Following the first meeting of emergency management, law enforcement, hospital and EMS officials along with fire department first responders to address preparedness for handling any cases of Ebola that might be diagnosed in Hopkins County, Hopkins County Memorial Hospital and Emergency Medical Services have begun taking a “disciplined and methodical approach” in addressing the crisis. Hospital Chief Executive Officer Michael McAndrew said existing policies have been reviewed and revised, based on the most up-to-date guidance from the Centers for Disease Control and Prevention [CDC]. “We have updated our Personal Protective Equipment (PPE) to conform to those recommended by CDC,” McAndrew said. “As the CDC revises recommendations, Memorial Hospital and Clinic will respond accordingly. Memorial Hospital and Clinic has revised triage forms and admission documents to include a travel screening question for all emergency department and clinic patients. “We have impermeable gowns, boot covers, N95 masks, face shields, goggles, caps, hoods and gloves,” McAndrew continued. “This week, nursing staff is being educated on correct procedures for donning and removing PPE. Memorial Hospital and Clinic also has hazmat suits including hoods and powered air purifying respirators on site.” Brent Smith, EMT-P, EMS director for Memorial Hospital District, has reviewed the protocols for the ambulances. Inservice training regarding donning and removal of hazmat suits for EMS staff have been initiated. The Hospital District Environmental Service staff has been trained to clean and decontaminate a room or space where an infected person has been or is housed. HCMH is also a member of a regional group, the Regional Advisory Council, which provides almost immediate access to additional supplies within an hour from fellow RAC hospitals, St. Michael's and Wadley in Texarkana, Paris Regional, Titus Regional in Mount Pleasant and Christus St. Michael's in Atlanta, as well as additional EMS services. The CDC believes that humans contract Ebola through direct contact with the blood and body fluids of a person who is sick with Ebola or objects that have been contaminated with the virus. Blood and body fluids [including but not limited to urine, saliva, sweat, feces, vomit, breast milk and semen] enter through a break in the skin or via mucous membranes, such as the nose, mouth and eyes. It is not spread through the air or by water. Ebola only spreads when people are showing symptoms. Symptoms of Ebola may appear between two and 21 days after direct contact with a person infected with and showing signs and symptoms of the virus. Signs and symptoms include: n Fever greater than 101.5 degrees n Severe headache n Muscle pain n Weakness n Diarrhea n Vomiting n Abdominal pain, and n Unexplained hemorrhage (bleeding or bruising) McAndrew said it is unlikely the hospital will see an Ebola patient in Hopkins County. “However, should it happen we are prepared to deal with it from a staff, equipment and process standpoint,” he said. “Staff exposure will be minimized through proper equipment, training and reducing the number of individuals who come into contact with the patient. Any suspected Ebola patient will be housed in an isolation room until it has been determined which specialty facility he/she will be transferred to.” Screening people who come in to the emergency department or clinic will be screened through the use of three questions: 1. Do you have a fever greater than 101.5 degrees and additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain or unexplained hemorrhage? 2. Have you traveled to West Africa within 21 days of the symptom onset? 3. Have you had direct contact with anyone who has been diagnosed with Ebola? Anyone who answers yes to the questions will be masked and taken to the isolation room. To the extent possible, the hospital will limit contact to one employee and immediately notify the state and appropriate infection control staff.