Twin Cities first responders ramp up for possible Ebola cases

As national, state and local leaders debate quarantines and other measures to combat Ebola, Twin Cities first responders have ­quietly introduced new protocols and reinforced existing ones.

This month, 911 dispatchers began asking callers about fever and international travel before first contact is made with patients and then relaying that information to paramedics, firefighters and police officers. Their new measures are steeped in science and incorporate lessons learned in other U.S. cities, they say.

Hennepin Emergency Medical Services (EMS) ambulances, which respond to 65,000 calls a year in Minneapolis and 13 southern and western suburbs, are now equipped with infectious-disease kits packed with protective gear to cover exposed skin and eyes as well as high-quality masks that filter out droplets of bodily fluids.

Allina Health Emergency Medical Services, which provides ambulance service to thousands of people in suburban and rural parts of the state, also has repackaged protective gear and is following the latest guidelines from the U.S. Centers for Disease Control and Prevention.

When fever and a history of international travel are present, the number of people exposed to a patient is kept to a minimum, said Hennepin EMS spokesman Robert Ball.

"That may mean not sending in a full complement of police officers, paramedics and firefighters," Ball said. "There may be a single police officer or firefighter and one of our paramedics going in to assess the [patient] and remove them."

Brian LaCroix, president of Allina Health EMS, said: "It's taking the appropriate precautions, but precautions based on science, not hysteria."

Ball stresses that Twin Cities paramedics see many infectious diseases — tuberculous, SARS, Lassa fever and Middle Eastern Respiratory Syndrome. They're ready for them all. "Possible TB cases are a once-a-week occurrence, and TB is actually airborne, unlike Ebola," he said.

"We haven't spoken publicly about Ebola," he said. "What we don't want to do is feed into the panic. We are not talking a lot about it publicly, but it doesn't mean we aren't working to be well-prepared."

This summer, the Brooklyn Park fire chief announced that first responders would ask about fever and international travel and would don protective gear when needed. The northern suburbs of the Twin Cities are home to the largest Liberian population outside of Africa. Liberia, Guinea and Sierra Leone are the epicenter of the Ebola outbreak.

Having kits ready

The Hennepin EMS changes are tweaks on existing procedures. "They went into play in the beginning of October as we were working on ways to ensure we are ­providing the best response we can," said Ball.

About a year ago, paramedics started asking about fever and foreign travel when they arrived on the scene of a medical emergency, but that didn't provide first responders with any prep time. The new policy builds in additional reaction time. The personal protective gear — gowns, gloves, hoods, masks and eye shields, and foot coverings — also has been reorganized so paramedics have everything they need immediately available.

"The goal is to make sure we don't have any exposed skin," Ball said. "We've carried forms of that equipment all the time. What we've done is rebuild it into particular kits. We are just repackaging it in a way that is easier for our staff to access it in one stop."

Paramedics also will place some protective gear, including surgical masks, on patients. And patients will be swaddled in bedding to prevent contact with bodily fluids.

One new protocol is simply to use the buddy system when suiting up and undressing after contact with a patient who may have an infectious disease.

"What we've learned from incidents elsewhere, whether it be Dallas or the folks working in West Africa, is to make sure you have an extra set of eyes on the procedures — a buddy check," Ball said. "We are human. The last thing you want to do is have one small error get you sick."

'We are prepared'

LaCroix, with Allina Health EMS, compared reaction to Ebola to that accompanying the emergence of HIV in the United States. At first, fear and anxiety were strong, but then first responders and health care workers moved to protect themselves with gloves and new protocols.

"Before HIV, health care workers didn't wear gloves," LaCroix said. "Most of us remember going to the dentist when they didn't wear gloves."

Today, that's unthinkable. With Ebola, medical professionals will again look at the science and make adjustments to stay protected.

"We are talking to our staff all the time," LaCroix said. "They are on the same continuum as the general public. Some people have heightened concerns; some say it's part of the job. They are well-educated on how to keep themselves safe."

LaCroix's message to the public about Ebola: "We've had a total of one person die of Ebola in the United States. We have 40,000 people die of influenza in a year. We need to keep this in perspective. We are prepared for Ebola.

"Now, did you get your flu shot?"

Shannon Prather • 612-673-4804