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Infection control

Up Download tutorial Infection control Mechanical ventilation Specimens for RT-PCR Steroids in SARS


Entering high risk area
Intubation
Leaving high risk area
PAPR for SARS
Precautions at home
Respiratory equipment

Click on the buttons to the left obtain infection control protocols used in the Prince of Wales Hospital ICU during the SARS epidemic.

Strict infection control is vital and cannot be stressed too much. During the SARS epidemic a nurse was stationed at the entrance of the ICU to ensure that everyone entering and leaving the ICU complied with infection control procedures. Enforcement was strict. Inadequate training and inadequate understanding of infection control measures are associated with increased risk of infection. Note that these control measures will need to be adapted when applied to an ICU in which some patients do not have SARS.

  • Hand cleansing
    • after all patient contact
    • after removing gloves
    • on entry and before leaving ICU
    • before using keyboards, telephones etc
    • if hands are visibly soiled hand washing is required. If not, alcohol based disinfectant rub may be superior for viral disinfection.
    • note that failure to follow hand hygiene procedures even when not in contact with patient associated with increased probability of infection
  • Do not touch nose or eyes at work
  • N-95 masks
    • select appropriate size and brand of mask using a commercial test device. Note that different brands of mask fit different people making it necessary to test each member of staff.
    • each time the mask is put on a test should be carried out to ensure that it is being worn correctly. (Note that this testing is an inadequate method for selecting masks).
      • place both hands over the mask and exhale vigorously
      • if air leaks around the nose adjust the nosepiece
      • if air leaks at mask edges, reposition the straps for a better fit
      • recheck
    • if supplies allow dispose of mask after use. Otherwise dispose of mask when soiled, after 1 day or after a high risk procedure.
  • Gowns
    • remove before leaving ICU
  • Gloves at all times in ICU
    • wash hands before putting on gloves and after removing them
    • change gloves between patients
    • change gloves before using phone, computers, writing notes etc
  • Eye protection at all times in ICU. Preferably full face visor
  • Cap
    • remove before leaving ICU
  • Mirror should be available for staff to check protective equipment has been properly put on
  • Staff entering and leaving the high risk area should be segregated
  • Additional precautions should be taken with respiratory equipment. Click here for details
  • Disposable keyboard covers
  • Pens to be left in ICU
  • Pagers to be kept in disposable transparent bags which should be discarded before leaving the ICU
  • No visitors
  • Care with disposal of excreta to avoid splashes
  • Prior to using toilet staff should remove gowns and gloves. A supply of gowns and gloves should be available next to the toilet so that staff can re-gown and glove.
  • Staff coming into direct contact with patient's body fluids should immediately take a shower
  • Spontaneously breathing patients should wear a surgical mask

A tutorial on infection control for SARS is now available for download


©Charles Gomersall, April, 2014 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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