Fort Bragg, California – November 21, 2014 — “Patient arrives at the Emergency Room; temperature 102.3◦ F, with nausea, vomiting, abdominal pain. . . .” This scenario happens hundreds of times a year at the hospital. However, this could be something much more serious than a case of the flu. Ebola Virus Disease (EVD) can present in much the same way. For that reason, Mendocino Coast District Hospital participated in the Mendocino County 2014 Statewide Medical and Health Functional Exercise.
During the exercise, Dr. Keith Curtis, an Emergency Medicine physician, nursing staff, and clerical support staff were challenged with an unannounced visit Thursday, November 20, from a person posing as a patient suffering symptoms of Ebola infection. Dr. Curtis and the nurses rapidly identified the serious condition of the mock patient by evaluating the patient’s recent travel history to Liberia in West Africa and the array of symptoms that were reported to the registration clerk. The nurse activated the Hospital Incident Command System, bringing all departments to high alert. The doctor notified the Mendocino County Public Health Department (MCPHD), Hospital Infection Control, and the Infectious Disease resource physician. The patient was directed to a safe location outside the ER, away from other patients. The nurse put on personal protective equipment (PPE) then guided the patient to a special isolation room where there would be no exposure to other patients or staff.
The Departmental Operations Center at MCPHD rapidly responded with a report that a specially designated ambulance was on the way to pick up the patient and transport her to the nearest Ebola treatment center.
The Hospital management team participated in the drill to study and improve the Hospital’s level of preparedness. Staff participation and enthusiasm was impressive! Specific steps to improve communication were identified. The Hospital Incident Command staff drilled on working with County Medical and Health Operational Area Program staff to requisition critical equipment and supplies of PPE. Volunteers from a number of departments are currently signing up for training in putting on and removing the personal protective equipment needed for this level of care.
As a result of this exercise, the Hospital will have an improved Ebola care plan to identify, isolate, notify appropriate agencies, and transfer the patient to the appropriate facility for care. The goals of the exercise were to have the patient cared for and staff able to safely return to their work, both of which were successfully met.
–Emmet O’Connell, MCDH Laboratory Manager and Infection Control Officer