Isolation Precautions

Standard Precautions - Baseline Defense Duty

• Applied to ALL patients, always, to prevent infection spread.
• Assumes potential infection from contact with:
  • Blood, all body fluids (except sweat), secretions, excretions.
  • Non-intact skin, mucous membranes.
• Core actions include:
  • Hand Hygiene (e.g., WHO 5 Moments).
  • Personal Protective Equipment (PPE): Use gloves, gown, mask, eye protection based on anticipated exposure.
  • Respiratory hygiene/Cough etiquette.
  • Safe injection practices & sharps management.
  • Environmental cleaning & disinfection.

⭐ Standard Precautions apply to ALL patients, regardless of their diagnosis or presumed infection status, and involve contact with blood, body fluids (except sweat), non-intact skin, and mucous membranes.

Contact Precautions - Keep Pathogens Put!

• When? Direct/indirect contact with patient or their environment.
• Key Bugs:
  • MDROs (e.g., MRSA, VRE, CRE)
  • Clostridioides difficile
  • Scabies, pediculosis (lice)
  • Infectious diarrhea (e.g., rotavirus, norovirus)
  • Major draining wounds or skin infections (e.g., impetigo)
• Actions:
  • Private room preferred; cohort with same pathogen if not.
  • Gloves & Gown: Don upon entry, discard before exiting room.
  • Hand Hygiene: Before gloving, after PPE removal.
  • Dedicated or disposable patient-care equipment.

⭐ For Clostridioides difficile, always use soap and water for hand hygiene as alcohol-based sanitizers are not effective against spores.

Droplet Precautions - Dodge the Droplets!

• Spread: Large droplets (>5 µm) from coughs, sneezes; travel ~3-6 feet.
• PPE: Surgical mask if within 3-6 feet. Patient wears mask if transported.
• Room: Single room ideal. Cohort if same pathogen.
• Examples (📌 PIMP My Droplets):
  • Pertussis, Pneumonia (Mycoplasma)
  • Influenza
  • Meningitis (N. meningitidis, H. influenzae type B), Mumps
  • Diphtheria (pharyngeal), Rubella

⭐ Droplet precautions require wearing a surgical mask when working within 3-6 feet of a patient with infections like influenza or meningococcal meningitis.

Airborne Precautions - Aerosol Alert Actions

⭐ Airborne precautions for diseases like Tuberculosis or Measles mandate an N95 respirator and placement in an Airborne Infection Isolation Room (AIIR) with ≥12 ACH and negative pressure.

• Patient Placement:
  • Single patient room: Airborne Infection Isolation Room (AIIR).
  • Monitored negative pressure; ≥12 air changes per hour (ACH).
  • Keep door closed.
• Respiratory Protection:
  • Fit-tested N95 respirator or higher for healthcare workers (HCWs) entering.
• Patient Transport:
  • Limit movement; patient wears surgical mask if transport essential.
• Examples: Tuberculosis, Measles, Varicella. 📌 My Tiny Virus Airborne.

PPE Protocol - Gear Up & Off Right!

Donning (Gear Up) - Order is Key:

• Hand Hygiene: Essential first step.
• Gown: Fully cover torso, tie securely.
• Mask/Respirator: Ensure proper seal (fit check).
• Goggles/Face Shield: Protect eyes and face.
• Gloves: Pull over gown cuffs (last on).

Doffing (Gear Off) - Critical for Safety:

• Perform in designated area, avoid self-contamination.

⭐ Correct sequence of doffing PPE is critical to prevent self-contamination; typically: 1. Gloves, 2. Gown, (Hand Hygiene), 3. Goggles/Face Shield, 4. Mask/Respirator, (Hand Hygiene).

High‑Yield Points - ⚡ Biggest Takeaways

• Standard Precautions: Apply to all patients; key is hand hygiene & appropriate PPE.
• Contact Precautions: For MDROs (e.g., MRSA), C. difficile. Require gloves & gown.
• Droplet Precautions: For influenza, meningitis. Use surgical mask within 3-6 feet.
• Airborne Precautions: For TB, measles, varicella. Need N95 respirator & negative pressure room.
• Hand hygiene is the cornerstone of infection prevention.
• For C. difficile or soiled hands, soap & water is mandatory over alcohol rubs.
• PPE Doffing: Gloves first, mask/respirator last; perform hand hygiene frequently.