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

Disposition

TOC Will Appear Here

Disposition

Disposition

Given the current lack of RDTs, confirmation of Ebola diagnosis will not be available in most suspected EVD cases presenting to the emergency department. Per guidance from the CDC, the decision to discharge a PUI for EVD who does not yet have a negative RT-PCR test or who presents within 72 hours of symptoms onset should be based on clinical criteria and the reliability of the PUI. It is also important to note that the emergency department disposition should be made in conjunction with both local and state health departments. The CDC recommends the following criteria be considered when determining suitability for discharge of a PUI:39

  • The medical team should believe the PUI’s illness is no longer consistent with EVD
  • The PUI should be afebrile for at least 24 hours without antipyretics or have an alternative explanation for the fever or other symptoms
  • The PUI should have either no laboratory results suggestive of EVD or have an alternative explanation for those that could be consistent
  • Proper follow-up and monitoring must be ensured
  • The PUI is able to self-monitor (or a caregiver is available to monitor) and comply with active monitoring and controlled movement
  • A plan has been established, and is understood by the PUI, for the PUI to return for medical care if symptoms recur
  • Local and state health departments agree with the disposition

If all of the above are not met, clinicians should strongly consider hospitalization of the PUI for ongoing monitoring and management. Prior to discharging patients with confirmed EVD, they should be free from gastrointestinal symptoms for at least 3 days and have negative RT-PCR results for Ebola virus from the blood.39

 
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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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