Isolation Procedures and Techniques
Here are some additional isolation procedures and techniques that can be followed when working with different types of wounds and diseases.
Isolation Unit or Room - A cubicle or room set up to separate persons with communicable disease from other persons.
Wound and Skin Precautions
Wound and skin precautions are used when the pathogenic microorganisms may be spread by direct contact or indirect contact with purulent material or drainage from an infected body site. This can include burns that do not extend over the entire body, gangrene or skin and wound infections caused by staphylococci, streptococci, or other microorganisms. A private room is not indicated. A gown and gloves are worn if the health worker will be in direct contact with the patient. Masks are not worn. Any articles used that come into direct contact with the patient must be isolated and discarded or bagged and labelled. Hands are washed using medical aseptic technique before and after patient care.
Respiratory Isolation Technique
This is designed to prevent transmission of infectious diseases over short distances through the air. Direct and indirect contact transmission may occur but is infrequent. Diseases requiring respiratory isolation include measles, mumps, and rubella. A private room is required or patients with the same disease may share a room. A mask and gloves are worn. Medical aseptic hand washing is used before entering the room and when leaving. All articles must be disinfected.
Enteric Isolation Technique
Enteric isolation technique is used when the patient has a disease that may be transmitted by direct contact or indirect contact with infected feces. This type of isolation is used for diarrheal diseases; gastroenteritis caused by Escherichia coli, salmonella, shigella
, hepatitis A or B, or unspecified hepatitis. A private room is indicated if patient hygiene is poor and thus at risk of contaminating others and for children. Gowns and gloves should be worn. Hands must be washed before and after the procedure. Contaminated articles should be discarded or bagged and labelled.
Strict Isolation Technique
Strict isolation technique is used to prevent transmission of highly contagious or virulent infections that may be spread by air or contact. A private room is required. A gown, mask and gloves must be worn. Contaminated articles used in the room must be specifically cared for by being discarded or bagged and labelled before being sent for decontamination and reprocessing. Hands must be washed after leaving the room.
Protective (Reverse) Isolation Technique
Protective isolation technique is used to protect a particularly susceptible patient from becoming infected. Patients who require this type of isolation are those with AIDS, infected burns, acute leukemia or lymphoma, large areas of denuded skin due to injury or disease, immunosuppressive therapy (organ transplant recipients), neutropenia, on anti-cancer chemotherapy severely immunocompromized patients and infants in critical care nurseries. A private room is required. The technique is similar to aseptic technique as practiced in the operating room. The mobile unit must be thoroughly cleaned before entering the unit and IRs must be encased in sterile covers. A sterile gown, gloves and a mask are donned as in sterile procedures. The technologist must plan his work carefully and work with an assistant to avoid contaminating the patient. Trips in and out of the reverse isolation room must be kept to a minimum.
Blood/body Fluid Precautions
Blood / body fluid precautions are designed to prevent infections that are transmitted by contact with blood or other body fluids such as HIV and HBV. A private room is indicated if patient hygiene is poor because of the higher risk to others. Masks are not indicated. Gowns are only indicated if soiling is likely. Masks are not indicated but gloves should be worn. Hands must be washed before and after touching the patient or contaminated articles. Contaminated articles should be discarded or bagged and labelled. Care should be taken to avoid needle-stick injuries. Used needles should not be recapped or bent; they should be placed in a prominently labelled, puncture-resistant container designated specifically for such disposal. Blood spills should be cleaned up promptly with hypochlorite.