Be safe, docs

Medical practitioners are at the frontline of saving lives every day, often times putting themselves at risk as they diagnose and treat myriad illnesses.

Their vulnerability is underestimated, but the devastating Ebola outbreak in West Africa clearly shows they are as susceptible as the rest of us.

This week, the World Health Organization issued an alert urging health care workers to take greater care in protecting themselves while they attempt to curb the spread of the virus that has already claimed 4, 818 lives and infected 13, 042 people.

To support its call, WHO published figures showing that up to October 29, a total of 523 health care workers had been infected with Ebola –– 82 in Guinea, 299 in Liberia, 127 in Sierra Leone, one in Spain and three in the United States.

A total of 269 health care workers have died from the disease.

Thankfully, Barbados remains Ebola-free; but with clear signs that a new level of training is needed among health care professionals, the Ministry of Health has been conducting Ebola Preparedness Education And Simulation Sessions.

Over the course of five hours on Wednesday, the medical workers were immersed in a series of training sessions that covered the identification, notification and isolation of suspected cases, key aspects of personal protection and the decontamination of an area with a suspected case.

Doctors attending the  Ebola training session.
Doctors attending the Ebola training session.

Chief Medical Officer Dr Joy St John is aware of public fear of the disease, but she stresses that Barbados has a strong public health system and it is therefore critical for the island’s medical workers to be fully prepared.

“We are trying our best to approach this systematically and logically, we are not expecting you to be screening facilities, but in case someone self-selects . . . and goes to one of your facilities, because that is what they are accustomed to doing they come to you for everything; they may not be thinking its Ebola.

“It is the intention to give you a gold standard and then you do your adaptation, depending on what your circumstances are, the number of patients you have, what kind of office you have. We are not hoping that you will be screeners, but we know that some people will slip through; so you have to find some way to deal with those patients that will slip through.”

The training emphasized that workers must put their personal safety first in order to remain healthy and able to treat patients.

In health care settings, Ebola is spread through direct contactwith blood or the body fluids of a person who is sick with Ebola or with objects, including needles and syringes that have been contaminated.

According to Dr Heather Armstrong, medical officer in the Ministry of Health, from the outset proper hand hygiene is a must and health care professionals must wash or cleanse their hands frequently, including before touching and handling a patient, after exposure to body fluids and after touching patient surroundings.

“Organisms transfer from your hands, which can then be transferred to other surfaces or other persons; organisms can survive for seven minutes. And inadequate hand hygiene, or when it is omitted, or if you use the inappropriate agent, it can mean that you are an agent in passing infection.”

She advised that soap, water and paper towels are best, and alcohol-based handrub can also be used.

“ Liquid soap is recommended because it is one use. With the bar soap that can become easily contaminated and each time you use that soap repeatedly it means that you can reinfect your hands.”

When it comes to Ebola, health care workers treating a suspected case or caring for an infected patients should have no skin exposed.

Dr Armstrong says the personal protective equipment [PPE] is the best way to prevent infection and it should be chosen based on the level of exposure expected, the type of procedures to be performed and its durability and appropriateness for the task.

Dr Walter  Alleyne wearing personal protective equipment (PPE).
Dr Walter Alleyne wearing personal protective equipment (PPE).

“If you are doing a simple job, you might just wear gloves. If you are doing a more invasive technique, then it means you have to increase the type of PPE you’re using.”

She stressed that protective gear should include gloves, full bodysuit or gowns, the N95 mask to protect the nose, mouth and eye protection which would include your goggles or visors to protect the face.

“You must be trained in the correct donning and doffing of the PPE.”

Once health workers complete patient treatment, they must refrain from direct interaction with other staff or patients in the office until the PPE has been safely removed in a defined and designated area, and then they are closely monitored.

“There should be follow-up care which involves fever monitoring twice for 21 days after exposure, immediate medical consultation if symptoms develop. Suspected health care workers must be cared for in isolation facilities, and anyone who might be in close contact with these persons must be traced.”

Dr Armstrong stressed that the immune system could play a big part in whether you are able to overcome the Ebola virus, and she advised the professionals to replace bad habits with good ones that would help the immune system to be healthy.

“Adopt a healthy lifestyle; eat a balanced diet; get good ventilation with exercise and enough rest.”

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