Transcript Infection Control in the Emergency Room

Infection Control in the Emergency
Room
DISEASE TRANSMISSION
CYCLE
Adapted from APIC 1983: WPRO/WHO,1990
AGENT
Disease producing microorganisms, such as HBV,
HIV and Mycobacterium tuberculosis (Tb)
RESERVOIR
SUSCEPTIBLE
HOST
Person who can become infected
Place where the agent lives, such as in or on
blood, humans, animals, plants, the soil, air or
water
PLACE OF EXIT
PLACE OF ENTRY
Where the agent enters the next host
(Usually the same way it left the old host)
Where the agent leaves the reservoir (host)
METHOD OF
TRANSMISSION
How agent travels from place to place (or person to
person)
Standard Precautions (Body
Substance isolation/universal
Precautions)
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Standard precautions represents a system of
barrier precautions to be used by all
personnel for contact with blood, all body
fluids, secretions, non intact skin, and
mucous membranes of ALL patients,
regardless of the patient’s diagnosis. These
precautions are the “standard care”. This
system embodies the concepts of “Universal
Precautions” & “Body Substance Isolation”
(CDC 1996)
The “Standard Precautions”
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All patients are treated the same, regardless
of whether or not they have a serious
infection or are friends, co-workers,
neighbors, or family. Every patient is treated
as if his/her blood and body fluids are
infectious.
Barriers are worn if contact with a body fluid
(e.g., blood, sputum, urine, stool, sweat, etc.)
is anticipated.
Standard Precautions: Key Components
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Hand washing (or using an antiseptic hand rub)
After touching blood, body fluids, secretions,
excretions and contaminated items
immediately after removing gloves
Between patient contact
Tietjen L, Bossemeyer D, N Mcintosh. 2003. Infection prevention Guidelines for health care facilities with
limited resources. JHPIEGO, USA
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Gloves
For contact with blood, body fluids, secretions and
contaminated items.
with mucous membranes and non intact skin
Masks, goggles, face masks
Protect mucous membranes of eyes, nose
and mouth when contact with blood and body
fluids is likely
Gowns
Protect skin from blood or body fluid contact
Prevent soiling of clothing during procedures that
may involve contact with blood or body fluids
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Linen
Handle soiled linen to prevent touching skin or
mucous membranes
Do not pre-rinse soiled linens in patient care areas
Patient care equipment
Handle soiled equipment in a manner to prevent
contact with skin or mucous membranes and to
prevent contamination of clothing or the
environment
Clean reusable equipment prior to reuse
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Environmental cleaning
Routinely care, clean and disinfect equipment and
furnishings in patient care areas
Sharps
Avoid recapping used needles
Avoid removing used needles from disposable
syringes
Avoid bending, breaking or manipulating used
needles by hand
Place used sharps in puncture-resistant containers
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Process instruments , and other items
after use by first decontaminating and
thoroughly cleaning them, then either
sterilizing or high level disinfecting them
using the recommended procedures.
Protect workers , through offering relevant
immunizations
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Patient resuscitation
Use mouthpieces, resuscitation bags or other
ventilation devices to avoid mouth-to- mouth
resuscitation
Patient placement
Place patients who contaminate the environment or
cannot maintain appropriate hygiene in private
rooms
Additional Isolation Types
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'Droplet Precautions' is used for diseases
spread through the air but are only on the
moist droplets sprayed out from a person's
mouth when they talk, sneeze, or cough. An
example of this is the flu or influenza.
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‘Airborne’ or ‘Respiratory Isolation’
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additional precautions may be used when
certain infectious diseases are known or
suspected, such as tuberculosis (TB),
measles, chickenpox, or mumps. These
germs are spread through the air. Persons
with these diseases are usually placed in
‘Airborne’ or ‘Respiratory Isolation’. This
involves the use of a mask before entering
the patient’s room, the door is closed, and
a warning sign is placed on the door.
‘Contact Precautions’
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‘Contact Precautions’ is used for diseases
spread by hand-to-hand contact such as lice,
scabies, or when a patient has a wound
infection (where we know a lot of bacteria are
present). A sign is placed on the door to warn
the person entering to use gloves and good
hand washing. Additional covers may be
worn over the clothes depending on the
procedure being done.
‘Protective Isolation’
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‘Protective Isolation’ is used when we need to
protect the patient from our germs (from our
hands, nose, and mouth). The patient usually has
a very low immunity and has a decreased ability
to fight off infection. Commonly this is seen in
cancer patients who are receiving chemotherapy.
In most cases hand washing is sufficient but
masks and gloves may be added. The sign on the
door will indicate what precautions need to be
used.
The Motto of The Day
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Stay Safe
Stay Healthy
And Remember being Safe is better than
being Sorry