EBOLA ACTION CARD: IN-PATIENTS AND HEALTH CENTRES
What to do if you suspect a patient or service user has Ebola:
WHO IS THIS ACTION CARD AIM AT?
This Action Card has been issued to provide LPT staff and receptionists with
instructions on what to do in the event that a patient self presents at a hospital
or health centre with Ebola like symptoms (see Identifying Suspected Ebola
Patients box below).
IDENTIFYING SUSPECTED EBOLA PATIENTS
Do any of these conditions apply to the patient / service user?
Ebola should be suspected in patients presenting to primary care services who
have a fever of ≥37.5°C OR have a history of fever in the past 24 hours AND
have recently visited any of the affected areas (Sierra Leone, Guinea and Liberia
as of 25th November 2014) within the previous 21 days.
OR
Have a fever of ≥37.5°C OR have a history of fever in the past 24 hours AND
have cared for/come into contact with body fluids of/handled clinical specimens
(blood, urine, faeces, tissues, laboratory cultures) from an individual or laboratory
animal known or strongly suspected to have VHF.
INFECTION RISK
Ebola is transmitted by direct contact with the blood or bodily fluids of an
infected person (alive or dead). People infected with Ebola can only
spread the virus to other people once they have developed symptoms,
such as fever. Even if someone has symptoms, it’s important to remember
that the virus is only transmitted by direct contact with the blood or body fluids
of an infected person. The incubation period of Ebola ranges from 2 to 21
days.
In the event of exposure to potentially infectious bodily fluids seek
advice: In-hours: Contact the LPT Infection Control Team on 0116 2951668.
 Out of hours: Contact Public Health England on 0344 225 4524
Also contact your line manager / On-call Manager to inform them.
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Amanda Hemsley, Senior Nurse Advisor – Infection Prevention and Control
Kevin Robotham – Emergency Planning Manager
V1 1 December 2014
ACTIONS TO FOLLOW
WHAT TO DO IF A PATIENT PRESENTS TO A PREMISES IN PERSON
Any patients that identify themselves to reception or clinical staff as being
unwell with a fever and having visited an area affected by Ebola in the past 21
days should not sit in the general waiting room.
 These patients should be directed to and isolated in a side room.
 Refrain from contact but reassure the patient that medical assistance is on
its way.
 All staff dealing with the patient should follow hand hygiene protocols.
 If necessary for LPT clinical staff to interact (But do not provide clinical
interventions) with the patient, utilise personal protective equipment
(PPE) (gloves, face mask and apron). Note: PPE Grab boxes are located
in LPT sites where there is an Urgent Care Centre or Minor Injuries Unit.
IF NO URGENT CARE
CENTRE / MINOR
INJURY UNIT / GP
PRACTICE ON SITE.
IF URGENT CARE
CENTRE / MINOR
INJURY UNIT / GP
PRACTICE ON SITE.
Contact the UCC / MIU / GP to
inform them that a suspected
Ebola patient is on site.
IF NOT
AVAILABLE
Receptionist to alert LPT
senior nurse / manager.
Senior nurse / manager to
Call 111 to seek advice.
They should triage the patient
to determine risk of Ebola.
They will ask you a number of
questions in order to
establish the likelihood that
the patient has Ebola.
SUSPECTED EBOLA
PATIENT
ISOLATE IN A SIDE ROOM
DEEMED AS
NOT HAVING
EBOLA
SUSPECTED EBOLA
PATIENT
ISOLATE IN A SIDE ROOM
UCC / MIU / GP may take
over responsibility of
patient.
HOWEVER, FOLLOW
ACTIONS ON
FOLLOWING PAGES
Treat the patient as a
non-Ebola patient
FOLLOW ACTIONS
ON FOLLOWING
PAGES
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Amanda Hemsley, Senior Nurse Advisor – Infection Prevention and Control
Kevin Robotham – Emergency Planning Manager
V1 1 December 2014
PATIENT TRIAGED AS A SUSPECTED EBOLA PATIENT
111 / Urgent Care Centre will arrange for the transfer by ambulance of
the patient to an acute hospital.

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
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The patient is to remain in isolation until arrival of the ambulance.
Refrain from contact but reassure the patient that medical assistance is on
its way.
All staff dealing with the patient should follow hand hygiene protocols.
