Ebola Information for Healthcare Coalitions

Topics on this page

Overview | Patient Evaluation and Diagnosis | Patient Management | Personal Protective Equipment | Privacy | Patient Movement | Infection Control | Patient Monitoring | Waste Management and Disposal | Transporting Samples and Infected Material | Presentations

Overview

• Checklist for Healthcare Coalitions for Ebola Preparedness:  This checklist is intended to enhance collective preparedness and response by highlighting key areas for healthcare coalitions to review in preparation for a person under investigation (PUI) for Ebola at a coalition member’s facility. The checklist provides practical and specific suggestions to ensure healthcare coalition members are able to detect possible Ebola cases, protect employees, and respond appropriately.

Patient Evaluation and Diagnosis

• Case Definition for Ebola Virus Disease: Early recognition is critical for infection control. Health care providers should be alert for and evaluate any patients suspected of having Ebola Virus Disease (EVD). This case definition explains the distinction between a Person under Investigation (PUI), probable cases and confirmed cases.  It also explains risk exposure levels.

Patient Management

• Identify, Isolate, Inform: Emergency Department Evaluation and Management for Patients Who Present with Possible Ebola Virus Disease:  The procedures in the accompanying algorithm provide guidance on the Emergency Department evaluation and management of patients who present with possible Ebola Virus Disease. The guidance in this document reflects lessons learned from the recent experiences of U.S. hospitals caring for Ebola patients.
• Safe Management of Patients with Ebola in U.S. Hospitals:  This document summarizes frequently asked questions, including those related to hospital readiness, patient management, infection control precautions, and personal protective equipment.

Personal Protective Equipment

• Guidance on Personal Protective Equipment (PPE) To Be Used by Healthcare Workers During Management of Patients with Ebola Virus Disease in U.S. Hospitals, Including Procedures for Putting On (Donning) and Removing (Doffing):   These procedures provide detailed guidance on the types of PPE to be used for the donning and doffing of PPE for all healthcare workers entering the room of a patient hospitalized with Ebola.  It incorporates lessons learned and emphasizes the importance of training, practice, competence, and observation of healthcare workers in correct donning and doffing of PPE selected by the facility.
• PPE Selection Matrix for Occupational Exposure to Ebola Virus:  Employers are responsible for ensuring that workers are protected from exposure to Ebola virus and that workers are not exposed to harmful levels of chemicals used for cleaning and disinfection.
  

Privacy

• Bulletin:  HIPAA Privacy in Emergency Situations:  The HIPAA Privacy Rule protects the privacy of patients’ health information (protected health information) but is balanced to ensure that appropriate uses and disclosures of the information still may be made when necessary to treat a patient, to protect the nation’s public health, and for other critical purposes.

Patient Movement

• Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure:  CDC has created interim guidance for monitoring people potentially exposed to Ebola and for evaluating their intended travel, including the application of movement restrictions when indicated. This interim guidance has been updated by establishing a “low (but not zero) risk” category; adding a “no identifiable risk” category; modifying the recommended public health actions in the high, some, and low (but not zero) risk categories; and adding recommendations for specific groups and settings.
• Questions and Answers about CDC’s Ebola Monitoring & Movement Guidance: Learn about updates to the interim guidance and answers to common questions.
  
