Isolation Techniques in Healthcare: Types and Protocols
Isolation Techniques in Healthcare
Isolation Techniques: The objective is to isolate contagious patients to prevent the transmission of disease to healthy individuals (standard isolation). Isolating patients also prevents them from contracting immunodeficiency-related diseases (protective isolation).
These techniques primarily address the second step of the epidemiological chain, utilizing mechanical and chemical barriers.
Isolation Protocols
Rules: Follow the protocol specified for each case. Keep doors to patient rooms closed and clearly identified. Practice thorough hand hygiene before leaving the room. Use gowns, gloves, masks, caps, and leggings as required. Ensure the patient’s room is equipped with all necessary medical equipment until discharge or transfer.
Double Bagging: Use a clean bag to contain a dirty bag. Place all contaminated materials inside the dirty bag within the patient’s room. Seal the dirty bag inside the clean bag before removing it from the room.
Types of Isolation
Strict Isolation
For highly infectious diseases (airborne, contact, direct, cutaneous).
Diseases: Varicella (chickenpox), congenital rubella, rabies, swine influenza, herpes zoster (shingles), pharyngeal diphtheria, etc.
Requirements: Single room with negative pressure, door always closed, mask, gowns, gloves, leggings, and dedicated medical equipment for the patient.
Protective or Reverse Isolation
To protect immunocompromised patients from contaminated environments.
Diseases/Conditions: Extensive uninfected burns, transplants, premature infants, patients treated with immunosuppressants, and leukemia/lymphoma patients.
Requirements: Single room with positive pressure, closed door, sterile instruments and equipment, mask, gowns, sterile gloves and leggings, antiseptic soap, dedicated medical equipment, and cleaning supplies solely for that room.
Respiratory Isolation
Transmission: Airborne
Diseases: Measles, rubella, pertussis (whooping cough), mumps, etc.
Requirements: Single room, negative pressure, door always closed to prevent air circulation, use of a mask, gloves when in contact with secretions, and disposal of tissues in incinerable containers or bags.
Enteric Isolation
Transmission: Direct or indirect (feces or objects contaminated by feces)
Diseases: Cholera, acute infectious diarrhea, salmonellosis, viral hepatitis.
Requirements: Single room not always necessary, disposable gloves and protective gown for staff in contact, bleach for disinfection of feces, and dedicated bedpans. Single-use food utensils.
Muco-cutaneous Isolation
Prevention: Preventing infections through contact with burn wounds, infected burns, or purulent drainage.
Diseases: Gas gangrene, non-covered wound infections, cutaneous infections, extensive infected burns, etc.
Requirements: Single room with washbasin, gown, mask, sterile gloves, and sterile surgical instruments.
Universal Precautions
When it is unknown if the patient has any infectious disease.
Requirements: Single-use gloves, antiseptic soap, disinfectant, rigid containers for sharps, masks, goggles, gowns, and waterproof aprons.
Order of Donning PPE
Order: Hand hygiene, cap, shoe covers (if necessary), mask, eye protection (if necessary), gown, gloves.
Hand Hygiene
Antiseptic Hand Wash: Lasts approximately one minute, friction-based, remove rings and watches.
Surgical Scrub: Approximately 5 minutes, rotating friction from arms to elbows, drying with a sterile towel.