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Infection Prevention, and Control Guidelines for Primary Care Physicians
Airborne Precautions
Introduction:
Airborne transmission refers to dissemination of microorganisms in the air. Organisms are contained in airborne droplet nuclei or in dust particles containing debris that remains suspended in the air for long periods of time. Such organisms are widely dispersed by air currents and inhaled by susceptible hosts who may be a distance away from the source. Environmental controls are important; special air handling and ventilation help reduce airborne transmission.
Disease Examples:
- Measles (Rubeola)
- Pulmonary Tuberculosis
- Varicella (Chicken Pox)
- Disseminated Zoster
- Mumps
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Best Practices:
Minimum standards of care for seeing patients with airborne infections are as follows:
1. If clinical status allows, assess these patients at the end of the office day
2. When patient arrives, instruct to perform hand hygiene and put on a mask that will be worn at all times while in office
3. Quickly triage patient out of common waiting areas, ensure that the patient is separate from other patients. If possible patients should enter and exit through a separate entrance and go directly in and out of the examination room
4. Move patient to examination room
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Close door and open window in room if possible.
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Inform care provider of risk via verbal, signage or flagging chart.
5. For direct patient care
- Perform hand hygiene
- Must wear an N95 (or equivalent) respirator for care of patients with infectious tuberculosis. An N95 respirator is not needed if the health care worker is immune to suspected airborne infection (e.g. chicken pox, measles).
6. At the end of office visit
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Perform hand hygiene
- Wipe all horizontal surfaces (with low level disinfectant) in the examining room that have been in contact with the patient
- Wipe all equipment (with low level disinfectant) used to examine the patient (blood pressure cuff, stethoscope, etc.)
- Allow for sufficient time for the air exchange in the room to be free of droplet nuclei before using the room for another patient with tuberculosis or for a non-immune patient
7. Ensure to report all Reportable Diseases to the Leeds, Grenville and Lanark District Health Unit (refer to Section 1 i)
References:
Health Canada, (1999) Routine practices and additional precautions for preventing the transmission of infection in health care, Vol. 25S4.
Health Canada,(1996) Guidelines for preventing the transmission of tuberculosis in Canadian health care facilities and other institutional settings,
Centers for Disease Control, (1994), Guidelines for preventing the transmission of mycobacterium tuberculosis in health care facilities,
College of Physicians and Surgeons of Ontario (2004) Infection Control in the Physicians Office
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