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Transcript
Isolation in ICU 7/2/11 Goal = prevent the transmission of microorganisms from infected or colonized patients to other patients, visitors and health care workers. Types - standard precautions contact droplet airborne STANDARD PRECAUTIONS - apply to all patients - universal precautions: -> -> -> -> -> gloves when touching blood, body fluid, non-intact skin and mucous membranes wash hands immediately after glove removal and between patients masks, eye protection, face shield during activities likely to generate splashes or sprays gowns during activities likely to generate splashes or sprays sharps: avoid recapping, removing needles by hand, place in sharp bins CONTACT ISOLATION = used to prevent transmission of epidemiologically important organisms from an infective or colonized patient through direct or indirect contact. Organisms - infectious diarrhoea group A streptococcus wound infections MDR bacteria (MRSA, VRE) viral conjunctivitis lice scabies RSV infection Management - standard precautions in ICU - involves: gloves and gown Jeremy Fernando (2011) DROPLET ISOLATION = designed to prevent droplet (larger particle) transmission of infectious agents when patient talks, coughs or sneezes. Organisms - adenovirius group A strep pharyngitis, pneumonia, scarlet fever H. influenza meningitis and epiglottis Influenza Mumps Rubella Meningococcal infections AIRBORNE ISOLATION = designed to prevent airborne transmission of droplet nuclei or dust particles containing infectious agents Organisms - Tb measles varicella zoster SARS Management - room: private, door closed, negative pressure (12 air changes/hour) mask: N95 or N100 bacterial filter and closed suction on circuit warning signs on doors bronchoscopy: minimise aerosols (paralyze, consider apnoeic ventilation during procedure) Jeremy Fernando (2011)
