What I heard from the CDC was extubation and dialysis were the culprits and both are highly invasive procedures. This contamination did not occur in a casual setting.
Every intensive care room has the capacity to provide ventilator assistance and dialysis to any patient. That means the equipment is in direct contact with bodily fluids with high concentrations of virus and especially the case with Mr. Duncan.
Mr. Duncan succumbed to Ebola infection with high levels of the microbe in his blood, therefore, the equipment he was sustained on was also highly contaminated. The equipment involved have two components, the disposable equipment that are in contact with the patient (primarily plastic) and the hardware that is expensive and decontaminated and reused.
The contaminated disposable equipment would have been properly contained in medical waste containers and the hardware might not have been and was most probably contaminated both outside the equipment as well as within.
The extubation of any patient is fairly straight forward after a person expires, but, dialysis maintains a catheter in the patient to carry out the procedure which serves as a connection between the patient and the machine. Dialysis is more heavily a blood intensive procedure than extubation, however, there are secretions that are involved in extubation that can be droplet and miniscule. Both procedures can offer an opportunity to contaminate a room if not handled meticulously. YES. Meticulously is possible.
I don't know what the nurse may or may not have done to allow exposure of her skin or otherwise to the extubation procedure or dialysis procedure, but, I am curious to the extent these life support systems are used in West Africa. These are First World treatments for patients, however, they are found in a variety of places in the world. These are not exclusively First World treatments.
If this is the first time or at the very least the first time in the USA that Ebola has come in contact with these invasive and life sustaining procedures this may be the initial experience with Ebola in this setting.
Again, I want to commend Dallas for all it's involvement in providing as intensive information and scrutiny this virus is receiving. I do not believe this is a breach in INITIAL diagnosis. The CDC stated the nurse reported her symptoms very early on and with a low population of virus in her blood test. I still believe we are carrying out good initial evaluation. This is a breach in protocol and/or an unknown source of contamination for the extensive amount of virus involved in Mr. Duncan's case.
There MAY be other exposures, but, we don't know that and can only be patient to maintain a vigilance. I do believe the USA is way ahead of any extensive exposure or outbreak. I have confidence in the CDC and it's vigilance. This has nothing to do with ports of entry into the country. This was a contamination of the internal room environment with the patient.
If I believed there was something questionable, I'd say so. I am in the USA along with everyone else.
Every intensive care room has the capacity to provide ventilator assistance and dialysis to any patient. That means the equipment is in direct contact with bodily fluids with high concentrations of virus and especially the case with Mr. Duncan.
Mr. Duncan succumbed to Ebola infection with high levels of the microbe in his blood, therefore, the equipment he was sustained on was also highly contaminated. The equipment involved have two components, the disposable equipment that are in contact with the patient (primarily plastic) and the hardware that is expensive and decontaminated and reused.
The contaminated disposable equipment would have been properly contained in medical waste containers and the hardware might not have been and was most probably contaminated both outside the equipment as well as within.
The extubation of any patient is fairly straight forward after a person expires, but, dialysis maintains a catheter in the patient to carry out the procedure which serves as a connection between the patient and the machine. Dialysis is more heavily a blood intensive procedure than extubation, however, there are secretions that are involved in extubation that can be droplet and miniscule. Both procedures can offer an opportunity to contaminate a room if not handled meticulously. YES. Meticulously is possible.
I don't know what the nurse may or may not have done to allow exposure of her skin or otherwise to the extubation procedure or dialysis procedure, but, I am curious to the extent these life support systems are used in West Africa. These are First World treatments for patients, however, they are found in a variety of places in the world. These are not exclusively First World treatments.
If this is the first time or at the very least the first time in the USA that Ebola has come in contact with these invasive and life sustaining procedures this may be the initial experience with Ebola in this setting.
Again, I want to commend Dallas for all it's involvement in providing as intensive information and scrutiny this virus is receiving. I do not believe this is a breach in INITIAL diagnosis. The CDC stated the nurse reported her symptoms very early on and with a low population of virus in her blood test. I still believe we are carrying out good initial evaluation. This is a breach in protocol and/or an unknown source of contamination for the extensive amount of virus involved in Mr. Duncan's case.
There MAY be other exposures, but, we don't know that and can only be patient to maintain a vigilance. I do believe the USA is way ahead of any extensive exposure or outbreak. I have confidence in the CDC and it's vigilance. This has nothing to do with ports of entry into the country. This was a contamination of the internal room environment with the patient.
If I believed there was something questionable, I'd say so. I am in the USA along with everyone else.
