Laurel Regional has 'process in place' for Ebola patients

Laurel Regional has 'process in place' for Ebola patients
Trudy Hall, vice president of medical affairs at Laurel Regional Hospital, said the hospital will send any Ebola cases it encounters to a Maryland Department of Health and Mental Hygiene center. (File photo by Nate Pesce)

Nationwide, hospitals and health care officials are aggressively developing strategies and protocols in response to the Ebola virus, which has claimed more than 4,000 lives in West Africa and one death in the United States.

Although no Ebola cases have been reported in Maryland, state and Laurel health care officials are doing the same.


On Monday, Gov. Martin O'Malley announced that all travelers returning from Sierra Leone, Liberia and Guinea, the countries hardest hit by Ebola, will be closely monitored during the 21 days that they could develop the virus. Airport screeners will provide Maryland health officials with the names and contact information of travelers from the three countries who are coming to the state. Those deemed a high risk for Ebola exposure will be restricted to their homes.

Health care workers and others who may have cared for Ebola victims will be restricted from attending large gatherings and using public transportation.

Last week, state health care officials laid out a comprehensive strategy for hospitals and health care workers to follow in diagnosing suspected Ebola cases and treating those who test positive for the disease. Laurel Regional Hospital officials say they are following the state's protocol and making sure they are prepared to deal with any cases according to state and federal guidelines.

The state's strategy, developed with assistance from the Centers for Disease Control and Prevention in Atlanta, calls for local hospitals to continue evaluating and isolating patients suspected of having Ebola. Those confirmed to have the virus would be treated at a federal facility, such as the National Institutes of Health; but if a federal treatment center is not available, the patient would be sent to either Johns Hopkins Hospital and the University of Maryland Medical Center, both in Baltimore; or MedStar Washington Hospital Center in Washington, D.C.

"We haven't had any cases so far, but if we do, we'll isolate them and send the patient to whatever center the [Maryland] Department of Health and Mental Hygiene tells us to send them," said Dr. Trudy Hall, Laurel Regional Hospital vice president of medical affairs. "They [DHMH] also determine who gets tested. We won't test or treat anyone for Ebola at Laurel Regional."

Also on  Monday, a patient that had been transferred to University of Maryland Medical Center in Baltimore at the request of state health officials and was being treated in isolation tested negative for Ebola, according to the MDHM.

In Maryland, blood work for potential Ebola cases will be sent to the state health department's lab, one of only 13 in the country authorized by the CDC to do Ebola testing.

"We're a small community hospital and our primary focus is on early detection, evaluation and following the state and CDC's check list and guidelines," she said. "The emergency room is our frontline so that means not having someone take a number and wait, but if they need screening, immediately putting them in isolation."

According to Hall, two rooms have been set aside at the hospital to be used only in caring for a potential Ebola patient. One would serve as a place for healthcare workers to don and take off protective gear.

A lead person, such as the head triage nurse, would coordinate the handling of potential cases and only one doctor and a nurse would provide hands-on patient care to minimize possible exposure and spreading of the virus. A new buddy system is also now in place where possible Ebola cases are concerned.

"Before, a nurse would go in a room [in infectious cases] and take their protective gear on and off, but now they will have a buddy to help them," Hall said. "The moment a [potential Ebola] patient comes in the emergency room doors, the one nurse would stay in the room handling hands-on care. They would not go in and out of the room. They would write on a clipboard what they need and their buddy would get it for them."

To make sure emergency room workers are prepared to handle any potential Ebola cases, drills that mimicked a real episode were conducted at the hospital.

"We wanted to walk them through this so they understand the protocols and feel comfortable with them," Hall said. "I'm happy with how they've responded."

One thing Hall said she is "upset" about is that urgent care centers in Laurel and elsewhere do not have the same set-ups as hospitals do to handle potential Ebola patients. She advises anyone who suspects they may have been exposed to the virus after traveling to the parts of West Africa where Ebola is rampant, to go to a hospital and not an urgent care center.


"We've asked urgent care centers to put a mask on any patients they receive and send them to us," she said.

With flu season starting, hospital officials predict some people who've traveled to West Africa will come to hospitals with symptoms similar to Ebola — fever and vomiting — but end up not being infected with the virus.

"We have had suspicions because it's flu season, but we haven't had to have anyone tested. DMHH determines who gets tested," Hall said.

With stricter state regulations in place, Hall said she hopes it does not lead to people being profiled just because they're from West Africa or have traveled there.

"We have to ask the right questions but so we don't target groups we have to remember that we live in a multicultural area with lots of people from West Africa, so, the message is not all people from West Africa have Ebola and we can't treat them differently because of where they're from," she said.

She admits that even though Ebola is not a new virus, and American hospitals are better equipped to handle it than West African medical facilities, the virus has never reached the endemic levels of today.

"This is a whole new world for American hospitals and we haven't had to deal with anything like this before. Every day we get something new from the CDC, so the rules [in dealing with Ebola] may continue to change," Hall said. "But I have faith in the hospital system, so people shouldn't be afraid. There is a process in place."