SJRHEM – Ebola Resource

This post will be updated with the most up to date advice for SJRHEM Staff (Updated December 2nd 2014)

Please visit the Horizon Ebola Resources for the most up to date local guidelines: Skyline  (requires ROAM login if offsite)



According to the World Health Organization, there are 16,911 confirmed cases of Ebola worldwide since the outbreak began in March 2014. Most of the cases have been isolated to regions in West Africa; mainly Guinea, Liberia and Sierra Leone. To put it in perspective, the land mass of these three countries within the huge continent of Africa equates to just under 430,000 square kilometres, slightly larger than Newfoundland.


Horizon Ebola Triage Tool

Download (PDF, 173KB)

NB Health Screening Tool

Download (PDF, 222KB)

NB EVD Patient Disposition Tool

Download (PDF, 366KB)


Please review this wonderful podcast on Ebola from Dr. Howard Ovens, an emergency physician in Toronto who worked through the SARS crisis. This is one of the most common sense approaches that I have come across. HERE

Public Health Association of Canada PHAC Ebola site – This is the link to the Public Health Association of Canada PHAC Ebola site, which is well organized with good general information.

Ebola Clinical Care Guidelines – This is the link to the Ebola Clinical Care Guidelines, which were developed jointly by CAEP, Canadian Critical Care Society (CCCS) and the Association of Medical Microbiology and Infectious Diseases Canada. It is a more detailed document to read but there is a table of contents to take you to the area of interest quickly.

Medscape Ebola (Medical News Format) – Easy read site.

The WHO site for Ebola – This is the link for the WHO site for Ebola.If you scroll down on the right hand side you will see the situation reports which will outline the disease activity in the affected countries. There is a lot of great general information on the site but it will take some time to read. Some of the documents are long pdfs.

The ACEP website
Theses sites are recommend  as a last resort because they are overloaded with information and the Canadian PHAC site (link above) gives much of the same messages in an accurate but abbreviated form.


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DEM Rounds – October 14th 2014

A big welcome to our nursing / nurse practitioner colleagues at todays rounds. Recent attendance at m&m’s and rounds has been increasing significantly, and a larger venue may soon be required! Just a reminder that ALL (Students, Residents, Physicians, Nurses, NPs, etc) are invited to these CPD (continuous professional development) events.

Dr Chris Vaillancourt  presented the recent update in Food Allergies

We were remind that we are frequently faced with patients and their parents requiring advice on the hot topic of food allergies and especially ‘prevention’ of food allergies

Notes from rounds:

If one parent with a food allergy the child has 30% chance of developing Atopy (atopic dermatitis, childhood Asthma, food allergy, allergic rhinitis) in that order – allergic march – developed over childhood in this order
If two parents  with food allergy = child risk = 70%

Allergen exposure in early infancy is good if its via the gut, bad if its via the skin (especially if atopic via atopic skin rash)
Due to activation of T-Helper Cells – TH1 vs TH2 = less allergies if TH1 activated via gut than TH2 vis skin

Current Strategies  – debunked
Maternal hypoallergenic food eating – false
No cat in house – false – in fact a cat in the house with new infant may be protective

Most kids are getting sensitised via ‘broken skin’ in first year life
Via T-Helper 2 system
Getting exposed via gut stims TH1 system  – reduced risk of allergy

Window of opportunity
For kids at risk
4-6 months window for oral sensitisation – may reduce risk of later food allergy

Other Recommendations
No evidence for using soy milk to prevent food allergy

Breast feed until 4-6months then feed them what you want

Wait fro LEAP study – big RCT looking at food allergies and due to present results in next 2 months



Dr Peter Ross  presented on Ebola. An extremely stimulating review of the current situation and state of preparedness of own own system. Much discussion was had both during and after the presentation.

It was noted that there is a Provincial plan for managing patient with suspected Ebola. This can be accessed via the Horizon Intranet (Skyline Homepage) This is updated regularly. SJRHEM has printed copies of the plan in accessible areas of the department. These should be accessed and read by all. We have already completed an in-situ simulation for a ‘potential’ ebola case this month. The report for this can be accessed in the Simulation Files  – InSitu Sessions – Oct 3rd.

PPE Training is ongoing

Dr Howlett will be posting an update to this website in the next week

Video: here

Full presentation here : 

Download (PDF, 796KB)


Dr David Lewis presented on limping kids

Take home pearls:

  • A limping/NWB child that can crawl is likely to have pathology below the knee
  • Examine least likely source of symptoms first.
  • Flex, Adduct and Int Rot hip most likely manoeuvre to elicit pain in hip pathology
  • Children >8yrs – X-ray hip first
  • If fever (>38°) or > 24hrs then bloods (incl CRP)
  • CRP < 12 is very reassuring
  • Positive ultrasound is most likely to be irritable hip
  • Negative ultrasound – X-ray leg

Full presentation here: 

Download (PDF, 2.08MB)


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