FMMS PRIMER ON BIOTERRORISM

Standard Precautions

• Standard precautions are employed in the care of ALL patients, under ALL circumstances.
• Wash hands after patient contact.
• Wear gloves when touching blood, body fluids, secretions, excretions and contaminated items.
• Wear a mask and eye protection, or a face shield during procedures likely to generate splashes or sprays of blood, body fluids, secretions or excretions.
• Handle used patient-care equipment and linen in a manner that prevents the transfer of microorganisms to people or equipment.
• Use care when handling sharps and use a mouthpiece or other ventilation device as an alternative to mouth-to-mouth resuscitation when practical.

Airborne Precautions

• Standard Precautions plus:
• Place the patient in a private room that has monitored negative air pressure, a minimum of six air changes/hour, and appropriate filtration of air before it is discharged from the room.
• Wear respiratory protection when entering the room.
• Limit movement and transport of the patient. Place a mask on the patient if they need to be moved.
• Conventional diseases requiring Airborne Precautions: measles, varicella, and pulmonary tuberculosis.
• Biothreat diseases requiring Airborne Precautions: smallpox, viral hemorrhagic fevers.

Droplet Precautions

• Standard Precautions plus:
• Place the patient in a private room or cohort them with someone with the same infection. If not feasible, maintain at least 3 feet between patients.
• Wear a mask when working within 3 feet of the patient.
• Limit movement and transport of the patient. Place a mask on the patient if they need to be moved.
• Conventional diseases requiring Droplet Precautions: invasive haemophilus influenzae and meningococcal disease, drug-resistant pneumococcal disease, diphtheria, pertussis, mycoplasma, gabhs, influenza, mumps, rubella, parvovirus.
• Biothreat diseases requiring Droplet Precautions: pneumonic plague, viral hemorrhagic fevers.

Contact Precautions

• Standard Precautions plus:
• Place the patient in a private room or cohort them with someone with the same infection if possible.
•  Wear gloves when entering the room. Change gloves after contact with infective material.
• Wear a gown when entering the room if contact with patient is anticipated or if the patient has diarrhea, a colostomy or wound drainage not covered by a dressing.
• Limit the movement or transport of the patient from the room.
• Ensure that patient-care items, bedside equipment, and frequently touched surfaces receive daily cleaning.
• Dedicate use of noncritical patient-care equipment (such as stethoscopes) to a single patient, or cohort of patients with the same pathogen. If not feasible, adequate disinfection between patients is necessary.
• Conventional diseases requiring Contact Precautions: MRSA, VRE, clostridium difficile, RSV, parainfluenza, enteroviruses, enteric infections in the incontinent host, skin infections (SSSS, HSV, impetigo, lice, scabies), hemorrhagic conjunctivitis.
• Biothreat Diseases requiring Contact Precautions: viral hemorrhagic fevers