L+M, Backus say they have already put latest Ebola procedures into practice

Both of southeastern Connecticut's hospitals said they have already implemented the updated Ebola procedures announced Monday by the American College of Emergency Physicians, the Centers for Disease Control and Prevention and the Emergency Nurses Association.

Rebecca Stewart, spokeswoman for Hartford HealthCare, the network that includes The William W. Backus Hospital in Norwich, said the Emergency Department there has implemented the recommendations from the hospitals in Nebraska and Atlanta that had successfully treated Ebola patients. Those recommendations, she said, became the current CDC guidelines.

Mike O'Farrell, spokesman for Lawrence + Memorial Hospital in New London, said this hospital has been "constantly monitoring updates and information to make sure we are either at or ahead of protocols." L+M was already following the guidelines issued Monday, he said.

Also Monday, Gov. Dannel P. Malloy outlined how the state is monitoring the health of any individual returning to Connecticut after traveling from one of the countries in West Africa affected by the Ebola outbreak.

Earlier this month, Malloy announced that the state was utilizing its authority to grant the Department of Public Health commissioner the discretion to quarantine people who have met the threshold for such action. As of last week, the department has issued four quarantine orders in the state involving nine people. One order involving one person has been rescinded based on a review of additional information related to travel activities. Currently, there are eight people in quarantine in Connecticut, according to a statement from the governor's office.

Under these protocols, the health department is working with federal authorities and is being notified of travelers arriving in Connecticut from the three West African countries impacted by the Ebola virus: Guinea, Liberia and Sierra Leone, the statement said. All such travelers will be subject to 21 days of active mandatory monitoring, and the health department will review each case and determine if additional steps are necessary. Under active monitoring, local health directors contact individuals daily to obtain their temperatures and determine whether they have developed any symptoms of illness.

If the Public Health Commissioner Jewell Mullen deems it necessary based on information gathered during the screening process, a quarantine will be required. Under these guidelines, a person held under quarantine is not sick, but is kept away from other people because they may have been exposed to an infectious or contagious disease. The state's isolation procedure will be implemented once a person is exhibiting symptoms, so that further infection of other people can be prevented. Information about the procedures can be found at: www.ct.gov/ebola.

The new CDC-ACEP procedures for emergency personnel announced Monday are designed to help health care staff evaluate and manage patients suspected of Ebola infection. The new guidelines were evaluated by a panel of experts to establish consistency for emergency care workers and "reflect lessons learned from the recent experiences of U.S. hospitals caring for Ebola patients," ACEP said in a news release.

"It's critical to protect the emergency medical staff who are on the front lines of caring for patients who may have Ebola," said Dr. Alex Rosenau, immediate past president of the organization. "They are the ones most at risk for contamination, because they come in direct contact with the patient, as demonstrated by the infections of the nurses in Dallas and the recent case of the emergency physician in New York."

The CDC guidelines include advice for:

• assessing patients, including those for whom travel histories are unavailable (for example, when patients are unconscious).

• putting on and removing of personal protective equipment.

• managing and isolating patients who may have Ebola.

• informing hospital personnel and other authorities about possible infection.

• providing direct observation of health care workers while putting on and taking off personal protective equipment.

"The new guidelines provided needed direction and drill down on specific situations to safely and effectively manage patients suspected of Ebola," said Dr. Stephen Cantrill, chairman of ACEP's panel.

j.benson@theday.com

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