1. Transmission-based
Precaution Techniques

2. AIRBORNE PRECAUTIONS

3. • Designed to reduce the risk of
airborne transmission of infectious
agents through dissemination of
small droplet nuclei >5 microns in
size or small-particle residue of
evaporated droplets that may
remain suspended in the air for long
periods or dust particles containing
the infectious agent.

4. • Microorganisms carried in this
manner can be dispersed widely by
air currents and may become
inhaled by or deposited on a
susceptible host within the same
room or over a longer distance from
the source patient
• Therefore, special air handling,
filtration, and ventilation are required

5. • Examples:
• measles, varicella (including
disseminated zoster), TB
• Wear respiratory protection when
entering the room of a patient with
known or suspected PTB or any of
the other known or suspected
airborne-transmitted diseases
• at least an N-95 respirator or PAPR

6. • Place the patient in a private room
that has:
• Monitored negative air pressure in
relation to the surrounding areas.
• At least 6 but preferably 12 air
changes per hour.
• Appropriate discharge of air
outdoors or monitored high-
efficiency filtration of room air before
recirculation.
• Door that is closed at all times with
the patient in the room.

7. • Health care workers who are
susceptible should not enter the
rooms of patients known or
suspected to have:
• measles (rubeola) or chickenpox
(varicella)
• If susceptible individuals must enter
the room, they should wear a N-95
or PAPR mask
• Persons immune to rubeola or
varicella need not wear a mask

8. • Limit the transport of the patient
from the room to essential purposes
only.
• Minimize patient dispersal of droplet
nuclei by placing a surgical mask on the
patient.
• Notify the destination department about
the patient and the patient's status so
they can provide protection to their staff
and other patients.
• Minimize the time the patient is in the
visiting department.

9. DROPLET PRECAUTIONS

10. • Designed for care of patients known
or suspected to be infected with
microorganisms transmitted by
droplets (large particles) that can be
generated by the patient when
coughing, sneezing, talking, or
during the performance of
procedures.
• Wear a mask when working within 3
feet (0.9 m) of the patient's mouth.

11. • Examples:
• Invasive Haemophilus influenzae type b
disease, including meningitis,
pneumonia, epiglottitis, sepsis
• Invasive N. meningitidis disease,
including meningitis, pneumonia, sepsis
• Diphtheria, mycoplasma pneumonia,
pertussis, pneumonic plague,
streptococcal pharyngitis, pneumonia,
or scarlet fever in infants and young
children
• Adenovirus, influenza, mumps,
parvovirus B19, rubella

12. • Place the patient in a private room.
• When a private room is not
available, place patients with the
same microorganism together
(cohorting).
• If neither of these is possible,
maintain spatial separation of at
least 3 feet between the infected
patient and other patients

13. • Special air handling and ventilation
are not necessary, the door may
remain open
• Limit the transport of the patient
from the room to essential purposes
only.
• If transport is necessary, minimize
dispersal of droplets by masking the
patient.

14. CONTACT PRECAUTIONS

15. • Used for patients known or
suspected to be infected or
colonized with epidemiologically
important microorganisms that can
be transmitted by direct or indirect
contact

16. • direct contact with the patient
• skin-to-skin or patient's skin to staff's
clothing as contact occurs when
performing patient care activities
that require touching the patient's
skin
• indirect contact
• touching with environmental
surfaces or patient care items in the
patient's environment.

17. • Examples :
• Methicillin (oxacillin)-resistant
Staphylococcus aureus (MRSA
[ORSA])
• Vancomycin-resistant Enterococcus.
• Vancomycin-intermediate-resistant S.
aureus, also known as glycopeptide-
resistant S. aureus.
• Clostridium difficile (when patient has
diarrhea).
• For diapered or incontinent patients,
Escherichia coli 0157:H7, shigella,
hepatitis A, rotavirus.

18. • Respiratory syncytial virus,
parainfluenza virus, or enteroviral
infections in young children; diphtheria;
herpes simplex virus (primary cases).
• Impetigo, major (noncontained)
abscesses, cellulitis, or decubiti.
• Pediculosis, scabies, staphylococcal
furunculosis in infants and young
children.
• Herpes zoster.

19. • Place the patient in a private room
or in a room with a patient who has
the same microorganism (cohorting)
• When possible, dedicate the use of
noncritical patient care equipment to
a single patient
• Consider disposable equipment
where possible.
• Thoroughly clean and disinfect
reusable equipment before use for
another patient.

20. • In addition to wearing gloves as
outlined under Standard
Precautions, everyone (including
visitors) must wear gloves when
entering the room.
• Change gloves after contact with
infective material, such as feces and
wound drainage.

21. • Remove gloves before leaving the
patient's environment and perform
appropriate hand hygiene
immediately with an antimicrobial
soap or alcohol-based waterless
antiseptic agent.
• After glove removal and hand
hygiene, make sure that hands do
not touch potentially contaminated
environmental surfaces or items in
the patient's room.