Ebola Information for EMTs

(Updated August 20, 2014)

Summary

An outbreak of Ebola Viral Disease (Ebola) is currently occurring in West Africa, specifically Liberia, Guinea, Sierra Leone, and Nigeria. Ebola is a viral infection that causes a severe, often fatal disease in humans. Early recognition is critical for infection control.

Ebola virus is transmitted through body fluids (blood, vomit, diarrheal fluids and other body fluids), via mucosal exposure or needle-stick similar to HIV and Hepatitis B or C. Healthcare providers, including EMTs, should be alert for any patients suspected of having Ebola and follow recommended precautions as outlined below.

Ebola is not transmitted through the airborne route the way flu and measles are transmitted, and there is no known risk from simply being in the same room as a patient with Ebola.

What you should do

1. Be vigilant. While there are no known cases of Ebola in the US or Rhode Island at this time, Rhode Island does have a significant population of people with family ties to West Africa (especially Liberia), and many travel to regions where the current outbreak is happening. Most of the borders of the affected countries are closed, however, and the World Health Organization has instituted exit screening at borders, so the likelihood of imported cases remains low.

2. Ask about travel history. Symptoms alone don't point to Ebola. If a patient shows any symptoms, ask if he or she recently traveled to West Africa, specifically Guinea, Liberia, Sierra Leone, and Nigeria. Ask whether he or she was exposed to sick persons.

3. Know the symptoms. Symptoms of Ebola include fever, headache, joint and muscle aches, weakness, diarrhea, vomiting, stomach pain, and lack of appetite. Some patients may experience a rash, red eyes, hiccups, cough, sore throat, chest pain, difficulty breathing, difficulty swallowing, and bleeding inside and outside of the body.

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, although 8-10 days is most common.

4. Take appropriate personal precautions. Keep a high index of suspicion for patients with symptoms who recently returned from travel to West Africa. Use standard precautions and personal protective equipment (PPE) to include:

Eye protection (goggles and/or face shield)
Facemask (Use N-95 only for aerosol generating procedures such as suction or intubation)
Gloves
Gown (fluid resistant or impermeable)
Remove all PPE following CDC standard guidelines.
Review and share these CDC posters today:
- English only: www.cdc.gov/vhf/ebola/pdf/ppe-poster.pdf
- English/Spanish: www.cdc.gov/HAI/pdfs/ppe/ppeposter1322.pdf

5. Prepare the patient for hospital arrival. This includes:

Good notification: Code the patient RED in the Patient Tracking System.
Taking and noting the patient’s temperature in the Patient Tracking System.
Transfer of patient to an isolation room with standard precautions.

6. Maintain a clean environment for the EMS vehicle, uniforms, and equipment.

Do not allow family members or others to accompany the patient during transport, including in the cab.
Following transport, conduct decontamination procedures for the vehicle:
- Use PPE while cleaning environmental surfaces
- Use a standard EPA-approved virucidal cleaner that is used for routine disinfection of EMS vehicles, and disposable wipes.
- Discard all PPE and materials used for cleaning in biohazard bags.
- Uniforms, if contaminated with body fluids, should be discarded in a biohazard bag. Do not take any contaminated garments home.

Contain all patient-generated waste in a biohazard bag and collect all sharps in a sharps container, all while in PPE.
Clean non-disposable equipment and PPE using manufacturer directions.
Refer to guidelines for environmental infection control at www.cdc.gov/hicpac/pdf/guidelines/eic_in_hcf_03.pdf

7. Upon hospital arrival, follow each hospital’s unique protocols and procedures for appropriate patient isolation.

8. Enlist the help of the hospital infection control team to assist with exposure evaluation and follow up if exposure to body fluids is suspected.

If you believe you’ve been exposed, complete a Rhode Island Pre-Hospital Exposure Form and follow your department’s Standard Operating Procedure (SOP).

9. If you experience symptoms within 2 to 21 days following transportation of a suspect Ebola case:

Call your doctor right away.
Isolate yourself from close contact with family members or others.
Fill out a Pre-Hospital Exposure Form. Submit this form to the hospital where your suspect case patient was transported.

10. To keep up to date on Ebola information, visit: