After ensuring that the airway is open and breathing is adequate, the prehospital treatment of cholera, or any infection that produces profound diarrhea, water loss and dehydration, revolves around fluid replacement therapy. The World Health Organization has created an oral rehydration formula that has been used successfully to treat dehydration secondary to cholera worldwide, but oral administration of fluids is not typical protocol for prehospital care providers.15 As such, initiate IV access and administer an isotonic crystalloid (normal saline or lactated Ringer's) per protocol for hypovolemia.
After providing patient care or coming into contact with a patient's clothes, bed linen or any equipment that may be contaminated, it is important to wash your hands thoroughly with soap and clean water.
This CE activity is approved by EMS World Magazine, an organization accredited by the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS), for 1.5 CEUs. To earn your credits, go to www.rapidce.com, or to print and mail a copy, download the test here.
1. Prevention & Control of Influenza-Recommendations of the Advisory Committee on Immunization Practices (ACIP) 2008. MMWR 57(RR07):1-60, Aug 8, 2008.
2. Centers for Disease Control. Questions & answers: 2010-2011 flu season. www.cdc.gov/flu/about/qa/1011season.htm.
3. CDC. Pertussis: What you need to know. www.cdc.gov/features/pertussis/.
4. Cherry JD, Heininger U. Pertussis and other Bordetella infections. In: Feigin RD, Demmler GJ, Cherry JD, Kaplan SL, eds. Textbook of Pediatric Infectious Diseases, Vol. 1, 5th ed. Philadelphia, PA: WB Saunders Co., pp. 1588-1608, 2004.
5. Pertussis report 2010-12-15. California Department of Public Health. www.cdph.ca.gov/programs/immunize/Pages/PertussisSummaryReports.aspx.
6. California Department of Public Health. Pertussis (Whooping Cough). www.cdph.ca.gov/healthinfo/discond/pages/pertussis.aspx.
7. Fernandez-Frackelton M. Infectious diseases: Bacteria. In: Marx: Rosen's Emergency Medicine, 7th ed. Mosby, 2009.
8. World Health Organization. Media center: Cholera. Fact sheet N107, June 2010. www.who.int/mediacentre/factsheets/fs107/en/index.html.
9. CDC. 2010 cholera outbreak. www.cdc.gov/haiticholera/situation/.
10. Pan American Health Organization. PAHO responds to cholera outbreak in Haiti. http://new.paho.org/disasters/index.php?option=com_content&task=view&id=1423&Itemid=1 .
11. Tasker F. Miami Herald Online. Fla. woman diagnosed with cholera after trip to Haiti. www.miamiherald.com/2010/11/17/1930271/florida-woman-diagnosed-with-cholera.html.
12. Centers for Disease Control and Prevention. MMWR 59(50);1637-1641, 2010.
13. Sack DA, Sack RB, Nair GB, Siddique AK. Cholera. Lancet 363 (9404): 223-233, 2004.
14. Pan American Health Organization. Infection control in cholera outbreaks. http://tinyurl.com/29fykuq.
15. WHO. Position paper on oral rehydration salts to reduce mortality from cholera. www.who.int/cholera/technical/en/.
Scott R. Snyder, BS, NREMT-P, is the EMS education manager for the San Francisco Paramedic Association in San Francisco, CA, where he is responsible for the original and continuing education of EMTs and paramedics. Contact him at firstname.lastname@example.org.
David A. Vitberg, MD, EMT-P, is an intensivist in critical care medicine at St. Agnes Hospital in Baltimore, MD, and an attending physician in the Department of Emergency Medicine at the Baltimore Washington Medical Center in Glen Burnie, MD. He stays close to his EMS roots in his role as an EMS physician with the Baltimore County Fire Department. Contact him at email@example.com.
Kevin T. Collopy, BA, CCEMT-P, NREMT-P, WEMT, is an educator, e-learning content developer and author of numerous articles and textbook chapters. He is also a flight paramedic for Spirit Ministry Medical Transportation in central Wisconsin and a lead instructor for Wilderness Medical Associates. Contact him at firstname.lastname@example.org.