Tuesday, July 14, 2015

Creutzfeldt-Jakob Disease (CJD)

We had someone who was suspected of having this disease - my knowledge isn't the best but I knew that it could be transmitted to others.... here's what the NIH says....

There are three major categories of CJD:
  • In sporadic CJD, the disease appears even though the person has no known risk factors for the disease. This is by far the most common type of CJD and accounts for at least 85 percent of cases.
  • In hereditary CJD, the person has a family history of the disease and/or tests positive for a genetic mutation associated with CJD. About 5 to 10 percent of cases of CJD in the United States are hereditary.
  • In acquired CJD, the disease is transmitted by exposure to brain or nervous system tissue, usually through certain medical procedures. There is no evidence that CJD is contagious through casual contact with a CJD patient. Since CJD was first described in 1920, fewer than 1 percent of cases have been acquired CJD.
No idea which category this patient had but still.... it's a prion disease that can be transmitted to others and that's what's important! Infection control wanted us to isolate the patient and maintain precautions - whatever that meant! No one told us a thing, just simply wrote an order and left!

Forward 3 hours later and the nurse was checking charts and found this order. Not knowing what to do she contacted infection control who took over an hour to call back and being told that it would be important to isolate and that for any invasive procedures that items had to be incinerated and not simply put into the garbage can OR the sharps container (even though it's a biohazard container).

Now that last bit became REAL important when at the end of shift the code button goes off on the unit and you wait a minute to see if it's real or not - and you make your way to the room to find out that the code is real - then you learn it's the patient with CJD!!!

So then when ppl come running with the code cart and you get all the personnel that need to be there for a code, you have to attempt to tell them all that they need serious PPD - so out everyone runs to get covered up and I go running to get N95 masks because who knows what you're going to be exposed to!

The code is finished and patient is determined to be deceased after several rounds of CPR and epi - so then we contact infection control to find out what to do with all this "stuff" left over and what is required for the body - and we all ask each other - is this a coroner's case - is it a mandatory autopsy?

NOPE! Not a mandatory autopsy - coroner says it's up to family to decide!

HOWEVER - dealing with the body is done differently - I get told by infection control that we need to use an EBOLA body bag!!! WOW! Wasn't expecting that. Didn't even know how to go about getting that! Thankfully infection control says that the ER has it and they can provide it. Whew, what a relief!

Then we work frantically to try to clean up the mess that's left after a code because ALL PPE was piled atop the patient and that simply would NOT be good when the family came and would see this person with "trash" (essentially) piled on top.... but we couldn't just put it in the corner or in the regular garbage. So we called housekeeping and STATed the "special" bags - which thankfully they did.

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