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Ebola Exposure Daily Symptom Monitoring Log
Audience
Hospital staff caring for patients under investigation or patients with confirmed Ebola virus disease (EVD).
Key Takeaways
- Los Angeles Department of Public Health (LACDPH) log to monitor contacts under Ebola Virus Disease (EVD) surveillance.
- This log is intended to be utilized to monitor EVD contacts temperature and symptoms twice a day.
- Completed Ebola Exposure Daily Symptom Monitoring logs must be faxed to Acute Communicable Disease Control (ACDC) (Fax:213-202-5999).
Implementing Respiratory Protection Programs In Hospitals: A guide for Respirator Program Administrators
Audience
Licensed healthcare professionals responsible for developing and implementing a respiratory protection program for aerosol transmissible diseases and airborne hazardous materials at their facility.
Key Takeaways
- This guide is a tool to help California hospitals/healthcare facilities develop and implement an effective respiratory protection program
- Emphasis on the healthcare setting
- Practical step-by-step manual
- Contains resources for training for respirator program administrator
- Lists diseases requiring airborne precautions and droplet precautions
Back to Basics Training Guide
Identifying and Testing for Special Pathogens
What qualifies as a reportable disease or condition?
Not sure if the disease or condition you’re treating must be reported? The resource below lists the nearly 100 mandated reportable diseases and conditions for Los Angeles County, as well as required forms, and instructions on where, how, and what to report.
Every health care provider is responsible for reporting suspected cases of certain diseases to certain health authorities, depending on the suspected pathogen involved and the circumstances.
Required reporting methods also vary by disease, but usually include some combination of:
- Immediate telephone call
- Within 1 day by email
- Within 7 days by fax, email, phone, or mail
Different pathogens have different protocols.
In addition to reporting methods and requirements, the testing and patient care requirements for suspected cases also vary by pathogen.
Guidance for clinical laboratories on testing needed for assessment and care of patients at risk of Ebola Virus Disease
Overview of molecular and serology tests for Middle East Respiratory Syndrome Coronavirus (MERS)
General information on monkeypox disease including signs and symptoms, transmission, prevention, and treatment; testing; and how to receive the vaccine
Overview of the viral tests for SARS-CoV-2 and their intended uses
If you need to send samples to the Public Health department in LA County, use this form.
Guidance for PPE in the Workplace
If your employees wear PPE in the workplace, California requires you to have a respiratory program in place. Starting and Managing a Respiratory Program in California
California has also adopted standards (the Cal/OSHA ATD standard) to help protect employees from certain airborne infections due to their work activities.
Transporting Special Pathogen Patients in Emergency Medical Services
Screening Calls
This screening tool for medical dispatch centers includes pre-arrival instructions for EMS providers who are responding to patients with a possible emerging infectious disease. It also lists countries under public health surveillance for responders to reference.
Assessing and Transporting Patients
This easy-to-read flowchart shows the process for determining a patient’s risk level for Ebola Virus Disease during pre-hospital care and gives guidelines on how to transfer them safely to an appropriate facility.
Preparing for Special Pathogen Cases
Drills and exercises can help ensure that your facility is prepared to respond effectively in the event of a special pathogen outbreak. NETEC has prepared the following exercise templates that follow ASPR guidelines to help with training at your facility.
Handling special pathogen cases requires special attention to waste management. Follow guidelines for safely handling, inactivating, transporting, and disposing of Category A infectious waste.
Viral Hemorrhagic Fever Preparedness and Response
Recommendations for frontline facilities
The U.S. Centers for Disease Control and Prevention (CDC) recommends all frontline healthcare facilities prepare for patients with Ebola or other viral hemorrhagic fevers (VHFs) by:
- Training staff to quickly identify, isolate, and manage potentially infected patients
- Developing systems to safely manage waste disposal, cleaning, and disinfection
- Notifying state and local public health officials according to protocols
Frontline facilities include acute care hospitals, urgent care clinics, critical access hospitals, and other emergency care settings, but not primary care offices or other non-emergent ambulatory care settings.
Preparing facilities for Ebola and other VHF Outbreaks
Personal protective equipment
The viral hemorrhagic fevers spread through contact with bodily fluids — so proper use of personal protective equipment (PPE) is especially important. In the case of Ebola, the CDC recommends frontline care facilities have enough PPE on hand for at least 12-24 hours of continuous care.
Facility preparedness
In addition to sufficient PPE practices, an effective VHF response also includes:
- High-level containment care (HLCC) units – physically isolated areas that use enhanced engineering controls to contain the viruses while staff provide all aspects of clinical care to potentially infected patients
- Zones for donning, doffing, and storage of PPE – including appropriate showering facilities for staff members exiting sensitive care units
- Designated areas of risk to reduce potential contamination and guide healthcare worker flow:
- Red/Hot Zone for patient rooms, laboratory
- Yellow/Warm Zone for anteroom, decontamination area, waste processing, doffing
- Green/Cold Zone for nurse station, clean supply room, staff egress changing area
- Telehealth strategies – allow healthcare workers to communicate with and assess patients remotely to limit direct contact
Responding to a Potential VHF Infection
The California state and LA County health authorities follow the "identify, isolate, and inform" model of care recommended by the CDC for patients suspected of infection with viral hemorrhagic fever.
