Isolation and protection measures have been updated, and early diseases were classified into sevenquarantineLater, the Universal Precaution was put forward. Recently, in order to meet the needs of epidemiology and emphasize various body fluids, secretionsExcretayesNosocomial infectionIn order to provide more correct protective measures for diseases caused by air, droplet, contact and other transmission routes, Standard Precaution and Transmission based Precaution are proposed asClinical guidelines。
The revised protective measures are divided into 1. Standard Precaution: protective measures for all patients; 2. According to the transmission route, protective measures can be divided into air protection, droplet protection and contact protection. The following protective measures are described as follows:
Standard protection
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It is mainly to reduce the risk of spreading microorganisms from known or unknown sources in the hospital. The source of infection includes all bloodbody fluid, secretions, excreta (except sweat), and incomplete skin and mucosa.The main measures are as follows:
1. Hand washing
When possible contactInfection sourceIn order to prevent the spread of pathogenic bacteria and protect all members of the hospital, everyone must observe hand washing measures.Wash your hands before and after taking care of the patient and preparing the patient's articles, and after handling the examination body.
2. Gloves
When contactedInfection sourceWear gloves and immediately take off gloves and wash hands after treatment.
3. Isolation clothing
Have beenInfection sourceWear when it is possible to pollute work clothes.In principle, a patient should use a piece of isolation clothing. After use, the contaminated isolation clothing should be immediately removed and washed.
4. Goggles
Have beenInfection sourceWear when splashing on the face is possible.
5. Appliances and equipment
Patient's blood, body fluid, etcInfection sourceContaminated instruments and equipment shall bedisinfectantThoroughly clean;If the appliance can only be used for a single time, it should be discarded after use and not reused.
6. Environment cleaning
Regularly and thoroughly clean and disinfect the environment, especially the patient unit and the frequently contacted surfaces. For details, please refer to Chapter 1 of the manual.
7. The needles, syringes, sharp objects, etc. shall be discarded in the anti acupuncture container. The needles after use shall not be returned as far as possible. If they must be returned, single glove needles shall be used.
II. Transmission based Prevention:
Ⅳ －5
Protective measures formulated for patients who have been confirmed or suspected to be infected by highly infectious pathogens, and whose transmission route cannot be blocked by standard protective measures only.It is divided into three categories as follows:
Air protection measures
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The air transmission protection measures are aimed at airborne pathogens. Air transmission mainly occurs through droplet nuclei (usually the particle size is less than or equal to 5mm, because it is suspended in the air for a long time) or the spread of dust containing pathogens.
(II)Infection source: Droplet nuclei or dust containing pathogenic bacteria.
（3） Control measures:
1. Mask: caregivers need to wear special masks;yesmeaslesPeople who are immune to chicken pox do not need to wear masks when taking care of measles and chicken pox patients.
2. Gloves: Not required.
3. Isolation suit: not required.
4. Separate room: the patient should be placed in the isolation room with negative pressure air conditioning (6~12 air changes per hour), and the door should be kept closed;The air shall be filtered and discharged, and shall not be reused.
5. Hand washing: hand washing is required before and after contact with patients or after handling pollutants.
6. Patient transmission: The patient should be placed in an isolated room as far as possible, and should wear a mask when going out.
7. Item handling:
(1) Equipment: decontaminate with hot water and send it to the supply room for treatment.
(2) Respirator: the surface of the respirator is wiped with 0.05% bleach water every day, and the respirator pipeline is decontaminated with hot water and then sent to the respiratory center for treatment with plastic bags.
(3) Bedding sheets and clothes:Infection sourceIn case of a large amount of pollution, it shall be preliminarily decontaminated before being sent to the laundry room;When dealing with high pollution sheets and clothes, you can wear isolation clothing without shaking.
⑷ Final disinfection: see Chapter I of the manual.
(5) Waste disposal: see Chapter II of the manual.
Droplet Precautions
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Foaming transmission refers to the direct contact of conjunctiva, oral and nasal mucosa with droplets containing pathogenic bacteria (usually the particles are larger than 5 μ m), and the droplets come from patients coughing, sneezing, talking or medical staff performing sputum extraction and bronchoscopy;Because its particles will not be suspended in the air, it usually occurs in close contact (generally 3 feet, within 100cm).
1. Mask: wear a mask when taking care of patients in a short distance (3 feet, within 100cm).
2. Gloves: Not required.
3. Isolation suit: not required.
4. Separate room: as far as possible, separate room or place patients infected with the same pathogen in the same room.
5. Hand washing: hand washing is required before and after contact with patients or after handling pollutants.
6. Patient transmission: The patient should stay in the room as far as possible, and please wear a mask when he must go out.
7. Material handling: isolated from air.
8. Waste disposal: see Chapter II of the Manual.
1. Mask: generally not required, with quiltInfection sourceWear a mask and goggles when you are worried about spraying.
2. Gloves: When contactingInfection sourceWear gloves and immediately take off gloves and wash hands after treatment.
3. Isolation clothing: quiltInfection sourceWear when it is possible to pollute work clothes.In principle, a patient should use a piece of isolation clothing, and the contaminated isolation clothing should be immediately removed and washed.
4. Separate room: as far as possible, separate room or place patients infected with the same pathogen in the same room.
5. Hand washing: hand washing is required before and after contact with patients or after handling pollutants.
6. Material handling: the same as air protection.
7. Waste disposal:
Contact protection measures
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The purpose of contact transmission protection is to reduce the spread of pathogenic bacteria to susceptible hosts through direct or indirect contact. Direct contact refers to contact with skin or moving patients, bathing, or medical behaviors that need direct contact. Indirect contact refers to contact with inanimate objects such as appliances or environment contaminated by pathogenic bacteria.Contact isolation is applicable to patients with known or suspected infection but no clinical symptoms, so as to avoid spreading infection due to direct or indirect contact.
