Ebola Virus Disease (EVD) has been a leading concern for most of you lately, and over the last few weeks the CRTO has received many inquiries from RTs across the province. The concerns ranged from questions about ‘Duty to Care’, to inclusion of RTs in preparation/training for managing a patient with Ebola in an Ontario hospital. In response, the CRTO has consulted broadly – including a meeting with the Chief Medical Officer of Health (CMOH) – to identify the practice issues RTs face, understand the provincial and federal response, and ensure that RTs have the information needed to practise safely and effectively. The following FAQs on Ebola and RT Practice in Ontario addresses some of the questions and concerns the CRTO has received in recent weeks.
Will RTs receive direct and/or specific instructions from the Ministry of Health and Long-Term Care (MOHLTC) regarding the Ebola situation in Ontario?
In short, specific direction on the majority of RT-related care activities will not be forthcoming from the MOHLTC in regards to Ebola. Rather, RTs need to be aware of the guidelines and resources available, while using your expertise and clinical judgment to apply them in your own workplace.
For example, the resources provide guidance on the PPE that should be worn when performing an aerosol- generating procedure (AGP). Since most activities performed by an RT in a critical care setting have the potential to be an AGP, it would be reasonable to wear the prescribed PPE in those instances.
What guidelines and resources on Ebola should I refer to and be familiar with?
Because the MOHLTC will not be providing specific direction on Ebola and RT-related activities, RTs should instead be familiar with the guidelines and resources available and use their specialized expertise in their particular work environment. The CRTO receives regular updates from the MOHLTC and CMOH, as well as the Public Health Agency. We post the latest Ebola updates, information and directives on our website in the Emergency Preparedness section.
CMOH Directives are meant to provide general guidance to all clinicians and facilities on managing patients with Ebola. They are meant to apply broadly to all practice settings and are not a prescriptive or procedure
For more information please contact Carole Hamp, Manager of Quality Practice at email@example.com or 416-591-7800 x 33.
manual for every clinical activity. Considering the complexity of our health care system and the number of potential interventions, this would simply be unrealistic. Instead, the CMOH Directives provide guiding principles and evidence-based practices that should form the backbone of clinical decision-making.
Several other sources of information can be used to supplement these Directives and should be considered as well (i.e. The CCS-CCPI-AMMI Ebola Clinical Care Guidelines from August 2014 and Public Health Agency documents).
If any specific questions arise that are no addressed in existing literature, RTs should also liaise with Infectious Disease/Infection Prevention and Control agencies within their facilities to develop evidence- informed answers and solutions.
How can we find out what other facilities or sites are doing?
Communication, information-sharing and networking with other RTs is absolutely essential in situations like this, as well as widely sharing your own approaches, solutions and protocols. At a minimum, RT departments in the designated hospitals should be in regular contact with each other (which we recognize is already occurring). We also encourage RTs to use existing mechanisms for sharing information, such as the CSRT listserve, for example.
What if RTs are not being included in Ebola training/preparation at my facility?
On this topic, you must resolve and negotiate these issues within your own facilities, where the principles of minimizing exposure should be balanced against preparing those who will be involved in caring for these patients. RTs can also use their specialized body of knowledge to take a leadership role in advocating for the implementation of evidence-based best practices.
As stated on the Public Health website, the Ebola risk for Ontarians (and Canada) remains low. However, it’s important that RTs continue to read the evidence, develop their practice and share information as much as possible. Thank you for contacting the CRTO with your thoughts and concerns, and if you have any further questions please contact Carole Hamp, Manager of Quality Practice at firstname.lastname@example.org or 416- 581-7800 ext. 33.