• Planning Considerations When Developing Standard Operating Procedures for the Transfer of an Ebola (or Other Highly Infectious Disease) Patient from/to an Air Transport Provider to/from a Ground Transport Provider: Guidance to aid in developing standard operating procedures for air-to-ground transfers of patients with Ebola or other serious infectious diseases.
• Guidance for Developing a Plan for Interfacility Transport of Persons Under Investigation or Confirmed Patients with Ebola Virus Disease in the United States:  This document provides guidance on developing plans for personnel, including ground and air medical transport providers, managers of EMS agencies, EMS medical directors, local and state EMS systems, local and state health departments, healthcare facilities, and others involved in the interfacility (including intrastate or interstate), transport of persons under investigation (PUIs) or patients with Ebola.
• Standard Operating Procedure (SOP) for Patient Handoff between a Healthcare Facility and a Transporting Ambulance: This document provides guidance to facilitate planning for and execution of patient handoff between personnel at a fixed facility (hospital or clinic) and the transporting ambulance agency. Information is presented in a chronological format and is provided at a level of detail that will afford local planners and operators the flexibility to develop procedures that are suitable for their environment.
• Standard Operating Procedure (SOP) for Air-to-Ground (Air-Ground) Patient Handoff: This document provides guidance to facilitate planning for and execution of patient handoff between an air ambulance agency and a ground ambulance agency. This may occur when an air ambulance agency transfers the patient to a ground ambulance agency or when a ground ambulance agency transfers a patient to an air ambulance agency. This SOP is focused on fixed-wing transport and not rotor-wing. It does not address broader air and ground ambulance SOPs. Information is presented at a level of detail that will afford local planners and operators the flexibility to develop procedures that are suitable for their environment.
• Standard Operating Procedure (SOP) for Decontamination of an Ambulance that has Transported a Person under Investigation or Patient with Confirmed Ebola: This SOP can serve as a model for emergency medical services (EMS) transport agencies to standardize the procedures and responsibilities for the decontamination and disinfection of an ambulance that has transported a person under investigation (PUI) for Ebola or a patient with confirmed Ebola. It is highly recommended that procedures and responsibilities for decontamination and disinfection of the ambulance be clearly defined before transporting a PUI. All personnel should be trained in donning and doffing (putting on and taking off) techniques for personnel protective equipment (PPE).

Infection Control

• Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Virus Disease in U.S. Hospitals:  Standard, contact, and droplet precautions are recommended for management of hospitalized patients with known or suspected Ebola. This guidance outlines only those measures that are specific for Ebola; additional infection control measures might be warranted if an Ebola patient has other conditions or illnesses for which other measures are indicated.
• Interim Guidance for Environmental Infection Control in Hospitals for Ebola Virus:  The role of the environment in transmission has not been established. However, given the apparent low infectious dose, potential of high virus titers in the blood of ill patients, and disease severity, higher levels of precaution are warranted to reduce the potential risk posed by contaminated surfaces in the patient care environment.
  

Patient Monitoring

• Identify, Isolate, Inform: Emergency Department Evaluation and Management for Patients Who Present with Possible Ebola Virus Disease:  The procedures in the accompanying algorithm provide guidance on the Emergency Department evaluation and management of patients who present with possible Ebola Virus Disease. The guidance in this document reflects lessons learned from the recent experiences of U.S. hospitals caring for Ebola patients.

Waste Management and Disposal

• Ebola Associated Waste Management:  This document is intended to provide hospitals and healthcare providers with key information about the safe handling, transport, and disposal of waste generated from the care of persons diagnosed with or suspected of having Ebola. 
• Procedures for Safe Handling and Management of Ebola-Associated Waste: This document provides detailed step by step procedures for use with the CDC guidance on Ebola-Associated Waste Management.
  
• Safe Handling, Treatment, Transport and Disposal of Ebola-Contaminated Waste:  Learn to protect workers involved in handling, treatment, transport and disposal of medical, laboratory and other waste must be protected from exposure to Ebola and from physical and chemical hazards that may be associated with waste management tasks
  

Transporting Samples and Infected Material

• Transporting Infectious Substances:  An infectious substance is regulated as a hazardous material under the U.S. Department of Transportation's (DOT's) Hazardous Materials Regulations (HMR; 49 C.F.R., Parts 171-180). This site offers Procedural Guidance on the Proper Packaging of Ebola Suspected Waste; Guidance for Transporting Ebola Contaminated Items; and information on transporting infectious substances safely.

Presentations

The following presentations provide templates that EMS agencies and personnel can use as templates to develop Ebola presentations for their staff.  The following presentations contain information that has been cleared by ASPR and CDC.

• Ebola 101 - CDC Slides for U.S. Healthcare Workers:  This presentation provides an overview of Ebola as a disease, information on the current outbreak.
  
• Webinar:  Ebola PPE Donning and Doffing Procedures:  This web-based training includes information on properly putting on and removing the PPE that is to be used during management of patients with Ebola in U.S. Hospitals.
  
• Ebola Overview:  This presentation provides an overview of the Ebola as a disease and the outbreak in West Africa.  It also provides information on the goals and challenges of the response, treatment of patients, management of clinical samples, patient monitoring and more.

Frequently monitor CDC’s Ebola website  and subscribe to updates from CDC for the most current information on Ebola.  CDC is available 24/7 for consultation.  State and local health departments with questions should contact  the CDC Emergency Operations Center (EOC) at 770-488-7100 or via email at eocreport@cdc.gov.