Screening
Because early symptoms of viral hemorrhagic fevers often mirror those of other infectious diseases, getting a detailed travel and exposure history from a patient is critical. The California Department of Public Health (CDPH) offers a screening form to help assess a patient's risk of infection.
Reporting
If a patient's screening indicates they might be infected with Ebola or another viral hemorrhagic fever, healthcare providers should isolate the patient and notify their local healthcare department immediately. In LA County, healthcare providers should contact the Department of Public Health Acute Communicable Disease Control Program:
8 a.m.–5 p.m. Monday–Friday at 213-240-7941 or
after hours at 213-974-1234.
When receiving these calls, local heath departments will provide immediate infection control guidance for the suspected case being reported, and then immediately notify the California Department of Public Health.
Patient Transport
The CDPH will provide consultation to help determine if a patient needs further evaluation or transport to a designated assessment and treatment facility. In cases of low risk of VHF infection, they may recommend the patient remain at the frontline facility while testing is conducted, to help minimize exposure.
Waste Management
Because of the nature of VHF symptoms, an HLCC setting can reportedly generate over 1,000 pounds of waste per patient. This includes solid and liquid patient waste, patient linens, healthcare worker PPE and linens, contaminated medical devices, and other general medical waste associated with VHF contamination, which are designated as Category A Infectious Substances. A comprehensive waste management plan and staff training are an important part of VHF infection control and prevention.
Starting and Managing a Respiratory Program in California
1. What is a respiratory program?
If your employees wear PPE in the workplace, California requires your operation to have a respiratory projection program with both a written and a training component that sets use guidelines specific to your facility.
To make a safer workplace for employees, the California Code of Regulations sets standards for controlling occupational diseases that are caused by breathing contaminated air, including respiratory pathogens.
These standards cover engineering methods of pathogen control to use in your in facilities, such as containment enclosures and ventilation, as well as when respirators are appropriate and what kinds should be used for which situations. California employers are also responsible for developing a written respiratory protection program, with worksite-specific procedures and instructions for respirator use.
2. Developing a Program for Your Facility
The California Department of Industrial Relations Division of Occupational Safety and Health (CAL OSHA) has published a guide for employers who are working to comply with these standards.
It offers a helpful overview on:
- When the standards for respiratory control measures apply
- How to design a respiratory protection program for your operation
- Elements to include in your written respirator or training program
- Types of respirators and their applications.
Written Respiratory Protection Program Template
If you need help creating or updating the written component of your program to comply with the requirements, the California Department of Public Health has published a customizable template you can edit to meet your facility's specific needs.
It includes responsibilities for the program administrator and other roles involved with the program, a section on when to use respirators and how to assess hazards, and customizable sections on training staff members on respirator use, fit testing, storage, maintenance, and care of equipment.
Exercise Templates to Use in Training
Several organizations offer templates you can customize to your facility that will help you design and lead your own training programs. Use these to help your staff members practice using your respiratory protection plan to effectively identify, assess, treat, manage, transport, and transfer high-risk patients in a respiratory pathogen event.
The National Emerging Special Pathogen Training and Education Center (NETEC)'s customizable exercise templates have examples you can use to run drills, tabletops, functional, and full-scale exercises. The Centers for Disease Control has published some free training modules that are especially designed for long-term care facilities.
3. Refer to LA County's Response Plan
For information on how Los Angeles County responds in the event of a threat, refer to its Emerging Infectious Disease Concept of Operations (CONOPS) plan. This describes the goals, strategies, and responsibilities for providing a coordinated and system-based healthcare response. Los Angeles County Emerging Infectious Disease Concept of Operations details its official response plan.
LACDPH Epi Forms
How to send samples to the LA County Department of Public Health Lab
Audience
Healthcare facilities sending specimens to LACDPH
Key Takeaways
Facilities needing to send specimens to LACDPH can follow the instructions here
LAHAN link - LA Health Alert Network
Audience
Los Angeles County health care professionals
Key Takeaways
The Los Angeles County Department of Public Health (LACDPH) emails priority communications to health care professionals through LAHAN. Topics include local or national disease outbreaks and emerging health risks. To receive LAHAN communications, click the ‘subscribe’ button. It takes less than a minute to sign up.
Interim Guidance Protecting Workers at SNFs/LTCs from Exposure to COVID19
Audience
Skilled nursing facility and long-term care facility employers and workers
Key Takeaways
Cal/OSHA’s regulations require protection for workers exposed to airborne infectious diseases such as COVID-19, first identified in December 2019. This interim guidance provides employers and workers in skilled nursing and long-term care facilities with vital information for preventing exposure to the virus. Employers and employees should review their own health and safety procedures as well as the recommendations and standards detailed below, to ensure workers are protected from COVID-19.
CAHAN link
Audience
Healthcare staff interested in receiving alerts, advisories, updates, and information on local and national disease outbreaks and emerging health risks.
Key Takeaways
- Email subscription for the Los Angeles Health Alert Network (LAHAN).
- The Department of Public Health (DPH) emails priority communications to health care professionals through LAHAN.
- Topics include local or national disease outbreaks and emerging health risks.
- This resource also provides a list of recent LAHAN communication.