If necessary for LPT clinical staff to interact (But do not provide clinical
interventions) with the patient, utilise personal protective equipment
(PPE) (gloves, face mask and apron). Note: PPE Grab boxes are located
in LPT sites where there is an Urgent Care Centre or Minor Injuries Unit.
A record should be taken of any patients, visitors or staff who was present
and may have been exposed to bodily fluids.
If the patient’s conditions deteriorate (vomiting, diarrhoea) having
spoken to 111, alert 111 immediately. Inform the ambulance crew on
their arrival.
ALERT SENIOR MANAGERS / INFECTION CONTROL



Inform your line manager (out of hours ensure the on call manager is
informed).
In hours - Inform LPT Infection Control Team on 0116 295 1668.
Notify Public Health England on 0344 225 4524.
USE OF ROOMS FOLLOWING SUSPICION OF EBOLA
Once the suspected case has been transferred to an acute hospital, the room
in which the patient has been isolated or any potentially contaminated areas
should not be used until a diagnosis of Ebola has been excluded. If the
diagnosis is confirmed, specific advice on decontamination must be sort from
the LPT Infection Control Team (out of hours from Public Health England).
 if the patient has symptoms limited to fever with no vomiting or diarrhoea, then high contact surfaces such as door handles or touch screens
should be wiped using standard disinfectants using standard precautions
but the premises does not need to be closed
 The room in which the patient was isolated and the toilets if they have
been used by the patient should not be used pending discussion with the
LPT Infection Control Team or local Public Health England team. However, rest of the premises can be used.
 If the patient meets the criteria for a suspected case and has symptoms
such has vomiting, diarrhoea and or bleeding. Close the affected area and contact LPT Infection Control Team (or Public Health England out
of hours) for advice.
 Ensure the cleaning / domestic staff have been informed so that they
do not clean up any waste bodily fluids until further advice is sought
from LPT Infection Control Team or Public Health England.
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Amanda Hemsley, Senior Nurse Advisor – Infection Prevention and Control
Kevin Robotham – Emergency Planning Manager
V1 1 December 2014
DEALING WITH SOILED CLOTHING
If the patient spills bodily fluids on their clothing: Wear PPE (gloves, face masks, apron, eye protection).
 Leave a clinical waste bag and gown in room.
 Instruct them to place the soiled clothing in the clinical waste bag.
 Instruct them to put on the gown.
 If the patient has vomited, bled or had diarrhoea since alerting 111 or
Urgent Care Centre / Minor Injury Unit, inform them immediately of the
change in the patient’s condition.
 Inform the Ambulance Crew on their arrival of changes / deterioration in
the patient’s condition, especially if potentiality infectious bodily fluids are
present.
 The waste bag is to be left in the room (Inform the Ambulance Crew as
they may need to take it with them). Otherwise leave in the room and seek
advice from LPT Infection Control Team / Public Health England
DECONTAMINATION OF ROOM
Cleaning and decontamination of any rooms in which a patient suspected of
having Ebola has been isolated, or any facilities used by the patient, should
be discussed with the LPT Infection Prevention and Control Team (or out of
hours with the Public Health England).
Once the suspected case has been transferred to an acute hospital other patients and staff must not use the room in which the patient has
been isolated or any potentially contaminated areas until they have been
decontaminated. This includes toilets and other high contact surfaces such
as door handles and telephones used by the suspected case.
The full risk assessment and initial investigations at hospital may rapidly exclude Ebola (though may take at least 24 hours); at which point it may be
clear that specific decontamination of the room is not required. The room
must be quarantined if the patient is being tested for Ebola. If the diagnosis is confirmed, then specific advice on decontamination will be provided by
the LPT Infection Prevention and Control Team or Public Health England.
Public areas where the suspected case has passed through and spent
minimal time in (such as corridors) but which are not visibly contaminated with
bodily fluids do not need to be specially cleaned and disinfected.
KEY CONTACT NUMBERS
For the Public - NHS 111
111
LPT Infection Prevention and Control
0116 2951668
Public Health England
0344 225 4524
LPT Divisional On-Call Managers
Via 0116 225 6000
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Amanda Hemsley, Senior Nurse Advisor – Infection Prevention and Control
Kevin Robotham – Emergency Planning Manager
V1 1 December 2014