Tufts Medical Center implements new protocols for Ebola

Tufts Medical Center (MC) has recently implemented a number of preventative measures and protocols in response to the recent Ebola outbreak in West Africa, which has also received much attention in the United States following a few reported cases, the most recent of which was diagnosed on Thursday in New York City.

Over the past three weeks Tufts MC has evaluated four patients for possible Ebola symptoms, but determined that none of them met the criteria for an expected Ebola case, according to Media Relations Specialist at Tufts MC Jeremy Lechan.

Harris Berman, dean of the Tufts University School of Medicine and professor of public health and community medicine, explained that the recent cases of Ebola in Texas have brought increased attention to the proper ways for all healthcare workers to deal with the disease.

At Tufts MC an extensive team of individuals has worked over the past several weeks to develop and implement the new measures and procedures to deal with potential suspected cases of Ebola, according to Brien Barnewolt, chairman and chief of the Department of Emergency Medicine at Tufts MC.

“Our procedure for evaluating patients is multi-faceted,” he explained.

Barnewolt said that there is a series of screening questions that take place upon first contact with the patient. These questions follow guidelines provided by the Centers for Disease Control and Prevention (CDC) and ask patients about international travel to West Africa and possible symptoms they may have.

“We use an electronic medical record here, so these questions have been incorporated into that,” he said. “Information is obtained right up front and recorded into the electronic medical record so [it is] readily available to [hospital staff].”

Barnewolt added that these types of questions are not new for such an outbreak. Similar questions had been developed when other infectious diseases, such as severe acute respiratory syndrome and Middle East respiratory syndrome, were prevalent.

According to Barnewolt, the symptoms that doctors look for include fever, abnormal bleeding, headache, nausea, vomiting and diarrhea. In addition, the patient must have either traveled to Sierra Leone, Guinea or Liberia or had contact with someone with Ebola in order to be considered a suspected case.

If any concern is raised during the screening process, the patient is handed a mask to put over his or her mouth and nose and is entered into the closest isolation room, Barnewolt added. The hospital has a team of experts in infectious disease that will respond to that location, where additional history of the patient is taken. The team then consults with the Boston Public Health Commission, the Department of Health and potentially the CDC in order to determine whether further testing will be necessary.

Barnewolt noted that Massachusetts has recently obtained the ability to do testing on a state level, whereas previously patients would have to be tested at the CDC in Atlanta.

“The state of Massachusetts is very much prepared and doing very well on that level, but continues to modify its evaluation process and response process,” he said.

Tufts MC is also continuing to learn from other healthcare institutions around the country, refining and modifying its own protocols as necessary, according to Barnewolt.

“The process is ongoing, it’s continuous and it’s time-intensive,” he said.

According to Berman and Barnewolt, Tufts MC has been training its personnel in proper protocols to follow, including how to use isolation units and personal protective equipment such as hazmat suits.

“Our hospital has a whole team of experts and individuals who have already worked countless hours … from the training of staff to the acquisition of materials to the writing of procedures and the rewriting of procedures to participation in numerous conference calls and educational opportunities with both regional and national experts,” Barnewolt said. “It’s pretty overwhelming … It’s been an excellent response.”

Both Berman and Barnewolt underscored that it is extremely unlikely that an outbreak of Ebola will happen in the United States, given that transmission only occurs through close contact with an infected person and that the United States already has a developed health system that will prevent spread of the disease.

Berman’s advice to the public is to “calm down,” adding that this is similar to other infectious diseases which the United States has had a lot of experience controlling in the past. However, he said that people should educate themselves about Ebola and how the disease is transmitted.

“It’s far more likely, in this upcoming flu season, that thousands of people will get the flu, and nationwide we will have many deaths from just the ordinary flu,” Barnewolt added. “While Ebola is a concern and it has everybody’s attention right now, while you’re educating yourself about Ebola and the very low chances of getting it, also educate yourself about the flu [and how to prevent it].”