ER Ebola Quarantine Screening Tool: A CDC Guide for Healthcare Workers

Atlanta, GA --  Just one day after the viral release of Who To Blame When You Get Ebola, the CDC has released a follow up ER Ebola screening tool to help emergency departments determine which patients need to be quarantined immediately.  Fear continues to grip the country after two nurses at a Dallas, Texas hospital contracted Ebola virus in the course of their normal workday activities.

"We know, without a doubt, this  all inclusive and fail proof ER Ebola screening tool will help healthcare workers know when to immediately initiate quarantine protocols.  There's no way anyone will be missed if this protocol is not broken,"  said Tom Frieden, Director of the CDC, being careful to avoid use of the word 'breached'.

The CDC has been under constant attack after blaming a breach in protocol as the cause of Ebola  transmission at Texas Health Presbyterian Hospital.  The White House has since responded by  organizing Ebola SWAT teams ready to travel anywhere in the country and hunt down healthcare workers who call in sick after Ebola strikes their hospital.    The White has even appointed a lawyer, Ron Klain, as this nation's  Ebola Czar to help triage lawsuits against community hospitals for failing to keep their yellow gown supply closet fully stocked during an outbreak of Ebola.

Not everyone is convinced the quarantine tool goes far enough.  "They should have just quarantined the whole country of Texas," said Rusty Bender, a college graduate living with his mother despite a Bachelor of Fine Arts degree.

EBOLA ER QUARANTINE TOOL photo.



BREAKING NEWS UPDATE!

In response to public criticism, the CDC has updated their Ebola ER quarantine tool to yield a greater net of protection.

"Retrospectively, we realized our original protocol failed to account for the possibility of some folks traveling out of Dallas to other communities, which we just didn't think of at the time," said Tom Frieden, in a hastily called news conference while wearing full barrier protection at his home.

The CDC is asking healthcare professionals to ask ER patients if they have come in contact with Ebola in the last 3 weeks.  The CDC understands most patients will have no idea and have accounted for this possibility in their updated guidelines.

"We want to be as thorough as possible and not have people who may have Ebola infecting our planes, trains and automobiles." said Mr. Frieden.

The CDC offered little guidance regarding the risk of coming into contact with Ebola, except to say anyone who witnesses a healthcare worker wearing scrubs at a grocery store should keep a large perimeter distance and to yell 'EBOLA", then call 911 if they see them coughing or sneezing.


 Updated ER Ebola Quarantine Screening Tool from the CDC (algorithm)



Ebola Halloween Hazmat Costumes Sell Out: CDC Found Hoarding Them.

Atlanta, GA --  Hours after Mark Zuckerberg donated $25 million dollars to the Centers for Disease Control and Prevention (CDC) to fight Ebola virus, Amazon sold out of Ebola hazmat costumes and thousands of Halloween shops from Los Angeles to New York confirmed brisk sales for Ebola gear ranging from age 3 months to XXXL.

Ebola Halloween Costumes Seen Helping Hospitals
After telling reporters his agency must 'rethink the way we address Ebola infection control', CDC Director Tom Frieden has confirmed he authorized spending all 25 million dollars on over-the-counter Ebola costumes.

In a news conference yesterday, the CDC proudly announced their well planned protocol to protect healthcare workers using Ebola costumes, describing them as 'full barrier protection gear with a Tyvek suit, eye protection, 2 Surgical masks, 2 Pairs of gloves, booties, Duct tape and plastic bin for easy storage.'

"We want doctors and nurses to be like, 'Damn. love your Ebola gear!" said the reliable source high inside the ranks of the CDC.

Some CDC employees knew a major policy shift was planned days before details were confirmed at the news conference.   Sarah Stenson, a CDC employee laid off yesterday for saying the word 'Ebola' out loud during work, a no-no, confirmed seeing several employees playing with bright yellow Ebola Hazmat outfits that looked identical to the ones she bought her 3 and 8 year-old boys for Halloween.

"My boss asked me last week how to sign up for Amazon Prime and now these Ebola costumes  show up on his desk complete with goggles, air mask, gloves and full body suit.  Coincidence?  I think not."

The CDC has acknowledged a need to better protect hospital workers against Ebola as a second healthcare worker at Texas Presbyterian Hospital tested positive for Ebola virus after caring for Eric Thomas Duncan, the Liberian who has since passed away of this deadly disease.

Rapid response teams within the CDC are now prepared to travel anywhere at a moment's notice to drop off enough Ebola costumes for 14 of the required 21 days of isolation.  However, due to the national shortage in Ebola costumes, the CDC is asking hospitals to recycle the gloves and suits by "turning them inside out' when supplies run low.

"We are also asking hospitals to return their Ebola costumes to CDC headquarters once the coast is clear so we can wash them out and give them to other hospitals that are in dire need of barrier protection," said Mr. Frieden proudly.



Who To Blame When You Get Ebola: A CDC Guide For Healthcare Workers

Atlanta, GA -- The Centers for Disease Control and Prevention (CDC) announced new flowchart guidelines Monday to help healthcare workers understand who they could  blame once they contract Ebola in the hospital setting.  The new recommendations follow declarations by Dr Thomas Friedman, Director of the U.S. Centers for Disease Control and Prevention, that nurse Nina Pham in a Dallas, Texas hospital contracted Ebola due to 'protocol breach' while caring for the now deceased Ebola victim Thomas Eric Duncan.

Nurses are used to getting blamed for everything.  In fact, most nursing programs teach nurses how to take one for the team when bad things happen.  Getting blamed for spreading Ebola is naturally accepted by most nurses as business as usual.

"After speaking with representatives from the American Nurses Association, everyone agreed blaming nurses for spreading Ebola was just the easiest thing to do," said Jason Fenster, a CDC spokesman who blamed his nurse last year for undercooked eggs while hospitalized for an undisclosed infection contracted at a CDC laboratory.

Following the release of these CDC guidelines,  officials at the Dallas, Texas hospital confirmed they are probably going to blame three or four nurses for spreading Ebola while taking care of Mr. Duncan, including one on maternity leave for the last six weeks.

"I've been in the hospital CEO business for 30 years.  Whenever bad things happen in a hospital setting,  we can count on at least one nurse to take the fall.  In fact, I'm so confident that a nurse is always at fault, we built an entire section into our hospital rules and regulations titled 'How To Blame a Nurse For Anything Bad That Could Lead To A Lawsuit," said Jed Brainer, CEO of Texas Presbyterian Hospital.

A spokesman at the CDC, who wished to remain anonymous, says guidelines to be released next week  for non-healthcare workers and pets who contract Ebola will likely blame nurses as well.

You can purchase this original algorithm as a t-shirt at The Happy Hospitalist Zazzle store here. It's also available as a coffee mug too! 


"Who to Blame When You Get Ebola:  A CDC Guide for Healthcare Workers"

Who to blame when you get Ebola.  A CDC guide for healthcare workers flowchart humor photo.


Make sure to check out the complete collection of original Ebola humor memes, stories and commentary only from The Happy Hospitalist.


Respiratory Rate of 20 Charted In Dead Patient Leaves Hospital Officials Baffled.

Babylon, NY --  Death pronouncements at most hospitals require a bedside patient evaluation to verify the absence of spontaneous respirations, but a death last week with a final respiratory rate of 20 documented in the electronic medical record (EMR)  has officials at Methodist Hospital scrambling for answers.

EMR DOCUMENTATION
"We have no idea how a dead person could have a respiratory rate of 20 documented in our EMR,"  said Lance Dugan, the Methodist Hospital CEO with no experience in medical documentation.

An outside consulting firm with specialized training in after-death EMR documentation has been  hired to lead the investigation, but hospital nurses believe they already know the answers.

"If you look at the drop down menu for respiratory rate it says, 'You have set your default respiratory rate to 20.  Would you like to change it?'", said a nurse at the hospital who wished to remain anonymous because diagnosing EMR issues was not within her scope of practice.

"Most nurses created a default respiratory rate during EMR orientation last year.    Some nurses chose 16.  A few chose an odd number like 17 to make it seem believable.  But, I'd say 90% of us chose 20  like we did on the old paper charts."

Many EMR systems allow automation of daily charting activities.    A closer look at the Methodist Hospital EMR discovered a glitch that doesn't prompt the nurse to change her default respiratory rate vital sign field in the event of a death pronouncement, a critical error I.T. officials said would be fixed by the end of the day.

"We have asked our vendor to modify the respiratory rate field to include a default option for death pronouncements,"  said Mary Jennings, an I.T. representative with no experience in medical documentation.

"In addition, some nurses have suggested we change default respiratory rate settings to simply 'low or high' and that change is currently under serious consideration."

The New York State Nursing Board has come out in support of default respiratory rate settings in EMR vital sign fields and feels Methodist Hospital is to blame for not providing respiratory rate death options in their electronic record.

"Our New York nurses are simply too busy to count to 20.  We will continue to push for all technology that provides for more automated charting opportunities and less bedside activities for our members,"  said Nancy Schneider, a nurse with no experience in medical documentation.

"Your charting shows a respiratory rate of 20.  The lie detector determined that was a lie."

Your charting shows a respiratory rate of 20.  The lie detector determined that was a lie humor meme photo.



Pre-Hospice Cardiac Clearance Recommended By American College of Cardiology.

Nashville, TN  --  The American College of Cardiology (ACC) created havoc Wednesday with  a landmark position paper recommending all patients considering hospice undergo pre-hospice cardiac clearance prior to initiating comfort care measures.  The College's expansion into pre-hospice evaluations coincides with Medicare's announcement of another 20% cut in reimbursement for cardiac services by 2016.

"While the A.C.C. doesn't have any hard data to prove this hypothesis, we believe hospice candidates who undergo thorough cardiac clearance prior to starting a comfort care program will really appreciate knowing their ejection fraction, the health of their heart valves, whether they are at risk for myocardial infarction  and the potential for any rhythm issues that could complicate their hospice program," said Raj Chopra, M.D, M.P.H, F.A.C.C, Chair of the Task Force on Clinical Expert Consensus Documents.

Position publications by medical societies often provide support for their members  despite a lack of strong clinical research to base their conclusions.  Many position papers contain low grade evidence or expert opinion that becomes standard of care in many communities.

"We actually prefer publishing position papers using expert opinion rather than Grade A evidence because, to the lay physician,  having the word 'expert' in the paper carries more weight," said Raj, a self proclaimed expert in the benefits of end-of-life pacemaker therapy.

Because hospitalists are frequently involved with palliative care decisions, the A.C.C. has been working closely with The Society of Hospital Medicine (SHM) to disseminate continuing medical education modules on pre-hospice cardiac clearance.  In return for their support, S.H.M. is begging A.C.C. members to stop publishing cardiac studies with acronyms that spell out words.

"The acronyms used to be cute, but now they're just annoying," said one SHM board member, who wished to remain anonymous.

The American Academy of Hospice and Palliative Care responded by recommending patients considering hospice rip off their telemetry and play dead already if any cardiologist came to their hospital room.