Ebola algorithm for the evaluation of the returned traveler: Difference between revisions
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==Overview== | ==Overview== | ||
The CDC has developed an algorithm for the evaluation of the returned traveler that can be used to stratify patients according to their risk of exposure and triage them urgently to the appropriate level of care.<ref name= | The Centers for Disease Control and Prevention (CDC) has developed an algorithm for the evaluation of the returned traveler that can be used to stratify patients according to their risk of exposure, test them for Ebola when indicated, and triage them urgently to the appropriate level of care.<ref name=CDC1>{{cite web |url=http://www.cdc.gov/vhf/ebola/pdf/ebola-algorithm.pdf|title=Algorithm for the Evaluation of the Returned Traveler|last1= |first1= |last2= |first2= |date= |website=www.cdc.gov |publisher=Centers for Disease Control and Prevention (CDC) |accessdate=October 28 2014}}</ref> | ||
==Algorithm== | ==Algorithm For Returned Travelers== | ||
Shown below is the Centers for Disease Control and Prevention (CDC) algorithm for the evaluation of the returned traveler developed by the CDC.<ref name=CDC1>{{cite web |url=http://www.cdc.gov/vhf/ebola/pdf/ebola-algorithm.pdf|title=Algorithm for the Evaluation of the Returned Traveler|last1= |first1= |last2= |first2= |date= |website=www.cdc.gov |publisher=Centers for Disease Control and Prevention (CDC) |accessdate=October 28 2014}}</ref> Click '''[http://www.cdc.gov/vhf/ebola/pdf/ebola-algorithm.pdf here]''' to access the PDF version of the CDC algorithm and print it. | |||
{{Family tree/start}} | {{Family tree/start}} | ||
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{{Family tree | | | | | |!| | | | | | | }} | {{Family tree | | | | | |!| | | | | | | }} | ||
{{Family tree | | | | | D01 | | | | | | D01= Determine the risk of exposure}} | {{Family tree | | | | | D01 | | | | | | D01= Determine the risk of exposure}} | ||
{{Family tree | |,|-|-|-| | {{Family tree | |,|-|-|-|+|-|-|-|.| | | }} | ||
{{Family tree | E01 | | E02 | | E03 | | E01= '''HIGH-RISK EXPOSURE'''| E02= '''LOW-RISK EXPOSURE'''| E03= '''NO KNOWN EXPOSURE'''}} | {{Family tree | E01 | | E02 | | E03 | | E01= '''HIGH-RISK EXPOSURE'''| E02= '''LOW-RISK EXPOSURE'''| E03= '''NO KNOWN EXPOSURE'''}} | ||
{{Family tree | |!| | | |!| | | |!| | | }} | {{Family tree | |!| | | |!| | | |!| | | }} | ||
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Direct skin contact with, or exposure to [[blood]] or body fluids of, an EVD patient<br> | Direct skin contact with, or exposure to [[blood]] or body fluids of, an EVD patient<br> | ||
OR<br> | OR<br> | ||
Processing blood or body fluids from an EVD patient without appropriate personal protective equipment (PPE) or biosafety precautions<br> | Processing blood or body fluids from an EVD patient without appropriate personal protective equipment ([[Ebola primary prevention|PPE]]) or biosafety precautions<br> | ||
OR<br> | OR<br> | ||
Direct contact with a dead body (including during funeral rites) in an Ebola affected area without appropriate PPE</div>| F02=<div style="float: left; text-align: left; width: 20em; padding:1em;"> | Direct contact with a dead body (including during funeral rites) in an Ebola affected area without appropriate [[Ebola primary prevention|PPE]]</div>| F02=<div style="float: left; text-align: left; width: 20em; padding:1em;">Household members of an EVD patient and others who had brief direct contact (e.g., shaking hands) with an EVD patient without appropriate [[Ebola primary prevention|PPE]] <br> | ||
OR<br> | OR<br> | ||
Healthcare personnel in facilities with confirmed or probable EVD patients who have been in the care area for a prolonged period of time while not wearing recommended [[Ebola primary prevention|PPE]]</div>| F03=<div style="float: left; text-align: left; width: 20em; padding:1em;">Residence in or travel to affected areas without HIGH- or LOW-risk exposure</div>}} | |||
{{Family tree | | |!| | | |!| |!| | | | }} | {{Family tree | | |!| | | |!| |!| | | | }} | ||
{{Family tree | | |!| | | | F01 | | | | F01=<div style="float: left; text-align: left; width: 20em; padding:1em;">Review case with Health Department including: <br> | {{Family tree | | |!| | | | F01 | | | | F01=<div style="float: left; text-align: left; width: 20em; padding:1em;">Review case with Health Department including: <br> | ||
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{{Family tree | | |!| | H01 | | H02 | | H01= Yes| H02= No}} | {{Family tree | | |!| | H01 | | H02 | | H01= Yes| H02= No}} | ||
{{Family tree | | |!| |!| | | | |!| | | }} | {{Family tree | | |!| |!| | | | |!| | | }} | ||
{{Family tree | | | I01 | | | | I02 | | I01= <div style="float: left; text-align: left; width: 20em; padding:1em;">'''TESTING IS INDICATED'''<br><br> | {{Family tree | | | I01 | | | | I02 | | I01= <div style="float: left; text-align: left; width: 20em; padding:1em;"><span style="color:red">'''TESTING IS INDICATED''' </span><br><br> | ||
• The health department will arrange specimen transport and testing at a Public Health Laboratory and CDC.<br> | • The health department will arrange specimen transport and testing at a Public Health Laboratory and CDC.<br> | ||
