RESUMO
On July 12, 2016, the Utah Department of Health (UDOH) was notified by a clinician caring for an adult (patient A) who was evaluated for fever, rash, and conjunctivitis that began on July 1. Patient A had not traveled to an area with ongoing Zika virus transmission; had not had sexual contact with a person who recently traveled; and had not received a blood transfusion, organ transplant, or mosquito bites (1). Patient A provided care over several days to an elderly male family contact (the index patient) who contracted Zika virus abroad. The index patient developed septic shock with multiple organ failure and died in the hospital on June 25, 2016. The index patient's blood specimen obtained 2 days before his death had a level of viremia approximately 100,000 times higher than the average level reported in persons infected with Zika virus (2). Zika virus infection was diagnosed in patient A by real-time reverse transcription-polymerase chain reaction (rRT-PCR) testing on a urine specimen collected 7 days after symptom onset. In addition, a serum specimen collected 11 days after symptom onset, after patient A's symptoms had resolved, was positive for antibodies to Zika virus by Zika immunoglobulin M (IgM) capture enzyme-linked immunosorbent assay (MAC-ELISA) and had neutralizing antibodies detected by plaque-reduction neutralization testing (PRNT). Working with Salt Lake and Davis County Health Departments, UDOH requested assistance from CDC with an investigation to determine patient A's exposures and determine a probable source of infection.
Assuntos
Infecção por Zika virus/diagnóstico , Zika virus/isolamento & purificação , Idoso , Evolução Fatal , Humanos , Masculino , Fatores de Risco , UtahRESUMO
As community paramedicine and other nonemergent initiatives become commonplace in EMS, caregivers are going to need communication skills that go beyond SAMPLE checklists. A minimalist approach to dialogue with patients, considered preferred if not essential in what was once almost exclusively a light-and-sirens environment, isn't acceptable when prehospital interventions require a thorough understanding not only of chief complaints, but also how the physical part of illness and injury is framed by the patient's environment. Be considerate, be as thorough as time permits, and pay attention! Next time we'll talk about interviewing prospective employees.
Assuntos
Serviços Médicos de Emergência , Entrevistas como Assunto/métodos , Relações Profissional-Paciente , Triagem/métodos , Comunicação , Humanos , Estados UnidosRESUMO
Student interviews help ensure a match between classroom imperatives and candidates'capabilities. Exploring students'maturity and judgment is often more important than confirming their academic proficiency. Walking into an interview unprepared can be as damaging for interviewers as for interviewees. Selecting the right people and the right process for conducting interviews depends on planning and practice. A team approach to interviewing can be particularly effective if team members take the time to discuss topics and roles before meeting with candidates. Although imprecise, interviews increase the chances that instructors and students will achieve mutually satisfying results, particularly when students play active roles. Next time we'll cover patient interviews.
