peter90036
Forum Elite
Topics: 24
Posts: 219
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what diseases require isolation,
would the person need to be isolated in a hospital, can go home without going to work or school?
what type of isolation
how long to keep in isolation
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ACTIVE TUBERCULOSIS
Treatment:
1. Isolation: hospitalize very sick patients and those living in congregate or high risk setting;
respiratory isolation is recommended for 2 months of treatment until disease is probably not communicable
2. Empiric regimens: 4 drugs
CLOSTRIDIUM DIFFICILE
Enteric isolation precautions for hospitalized patients. - Honor the isolation until diarrhea is resolved. Wash your hands
Pneumonia in HIV positive patient Pt isolation as indicated . (huh?)
Airborne Precautions
(particles 5 microns or smaller in size)
-Illnesses include: Tuberculosis, