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<< Ebola Virus Disease: Epidemiology, Clinical Presentation, and Diagnostic and Therapeutic Modalities (Pharmacology CME)

Emergency Department Evaluation

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Emergency Department Evaluation

Emergency Department Evaluation

Local or state health departments should be contacted immediately any time EVD is suspected in order to coordinate testing for Ebola and transfer of the patient to a designated Ebola assessment hospital or treatment center, if appropriate. In the United States, a patient already identified as a person under investigation (PUI) for EVD should be cared for in an Ebola assessment hospital or Ebola treatment center.44 Nonetheless, all acute healthcare facilities should be prepared to identify and safely care for a person with suspected EVD.

After stabilization of vital signs, the next step in the evaluation of patients with possible EVD is determination of risk category. This is best accomplished by taking a thorough epidemiologic history, with special focus on any recent travel to countries with widespread Ebola or contacts with signs or symptoms of EVD. The CDC has designated 4 risk categories: high risk, some risk, low risk, and no identifiable risk, which are described in Table 3.

Table 3_ Epidemiologic Risk Categories For Ebola Virus Disease

Available at: http://www.cdc.gov/vhf/ebola/exposure/risk-factors-when-evaluating-person-for-exposure.html

Once the risk level is determined, attention should be turned to assessment of clinical signs and symptoms. Prospective data on the clinical presentation of EVD in children are lacking at this time; however, available data suggest a presentation similar to that seen in adults.The early signs and symptoms of EVD are nonspecific and typically appear 6 to 12 days after exposure (range 2-21 days), though asymptomatic infection has been described.14,45-47 In 20 confirmed cases of pediatric EVD in Uganda, fever was the most common finding, followed by weakness, loss of appetite, nausea and vomiting, cough, and diarrhea.22 The gastrointestinal symptoms of EVD often develop on days 3 to 10 of the illness, consisting of large-volume, watery diarrhea and recurrent emesis.48 These may lead to significant fluid loss, resulting in severe dehydration and shock. Bleeding is a late manifestation of EVD and has been reported less commonly in children compared with adults. Neurologic manifestations are rare in children, though headache, confusion, delirium, seizures, and coma have all been reported.14,22 Additional findings may include conjunctivitis, pharyngitis, maculopapular rash, arthralgias, and hiccups.14,45-47

 
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Publication Information
Authors

Marlie Dulaurier, MD;Katherine Moyer, DO;Rebecca Wallihan, MD

Publication Date

July 2, 2016

CME Expiration Date

August 2, 2019

CME Credits

4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits.
Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 0.5 Pharmacology CME credits

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CME Information

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