Standard Precautions

Last Updated on by FRCEM Intermediate

Standard precautions include:

  • isolation: allocating a single room with a closing door to a patient with a suspected or confirmed infection
  • Hand-washing: hand hygiene, before and after every episode of patient contact (‘WHO’s 5 moments’)
  • wearing specific personal protective equipment
  • Safe handling and disposal of infectious material, particularly sharps
  • routine environmental cleaning
  • reprocessing of reusable medical equipment and instruments
  • respiratory hygiene and cough etiquette
  • Aseptic Practice – aseptic non-touch technique (ANTT)
  • waste management
  • appropriate handling of linen
  • restricting movement both patients and healthcare workers

SYNDROMES AND ORGANISMS REQUIRING TRANSMISSION-BASED PRECAUTIONS

Contact precautions

  • diarrhea in incontinent or diapered patients with suspected infectious cause (e.g. enterohemorrhagic Escherichia coli O157:H7, Shigella spp, hepatitis A virus, noroviruses, rotavirus, C. difficile)
  • abscess or draining wound that can’t be covered (MRSA or group A Strep – also need airborne precautions for 24h if suspected invasive GAS)
  • localized HSV
  • enterovirus meningitis

Droplet precautions (in addition to contact precautions)

  • suspected meningococcemia or meningococcal meningitis (first 24h of antibiotic therapy)
  • suspected VHF

Airborne precautions (in addition to contact precautions)

  • suspected LRTI in adults (e.g. fever, cough, lung infiltrates) due to M. tuberculosis, Respiratory viruses, S. pneumoniae, S. aureus (MSSA or MRSA)
    — eye protection also required if: suspected SARS, avian influenza, Tb or aerosol-generating procedures in an HIV positive patient
  • Suspected viral LRTI in children (e.g. Respiratory syncytial virus, parainfluenza virus, adenovirus, influenza virus, Human metapneumovirus)
    — also, need droplet precautions until adenovirus and influenza are ruled out
  • Suspected measles
  • Vesicular rash (suspected Varicella-zoster, herpes simplex, variola (smallpox), vaccinia viruses)
  • Tb meningitis

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