<p>No, his call was made during the second visit, when Duncan was in the ER and very sick, and the family thought it was likely Ebola. You are right that Louise Troh’s D who called the ambulance told the EMTs to use protection for that reason.</p>
<p>When he went to the ER the first time he was reportedly there for 3 hours or so, but it wasn’t just waiting: they performed a number of scans and tests for things like appendicitis. They really did look for a cause…it’s just that it would appear the doctor didn’t read the triage nurse’s notes re Liberia. It is hard to believe that when any reasonably informed layperson was aware of the Ebola connection to Liberia–and the symptoms–that a <em>doctor</em> would dismiss the possibility.</p>
<p>I would not want to be that doctor. Especially if–heaven forbid–one of the nurses dies. I wonder if everyone in the hospital knows who dropped the ball? I’m somewhat surprised the name hasn’t come out, even though I am glad for his or her sake.</p>
<p>Just a side note the majority of doctors don’t ever read nurses notes. The only time nurses notes seem to be scrutinized is when the charts are called for a deposition in a law suit.
A rule one of my instructors told me way back when was if it was pertinent, assume nobody is reading your notes make the phone call and document who you told the information to and document the time you made the call. This has saved my tail many of times when the ball was dropped by the doctor. </p>
<p>Really! Nrdsb did say that if she were the triage nurse she would have persisted in making sure that the doctor knew about Liberia. Quite possibly because she knows how likely doctors are to skip the notes.</p>
<p>This is the kind of fractured information and care that leads to mistakes and confusion on the part of patients and healthcare workers. Us patients figure if we tell the first healthcare workers, the information is conveyed to the team. I guess we need to do more as patients to be sure to repeat and repeat info we consider crucial and not assume that it will be brought to the attention of the rest of the team. It is troubling.</p>
<p>In this unfortunate case, it seems everyone did bare minimum. If the family knew that it was Ebola during the seocnd visit, they could have spelled it out whether it’s their job or not. It would have saved a lot of headache. Considering they had ties to Liberia recently visiting there, Ebola may have been on their radar more than the nurse’s.</p>
<p>Yes, considering there had never been an ebola case diagnosed in the US before, I can see how it would not be at the top of the staff’s radar vs. the family who KNEW that Duncan had been in an area where many died from ebola, whether or not he knew the pregnant woman he tried to help get to the hospital had ebola or not. It would have been better for everyone if the family had been clearer that ebola was something that should be ruled in or out, whether or not it was their “duty.”</p>
<p>Yale student not out of the woods yet. Still waiting a final determination on whether he has Ebola or not. </p>
<p>Also interesting that New Haven schools will not permit attendance of any student who has been to the hot zone countries until the 21 day incubation period has passed. </p>
<p>Around here, the docs do read the nurses notes. Family has had several hospital visits in the last year, including ER, and by the time the docs come around, they know what’s going on. They had to have read the notes.
I’m not saying that repeating could hurt, but I think the norm is for the docs to read the information and to come to the patient with some kind of plan. That has been our experience, anyway.</p>
<p>Even if he read, just reading Liberia and reading Ebola spelled out may have been different. The doctor did ask him if he was in contact with a sick person. Duncan said no. Wouldn’t that be a good opportunity to bring up Ebola?</p>
<p>“Boy, if I was one of the folks on the cruise ship, I’d be very upset–saving up to go on a cruise and not being able to dock at the planned ports–yep very disappointing and likely to generate significant complaints from the other passengers.”</p>
<p>Well, I certainly hope that the Texas Department of Health is fixing up some quarantine camps for the people on the cruise. I expect they will need to be held for 21 days - after all, we wouldn’t want them just disembarking and going on their merry way when they have been exposed to someone who may have handled Dallas Ebola specimen. </p>
<p>Actually, they just need to hold those fellow cruise pax the length of time that is remaining on the exposed persons “quarantine.” I heard that it’s been 19 days since she handled Duncan’s specimens, so it’s just two more days. This is assuming she dies not develop Ebola symptoms.</p>
<p>It’s easy to mock, but that’s how the word quarantine originated - European countries would make ships wait 40 days before letting them dock during the Black Death.</p>
<p>^^Let’s just close all our borders, stop all flights in and quarantine everybody for the next 21 days. That should take care of the problem. Wait, that belongs on the Hysteria thread.</p>
<p>Now if the nephew called CDC during the second visit, I have to agree that it’s odd. Duncan and the family don’t say a word about Ebola while in the hospital and the nephew calls CDC to accuse the hospital not taking it seriously? I am sure one can make an argument for the family if one really believes them. To a casual observer, it’s certainly an odd sring of events.</p>
<p>Jumping in late on the “czar” thing but here goes nothing . . . It seems like we have lots of health care professionals and not enough people who are used to running the show and pulling together all the disparate strings of information and centers of potential action. I would think this needs someone with a broader influence who can get the info from the healthcare experts then interface with the congress, president, states and municipalities, private businesses that have been impacted and other countries. I know nothing about the guy who was chosen so I’m not giving a thumbs up or down on that but a project manager / facilitator seems in order.</p>
<p>I agree. I was also thinking about what kind of person would WANT to take on this challenge? The stakes are incredibly high…what if things get worse? A lot of blame will be laid at the feet of the czar. That’s a lot to take on.</p>