re: CDC head slammed for blaming nurse infected with Ebola

quote:

---

Where do you get your numbers? Louis Farrakhan?

1883 official,

---

Sorry, I must have confused it with BUsh's other great success story.

quote:

---

and in case you missed it - THE HURRICANE AND FLOODING DID THAT

---

in case you missed it - EBOLA IS CAUSED BY A NATURALLY OCCURING INFECTIOUS DISEASE - NOT OBAMA. Yet you seem perfectly willing to blame him for it. Why does Bush get 0% of the blame for the disasters that occur under his watch, but Obama gets 100% of the blame for every dead Ebola patient?

quote:

---

There is no hurricane machine that Cheney and Bush used to whack New Orleans and "black people" - despite what Kanye says.

---

So you're saying Obama engineered Ebola and gave it to Thomas Duncan and sent him to the U.S.?
Rock on! You're a fricking nutbag!

quote:

---

What is proper "Ebola protocol"? I've been in healthcare for 15 years and I've never seen any.

---

So its safe to say that if you were treating an Ebola patient - you would probably breach protocol, not knowing it - correct?

Did the CDC director say the nurse breached protocol because she was a bad person and was lazy and didn't mind spreading the disease? If he just stated factually that it was breached I don't see how that's "blaming" anyone.

THE IMPORTANT POINT here did she contract the disease because protocol was breached, or did she contract it because existing protocols are not adequate? The question of who to "blame" is a media distraction.

quote:

---

CDC head was put in a bad position. He had to explain the probable cause of her infection. I don't envy him.

---

Agree. And the truth hurts. The statement may have been insensitive, but I would rather the head of the CDC be good at Disease Control rather than media control.

quote:

---

It's not like infectious disease is some new concept. US hospitals should be able to handle it if they are serious about healthcare.

---

Not only are US hospitals "able to handle" infectious disease, they do it better than any healthsystem in the world.

Ebola presents practical and rather unique challenges in the hospital setting though. There is a copious amount of GI content produced in terms of both diarrhea and vomit. Both can be projectile, and uncontrolled by the patient. It's a situation somewhat comparable to untreated cholera victims. Keeping such an environment sanitized is quite a task.

So while Ebola is indeed simply an infectious disease, it also presents different concerns from a healthcare safety standpoint. Freiden additionally referenced intubation, mechanical ventilation and dialysis as "unusual care" and risky. I have no idea WTF he was thinking in making those statements. Both of those are used routinely. Both are use in cases involving infectious disease. both are used under long-established protocols.

quote:

---

Freiden additionally referenced intubation, mechanical ventilation and dialysis as "unusual care" and risky. I have no idea WTF he was thinking in making those statements. Both of those are used routinely. Both are use in cases involving infectious disease. both are used under long-established protocols.

---

And both are specifically referenced in CDC documents to be avoided. When it is absolutely necessary there are additional requirements.

quote:

---

Aerosol Generating Procedures (AGPs)
Avoid AGPs for patients with EVD.
If performing AGPs, use a combination of measures to reduce exposures from aerosol-generating procedures when performed on Ebola HF patients.
Visitors should not be present during aerosol-generating procedures.
Limiting the number of HCP present during the procedure to only those essential for patient-care and support.
Conduct the procedures in a private room and ideally in an Airborne Infection Isolation Room (AIIR) when feasible. Room doors should be kept closed during the procedure except when entering or leaving the room, and entry and exit should be minimized during and shortly after the procedure.
etc

---

CDC Ebola Protocols

Dearest Tuba

The causation of disease and the handling of a disease situation are two different things. NOBODY is accusing Obama of causing Ebola.

Why do you insist upon engaging in ridiculous, nonsensical hyperbole in order to avoid discussing the actual facts of a matter? In this particular instance, Obama's HANDLING of this disease situation is a legitimate, debatable matter. Personally, I think he is being far too passive. will his passivity come back to bite him in the butt? I hope not, because none of us wants this disease to spread.

In the meantime, tuba, how about leaving the stupid hyperbole in your weak little mind where it belongs?

quote:

---

Right.
The problem being Intubation/Ventilation is not only NOT an AGP, it generates a sealed system preventing aerosol production/distribution. IOW it eliminates aerosol risk as compared to an unsecured airway.

---

From the CDC:

quote:

---

Although there are limited data available to definitively define a list of AGPs, procedures that are usually included are Bilevel Positive Airway Pressure (BiPAP), bronchoscopy, sputum induction, intubation and extubation, and open suctioning of airways.

---

I don't know about the dialysis, but I guess it could depend on the type and what procedures were followed. I would go with what the CDC says on it.

While knowing that intubation can be life saving, I can see why the CDC recommends against it. By that point an Ebola victim is probably too far gone anyway.

quote:

---

Just as you would "go with" an astrophysicist who says gravity on the Earth and Moon are the same. It's understandable on your part, but it doesn't make the answer any more right.

---

Not related at all, but "gravity" is the same in both places. The "effect of gravity" on a person would be different. But I am not sure what TDG quote you are referring to.

quote:

---

Observations made here regarding aerosolization in intubated vs nonintubated patients are not controversial. They aren't even debatable. I'd happily explain further when I've got more time, if you're interested.

---

The CDC says not to do it. If a medical professional thinks their rules are silly and goes ahead anyway, they shouldn't complain when they get Ebola and the CDC says they broke protocol.

quote:

---

The fact there is reference to OPEN suctioning at all in an ID setting is also interesting. I haven't seen open suctioning done in a US ICU setting under those circumstances in 15yrs.

---

They are giving a list of AGP's, as in things not to do in an ID setting.

quote:

---

If people are forced to enter the country by sea travel - that just means a longer time for their fellow travellers to become infected. If they enter by land - it means they have the potential to spread the disease to Mexico or Canada on their way here. Air travel seems like the best option.

---

Is it the US government's duty to protect US citizens or to protect foreigners traveling to our country by sea or to protect citizens of other countries who let foreign travelers into their territory and give them unrestricted access to our borders?

Which is it?