• The health department, in consultation with [[CDC]], will provide guidance to the hospital on all aspects of patient care and management</div>| I02=<div style="float: left; text-align: left; width: 20em; padding:1em;">'''TESTING IS NOT INDICATED'''<br><br> | • The health department, in consultation with [[CDC]], will provide guidance to the hospital on all aspects of patient care and management</div>| I02=<div style="float: left; text-align: left; width: 20em; padding:1em;"><span style="color:red">'''TESTING IS NOT INDICATED''' </span><br><br> | ||
''If patient requires in-hospital management:''<br> | '''''If patient requires in-hospital management:'''''<br> | ||
• Decisions regarding infection control precautions should be based on the patient’s clinical situation and in consultation with hospital infection control and the health department<br> | • Decisions regarding infection control precautions should be based on the patient’s clinical situation and in consultation with hospital infection control and the health department<br> | ||
• If patient’s symptoms progress or change, re-assess need for testing with the health department<br><br> | • If patient’s symptoms progress or change, re-assess need for testing with the health department<br><br> | ||
''If patient does not require in-hospital management''<br> | '''''If patient does not require in-hospital management'''''<br> | ||
• Alert the health department before discharge to arrange appropriate discharge instructions and to determine if the patient should self-monitor for illness<br> | • Alert the health department before discharge to arrange appropriate discharge instructions and to determine if the patient should self-monitor for illness<br> | ||
• Self-monitoring includes taking their temperature twice a day for 21 days after their last exposure to an Ebola patient</div>}} | • Self-monitoring includes taking their temperature twice a day for 21 days after their last exposure to an Ebola patient</div>}} | ||
{{Family tree/end}} | {{Family tree/end}} | ||
<sup>Algorithm adapted from the Centers for Disease Control and Prevention: Algorithm for Evaluation of the Returned Traveler.<ref name=CDC1>{{cite web |url=http://www.cdc.gov/vhf/ebola/pdf/ebola-algorithm.pdf|title=Algorithm for the Evaluation of the Returned Traveler|last1= |first1= |last2= |first2= |date= |website=www.cdc.gov |publisher=Centers for Disease Control and Prevention (CDC) |accessdate=October 28 2014}}</ref></sup> | |||
==References== | ==References== | ||
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[[Category:Hemorrhagic fevers]] | [[Category:Hemorrhagic fevers]] | ||
[[Category:Needs overview]] | [[Category:Needs overview]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} |
Latest revision as of 17:37, 18 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
The Centers for Disease Control and Prevention (CDC) has developed an algorithm for the evaluation of the returned traveler that can be used to stratify patients according to their risk of exposure, test them for Ebola when indicated, and triage them urgently to the appropriate level of care.[1]
Algorithm For Returned Travelers
Shown below is the Centers for Disease Control and Prevention (CDC) algorithm for the evaluation of the returned traveler developed by the CDC.[1] Click here to access the PDF version of the CDC algorithm and print it.
Is there a FEVER (subjective or ≥101.5°F or 38.6°C) or compatible EVD symptoms (headache, weakness, muscle pain, vomiting, diarrhea, abdominal pain or hemorrhage) in a patient who has traveled to an Ebola-affected area in the 21 days before illness onset? | |||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||
1. Isolate patient in single room with a private bathroom and with the door to hallway closed 2. Implement standard, contact, and droplet precautions (gown, facemask, eye protection, and gloves) | Report asymptomatic patients with high- or low-risk exposures in the past 21 days to the health department | ||||||||||||||||||||||||
Determine the risk of exposure | |||||||||||||||||||||||||
HIGH-RISK EXPOSURE | LOW-RISK EXPOSURE | NO KNOWN EXPOSURE | |||||||||||||||||||||||
Percutaneous (e.g., needle stick) or mucous membrane contact with blood or body fluids from an EVD patient OR | Household members of an EVD patient and others who had brief direct contact (e.g., shaking hands) with an EVD patient without appropriate PPE OR | Residence in or travel to affected areas without HIGH- or LOW-risk exposure | |||||||||||||||||||||||
Review case with Health Department including: • Severity of illness | |||||||||||||||||||||||||
Is EVD suspected? | |||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||
TESTING IS INDICATED • The health department will arrange specimen transport and testing at a Public Health Laboratory and CDC. | TESTING IS NOT INDICATED If patient requires in-hospital management: | ||||||||||||||||||||||||
Algorithm adapted from the Centers for Disease Control and Prevention: Algorithm for Evaluation of the Returned Traveler.[1]
References
- ↑ 1.0 1.1 1.2 "Algorithm for the Evaluation of the Returned Traveler" (PDF). www.cdc.gov. Centers for Disease Control and Prevention (CDC). Retrieved October 28 2014. Check date values in:
|accessdate=
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