Describing readmissions to an Ebola case management centre (CMC), Sierra Leone, 2014

Abstract

Case management centres (CMCs) are part of the outbreak control plan for Ebola virus disease (EVD). A CMC in Sierra Leone had 33% (138/419) of primary admissions discharged as EVD negative (not a case). Fifteen of these were readmitted within 21 days, nine of which were EVD positive. All readmissions had contact with an Ebola case in the community in the previous 21 days indicating that the infection was likely acquired outside the CMC.

Ebola and Health Partnerships, Action in a Time of Crisis

“…When concerns about nosocomial transmission within the isolation unit were raised, we were able to demonstrate that this was infrequent, by examining the frequency of readmissions (amongst patients Ebolawho tested negative and were discharged), which was low. We identified a maximum positive readmission rate of 3.3% [19], lower than has been previously reported [20].…”

Codification of Islamic Republic of Iran's Emergency Medical Services (EMS) Native Reaction Protocol to Suspected Ebola Patients based on World Protocols

“…In facing Patients with acute severe symptoms who are known as people with restraining orders end tracheal intubation (DNI) and the prohibition of carrying out CPR (DNR) we have the permission not to do end tracheal intubation and carrying out CPR in case of cardio respiratory arrest [12].…”

“…If the patient has symptoms of infectious disease but no history of traveling to West Africa in past 30 days or any other traveling history, also there is no sign of diarrhoea, vomiting or bleeding, emergency medical services' personnel should use their usual method of infection control for the patient and they must use appropriate personal protection equipment's including: two pairs of gloves, masks N95 or N100, gowns, goggles and a face Shield [12].…”

“…Emergency Medical Services personnel must cover the patient with plastic protective cover when they want to put him on the stretcher in addition to covering stretcher mattress [12,13].…”

“…Sterilize the Ambulance inner surface with bleach solution 10% or other approved disinfectants. Sterilize the outer surface of the ambulance with a 10% bleach solution or other approved disinfectants [12][13][14][15][16].…”