Airborne or Droplet?

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Specializes in Cath Lab, OR, CPHN/SN, ER.

Which precautions?

I've read to wear a N-95 mask, but why wouldn't it be droplet like influenza?

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Specializes in Too many to list.

This interview explains why in detail.

http://minnesota.publicradio.org/display/web/2009/04/28/midmorning1/

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Specializes in OB, HH, ADMIN, IC, ED, QI.
Which precautions?

I've read to wear a N-95 mask, but why wouldn't it be droplet like influenza?

I don't think there's a difference between "airborn" and "respiratory/droplet" infective methods of communicability. If your facility has both types of isolation techniques, they're behind the times......

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I saw on CDC website a couple days ago that standard, contact, AND droplet precautions should all be used for Swine Flu. If this is an issue for you at work, I would certainly verify this and check for updates to this and other info at CDC.gov since things are changing rapidly. Might be good to also check WHO.int and your state health department website to get info. Third, be certain you are also following your hospitals policy and procedures as well. Always get facts from reputable/reliable sources.

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Specializes in OB, HH, ADMIN, IC, ED, QI.
I saw on CDC website a couple days ago that standard, contact, AND droplet precautions should all be used for Swine Flu. If this is an issue for you at work, I would certainly verify this and check for updates to this and other info at CDC.gov since things are changing rapidly. Might be good to also check WHO.int and your state health department website to get info. Third, be certain you are also following your hospitals policy and procedures as well. Always get facts from reputable/reliable sources.

CDC's version is of course the correct one, and they do not mention "airborn"

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I do not think my facility is "behind the times," and we have deferent standards between droplet and airborne precautions. Airborne gets you a negative pressure room with a internal HEPA air filter and a filtered exhaust-very different and much more expensive to provide that droplet precautions.

So what are we doing wrong?

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Specializes in OB, HH, ADMIN, IC, ED, QI.
I do not think my facility is "behind the times," and we have deferent standards between droplet and airborne precautions. Airborne gets you a negative pressure room with a internal HEPA air filter and a filtered exhaust-very different and much more expensive to provide that droplet precautions.

So what are we doing wrong?

The negative pressure room should be used for "droplet/respiratory" isolation (which in times uncomplicated by a pandemic flu, is usually for Tb and suspected Tb patients, mostly). The "airborne" connotation is false, as it infers that there is a difference between "droplet/respiratory" technique and "airborne", which your facility seems to think is true. Apparantly that is to designate the use of your negative pressure room only in circumstances deemed "airborne", which gives that term special status. Check with CDC by putting your question to them.

I have spent a large part of my 49 year nursing career as an Infection Control Nurse at several facilities, one of which was a "County" teaching hospital. I have also acquired the Public Health Nurse specialty certification and keep in touch with CDC by receiving their newsletter MMWR, still.

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Specializes in OB, HH, ADMIN, IC, ED, QI.

My computer needs a hearing aid/speakers or headset, as I couldn't hear the interview. Was there a special point made in it that you could tell us about?

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Specializes in OB, HH, ADMIN, IC, ED, QI.
Which precautions?

I've read to wear a N-95 mask, but why wouldn't it be droplet like influenza?

It is, plus contact and standard precautions. :up:

Has your N95 mask been properly fitted? If not, your Employee Health Nurse should be able to do that for you.

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interim guidance for clinicians on identifying and caring for patients with swine-origin influenza a (h1n1) virus infection

infection control of ill persons in a healthcare setting

updated

april 28, 2009 02:45 pm et

patients with suspected or confirmed case-status should be placed in a single-patient room with the door kept closed. if available, an airborne infection isolation room (aiir) with negative pressure air handling with 6 to 12 air changes per hour can be used. air can be exhausted directly outside or be recirculated after filtration by a high efficiency particulate air (hepa) filter. for suctioning, bronchoscopy, or intubation, use a procedure room with negative pressure air handling.

the ill person should wear a surgical mask when outside of the patient room, and should be encouraged to wash hands frequently and follow respiratory hygiene practices. cups and other utensils used by the ill person should be washed with soap and water before use by other persons. routine cleaning and disinfection strategies used during influenza seasons can be applied to the environmental management of swine influenza. more information can be found at http://www.cdc.gov/ncidod/dhqp/gl_environinfection.html.

standard, droplet and contact precautions should be used for all patient care activities, and maintained for 7 days after illness onset or until symptoms have resolved. maintain adherence to hand hygiene by washing with soap and water or using hand sanitizer immediately after removing gloves and other equipment and after any contact with respiratory secretions.

personnel providing care to or collecting clinical specimens from suspected or confirmed cases should wear disposable non-sterile gloves, gowns, and eye protection (e.g., goggles) to prevent conjunctival exposure.

masks and respirators: until additional, specific information is available regarding the behavior of this swine influenza a (h1n1), the guidance in the october 2006 "interim guidance on planning for the use of surgical masks and respirators in healthcare settings during an influenza pandemic" http://www.pandemicflu.gov/plan/healthcare/maskguidancehc.htmlicon_out.png should be used. these interim recommendations will be updated as additional information becomes available.

interim recommendations:

  • personnel engaged in aerosol generating activities (e.g., collection of clinical specimens, endotracheal intubation, nebulizer treatment, bronchoscopy, and resuscitation involving emergency intubation or cardiac pulmonary resuscitation) for suspected or confirmed swine influenza a (h1n1) cases should wear a fit-tested disposable n95 respirator.*
  • pending clarification of transmission patterns for this virus, personnel providing direct patient care for suspected or confirmed swine influenza a (h1n1) cases should wear a fit-tested disposable n95 respirator when entering the patient room.

*respirator use should be in the context of a complete respiratory protection program in accordance with occupational safety and health administration (osha) regulations. information on respiratory protection programs and fit test procedures can be accessed at http://www.osha.gov/sltc/etools/respiratory. staff should be medically cleared, fit-tested, and trained for respirator use, including: proper fit-testing and use of respirators, safe removal and disposal, and medical contraindications to respirator use.

additional information on n95 respirators and other types of respirators may be found at: http://www.cdc.gov/niosh/npptl/topics/respirators/factsheets/respfact.html, and at www.fda.gov/cdrh/ppe/masksrespirators.htmlicon_out.png.

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Specializes in OB, HH, ADMIN, IC, ED, QI.

Quote from Quote used in NurseJanIAm's post above

"Patients with suspected or confirmed case-status should be placed in a single-patient room with the door kept closed. If available, an airborne infection isolation room (AIIR) with negative pressure airborne infection isolation room (AIIR) with negative pressure air handling with 6 to 12 air changes per hour can......."

So, the room itself is termed "airborne infection isolation room", while the technique itself is called "respiratory".

Thank you very much, "NurseJanIAm"

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i work on an infectious disease floor in upstate ny that has reserved 5 beds for the flu. we are using droplet/contact precautions.

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