Ambulatory clinics prepare for Ebola patients
An Ebola scare at an urgent-care clinic in Texas and another at a doctor’s office near Boston have underscored the need for ambulatory care providers to prepare for patients who may present with Ebola-like symptoms, experts say.
Ebola was ruled out in both cases— one at a CareNow urgent-care clinic in Frisco, Texas, Oct. 8 and another at Harvard Vanguard Medical Associates in Braintree, Mass., Oct. 12.
The Centers for Disease Control and Prevention has posted documents to help outpatient providers, including a checklist to evaluate patients for Ebola and a preparedness checklist. If a patient presents with symptoms of Ebola—which can include fever, headaches, weakness, vomiting and diarrhea—and has traveled to West Africa or had contact with an Ebola patient in the past 21 days, providers should isolate the patient in a single room with a private bathroom and close the door.
If patients present with symptoms at the front desk, they should be placed in the nearest room possible, said Julie Loomis, assistant vice president of risk management at State Volunteer Mutual Insurance Co.
Loomis said it is especially important that all medical offices purchase CDC-recommended personal protection equipment for every staff member who could come into direct contact with patients. Most non-emergency clinics currently do not have personal protection equipment, or not enough for every staff member, she said.
Dr. Ron Yee, chief medical officer for the National Association of Community Health Centers, said most community health centers have some personal protection equipment but likely not enough for all staff. An effort is underway with the centers’ state partners to ensure they get adequate equipment.
Loomis said screening patients at the front door could create unnecessary panic. Other experts say such a procedure could violate providers’ legal and medical obligations if they turn away a patient with a serious condition.
Ultimately, patients should be told not to come to a doctor’s office if they think they might have Ebola, Loomis said. She added that staff could screen patients about their recent travel history when they call to make an appointment.