared for a rule out TB patient this week that required a sitter at bedside at all times due to her verbalizing suicidal thoughts. The poor sitter had to sit in there the entire 12 hours(with breaks of course) with the N95 on....I couldn't have done it(esp since I'm claustrophobic).
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