Recommended - 16 hrs Advanced…Day one Classroom - Day 2 Hands on situations drills…Decontamination systems
will be involved..day 2 will introduced the stress, different situations and the command structure…Control and security will
come into the theater of operation…Safety and security officers will be shown the need to act and take control .…
- 8 hour minimum training course – Other modules can be added as needed.
Secondary Staff -
4 hour introduction... This can be expanded as the alert system is elevated
As soon as possible, the hospital should acquire all of the materials needed to meet appropriate hygiene standards and contact precautions.
Non--touch Infrared thermometers (you will need several)
• Chlorine powder or 40 gallons of bleach
• Chlorine hand wash buckets with
spigots -- One for the ER, one for each ward, one for registration (one of the ill health care workers was a registration clerk),
one for the visitors area, and at least 4 for the isolation unit.
• Disposable gowns with sleeves for the ER. (Medline Polyethylene
Thumb Loop Style Isolation Gowns can be ordered for $0.50 USD each online). The quantity ordered will depend on the volume of ER patients
and number of hospital beds, but we recommend having a very generous supply of these gowns.
• Gloves (will essentially require twice
as many gloves as currently using)
• PPE for 2--4 weeks (typically use approx. 12--14 suits/day when caring for 1--4
as teams of 2--3 enter the unit approximately every 3--4 hours).
o Tyvek or Tychem overalls by Dupont (Size XXL and Medium).
Any other products should be tested for impermeability before using.
o Tyvek hood/mask (isoclean or microclean)
o N95 mask (duck--bill
o exam gloves
o surgical gloves (size 6.5, 7.5, 8) to be worn over the top of the exam
o rubber boots (size 7, 8,
o rubber aprons
o heavy rubber gloves
• Several rolls of Duct tape (some of the suits have thumb loops and are safe
to be worn without taping the sleeve to the glove, but for those without thumb
loops, duct tape is needed to secure the glove).
sprayers (garden sprayer okay. Square lever pump work better than round sprayers with a pump on top).
• Scrubs that can be dedicated
for Ebola care. (After use, these should be soaked in a bleach solution for 1 hour before washing).
• Buckets or bedside commodes (many
patients have cholera--like diarrhea)
• Wide shallow basins to be used as foot baths
• Several approx. 40--gallon plastic trash cans
to mix chlorine solution and soak aprons, scrubs, and boots.
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• Thick garbage bags (heavy--duty)
• Electronic BP cuff to be
used on confirmed cases only (cannot auscultate BP
through the tyvek suit)
• Pulse oximeter to be used on confirmed cases
• Oxygen canisters
or oxygen concentrators and tubing
• Foley catheters and insertion kits (To be used early in care. Volume management is the mainstay
of treatment and urine output of 0.5 ml/kg/hr must be maintained)
• Plastic mattress covers
• Extra mattresses
• Linens and patient gowns
(soiled linens and gowns will typically be disposed of so a plentiful supply is needed)
• Adult diapers
• Chux underpads
• IV tubing,
IV cannulas and IV flush.
• Syringes, needles, alcohol
• IV Lactated Ringers (patients require 6--8 liters/day at times).
• IV Potassium
supplementation (hypokalemia can be severe in these patients with profuse diarrhea)
• Oral Levaquin
• Oral Azithromycin
• Paracetamol or Acetaminophen
• Antimalarial med (Coartem or IV Artesunate)
• Multiple Vitamin
• Vitamins A, B--complex, and
• Parenteral nausea medication (we avoided the promotility agent, metoclopramide because of the diarrhea that most patients have)
• Parenteral pain medication (in our experience, 2 mg morphine tid was a much more effective antimotility agent than imodium
or lomotil in those with severe diarrhea)
• Blood typing kits (If the reference lab is unable or unwilling to provide blood typing).
Nutritional supplements (plumpy--nut or nutritional shakes)
Establish a reliable supply chain. Frequent shipments may be required to
UPDATE ... OCT 23, 2014 I just sent out a Letter to Canada, to prepare the funding and planning for 1000 of our High-Tech Hospital
and Clinic System for Africa. In our early planing this was designed with the intent for Infectious Deseases. This design will
involve the ventalation and lighting systems to control and kill the virus as the workers move through different sections. Once delivered
the building system will be setup and working with-in a week if our plan is followed. There is no other repid responce
system in the world with this protection in this type of operation. I am the ASIA repersinitive for this solution. D.Rymer
... Oct 24, 2014 Whereas.... The movement around the world to make ready is moving at a snales pace... My visits to privite
hospitals here in Mindanao offten reply that they will start their training as they receive a Ebola Patient... The Government
Hospital here in Gensan has sent repersentivies to Manila to train with the DOH. Outside of the Government starting..... I see
so far a repeate of another failed disaster where people are not ready and proprety trained. There is little to none Level 3
protection equipment. At this point our offer to assistance is not being received as the ungency of what it repersents. D.Rymer
NOTE THE EARLY RELEASE OF RECOMMENDED SUPPLIES THAT HOSPITIALS NEED NOW....
This list will be under constance change and I will
also direct suggestions for the Barangay and Home level.
We need to be using Level 3 Protection.... In Truth this will not be possible
here in the Philippines. We will try and place a plan that will save lives to the hightest level possible if this Virus makes entry....Studies
say that this is highly possible.