I was wondering how different facilities handle RSV infants? We put the infant in isolation which requires anyone entering the room to don a mask, gloves, and a isolation gown. What I don't understand about this is when these infants are admitted from our ED they haven't been in isolation (and are known to have RSV). They are brought from the ER up three floors with no one wearing a gown or mask or gloves, and then BOOM! they are in isolation. Just doesn't make a whole lot of sense to me. I work for a small hospital with a general med/surg floor which also does telemetry and peds. We do not have a separate unit for peds. I am curious what precautions other hospitals are taking with RSV+ patients. What about children's hospitals? What kind of precautions to you place RSV+ babies in? Thanks for any information.
Jan 11, '02
Hey dee! Here's our policy; basically it's just contact precautions. Never quite understood why it's not also droplet since it CAN be spread by droplets from coughing and sneezing. All the literature I've read at work and on the net only recommend strict handwashing as prevention.
From our IC manual:
THIS CATEGORY APPLIES TO DISEASES WHICH ARE ONLY TRANSMITTED BY DIRECT CONTACT WITH THE PATIENT OR THE PATIENT'S ENVIRONMENT. Contact precautions are required for all patients known or suspected to be infected by germs that travel by direct contact.
Examples are: Resistant Bacteria, Parainfluenza, Lice, C. Difficile, Herpes, Shigella, RSV, Impetigo, Scalded skin
Gloves are needed to enter room
Change gloves immediately after contact with infective material
Wear a gown for SUBSTANTIAL contact with patient or environmental surfaces.
I don't recall us even placing them on "contact" though. The few we've had so far this year, we have just used universal precautions. Not seeing any increase in spread.
The most effective preventive measure against the spread of RSV and other respiratory viral infections is careful and frequent hand washing. Once one child in a group is infected with RSV, spread to others is rapid. Frequently, a child is infectious before symptoms appear. Therefore, an infected child does not need to be excluded from child care unless he or she is not well enough to participate in usual activities.
If your child develops an illness caused by RSV infection, make sure that proper procedures regarding hand washing, hygiene, disposal of tissues used to clean nasal secretions, and cleaning and disinfection of toys are followed. Do not exclude your child from day care or school unless he or she is unable to participate comfortably in activities.
Dept. of Health and Human Services
U.S. Public Health Service
Centers for Disease Control and Prevention
Sooooooo, I guess they shouldn't be isolated??
Last edit by nurs4kids on Jan 11, '02
Jan 12, '02
So my son was admited to Childrens for an URI. as a standard precaution they did the nasal culture and placed him in isolation. He was DC'd to home before the results came back and we were called the next day and informed that he was indeed positive for RSV and to just watch him.
Unfortunatley he got worse so I called the ED to let them know ahead of time that we were on our way and that he had confirmed RSV.
We got there and they triaged us in a common triage area, did his weight, took vitals etc... everything in this common area. They then placed him in a private room where everyone was gowned and gloved and masked prior to entry.
They toted him across the entire first floor to radiology for a chest film, where no one was gowned or masked and of course he was coughing and crying. They walked us back again throught the hallls to go back the ED.
When he was admitted, they again walked him through the hospital, even shared and elevator with another child to the 4th floor. We were being escorted by a volunteer who herself was gowned etc... Not really sure what you can really do about transport, perhaps mask the patient. And to do a portable x ray into an iso room means sterilizing everything afterwards. I'm not sure of the policy in this hospital but it sure felt like my guy was spreading his "stuff" all over the place!