Emergency Preparedness 19:
Patient Isolation Precautions
Standard Precautions
- Wash hands after patient contact.
- Wear gloves when touching blood, body fluids, secretions, excretions, and contaminated items.
- Wear a mask and eye protection or a face shield during procedures likely to generate splashes or sprays of blood, body fluids, secretions, or excretions
- Handle used patient care equipment and linen in a manner that prevents the transfer of microorganisms to people or equipment.
Use care when handling sharps. Use a mouthpiece or other ventilation device
as an alternative to mouth-to-mouth resuscitation when practical.
Employ Standard Precautions in the care of ALL patients.
Airborne Precautions
Standard Precautions plus:
- Place the patient in a private room that has monitored negative air pressure, a minimum of 6 air changes/hour, and appropriate filtration of air before it is discharged from the room.
- Wear respiratory protection when entering the room.
- Limit movement and transport of the patient. Place a mask on the patient if he or she needs to be moved.
Conventional Diseases Requiring Airborne Precautions: Measles, Varicella, Pulmonary Tuberculosis. Biothreat Diseases Requiring Airborne Precautions: Smallpox.
Droplet Precautions
Standard Precaution plus:
- Place the patient in a private room or cohort with another patient with same infection. If not feasible, maintain at least 3 feet between patients.
- Wear a mask when working within 3 feet of the patient.
- Limit movement and transport of the patient. Place a mask on the patient if he or she needs to be moved.
Conventional
Diseases Requiring Droplet Precautions: Invasive Haemophilus influenzae
and meningococcal disease, drug-resistant pneumococcal disease,
diphtheria, pertussis, mycoplasma, GABHS, influenza, mumps, rubella,
parvovirus.
Biothreat Diseases Requiring Droplet precautions: Pneumonic Plague.
Contact Precautions
Standard Precautions plus:
- Place the patient in a private room or cohort with another patient with same infection (if possible).
- Wear gloves when entering the room. Change gloves after contact with infective material.
- Wear a gown when entering the room if contact with patient is anticipated or if the patient has diarrhea, a colostomy, or wound drainage not covered by a dressing.
- Limit the movement or transport of the patient from the room.
- Ensure that patient care items, bedside equipment, and frequently touched surfaces receive daily cleaning.
- Dedicate use of noncritical patient care equipment (such as stethoscopes) to a single patient or a cohort of patients with the same pathogen. If not feasible, adequate disinfection between patients is necessary.
Conventional Diseases Requiring Contact Precautions:
MRSA, VRE, Clostridium difficile, RSV, parainfluenza, enteroviruses,
enteric infections in the incontinent host, skin infections (SSSS, HSV,
impetigo, lice, scabies), hemorrhagic conjunctivitis.
Biothreat Diseases Requiring Contact Precautions: Viral Hemorrhagic
Fevers.
For more information, see: Garner JS. Guideline for Infection Control Practices in Hospitals. Infect Control Hosp Epidemiol. 1996;17:53-80
Source:
USAMRIID’s Medical Management of Biological Casualties Handbook, 4th
ed. Obtained from
www.usamriid.army.mil/education/bluebook.html (Link to 6th Edition)