Summary of Responding to Emergencies-Cholera Alert Detection and Management

Responding to Emergencies-Cholera Alert Detection and Management

Step 1 Clinical History (10 mins)

Objective:

Step 2 Physical Examination (15 mins)

Objective: You will practice determining

What signs should be first assessed as part of the physical examination.
Which danger signs, if any, may suggest hypovolemic shock.
Which parameters you need to check to carry out a assessment of your patients hydration status.
Your patients signs and symptoms to define the hydration status

Step 3 Initial Clinical Diagnosis (10 mins)

Objective:

Decide what actions to take in order to make the initial clinical diagnosis that will orient you to start the initial treatment for your patient.

Step 4 Initial Treatment Choice (15 mins)

Objectives:

Step 5 Transmissions-Based Precautions (15 mins)

Objectives:

Recognise how cholera is transmitted.
Decide which Cholera Transmission-Based Precautions must be applied to prevent the infection transmission.
Decide what are the most important infection prevention and control (IPC) measures to prevent cholera transmission.
Select which BASIC Personal Protective Equipment (PPE) the staff must wear to manage cholera suspected patients.
Select what ADDITIONAL PPE is required to administer the intravenous treatment.

Step 6 Treatment Administration Part 1 (10 mins)

Objectives:

Recognise how to start an intravenous rehydration.
Calculate what the RL bolus volume is based on your patient’s weight.
Calculate how many drops per minute correspond to a specific RL volume in 30 minutes.
Select which parameters are priorities to monitor closely during the administration of the bolus in the first 30 minutes.
Recognise what other priority tasks need to be taken as medical supervisor.

Step 6 Treatment Administration Part 2 (20 mins)

Objectives:

Select the main uses of the three different concentrations of chlorine solutions employed in cholera: 2%, 0.2% and 0.05%.
Chose what additional PPE must the person wear when preparing chlorine solutions
Recognise what can be used as disinfection if chlorine solution is not available.
Recognise what areas need to be disinfected.
Decide what the main physical requirements are to start setting up a cholera isolation area.
Decide who will be allowed to circulate in and out of the isolation area.
Decide what elements must be present at the gate.
Select what is needed in the tent where the suspected cholera patients will be placed.
Select the Watsan essential requirements needed in the tent?
Recognise the IPC precautions to be used during the initial management of a cholera alert in a health facility outside an epidemic context.

Step 7 Case Definition (10 mins)

Objectives:

Select the key objectives of an epidemiological surveillance for an outbreak response in MSF.
Select the regular responsibilities in an epidemiological surveillance as a medical supervisor of the health facility.
Select the uses of Standard Case definitions.
Recognise how to classify when there are more than one case definitions fits.

Step 8 Epidemiological History & Reporting Part 1 (20 mins)

Objectives:

Recognise the purpose of investigating alerts whether there is an ongoing emergency that requires MSF intervention or not.
Distinguish at health facility level, when a situation is an alert.
Identify what is an alert threshold is.
Select how often reports must be made on cholera, based on the epidemiological context.
Identify who a medical supervisor should report the alert to when a case of a disease requires immediate reporting.
Identify what should be done from the epidemiological perspective immediately after identifying a suspected cholera case.
Select the reasons why the epidemiological history is important when a suspected cholera case is identified.

Step 8 Epidemiological History & Reporting Part 2 (20 mins)

Objectives:

Identify what information is needed to make a report on the suspected cholera case to the line manager.
Recognise what the
Select what amount of RL your patient must receive in the next 3 hours according to the protocol.
Identify what immediate actions you need to take to investigate a cholera alert.

Step 9 Sample Collection Part 1 (15 mins)

Objectives:

Decide what an “alert investigation” implies at our level, at the health facility.
Recognise the importance of a laboratory investigation.
Identify who at MSF takes the decision about alert investigation.
Recognise what should be considered before collecting the sample from a suspected cholera patient.
Identify what tests or transport media are used in MSF for cholera confirmation.
Select the IPC precautions required for collecting stools specimens for cholera investigation.
Identify the procedure to collect and prepare a stool sample using the Cary-Blair transport medium.

Step 9 Sample Collection Part 2 (15 mins)

Objectives:

Identify the practical use of the case register.
Recognise what must be recorded in the case register.
Select who decides the format of the line list in MSF.
Select what our colleagues in other MSF missions do, when there is not an agreed format.
Identify when an antibiotic should be administered to the patient.
Decide the antibiotic of choice for cholera.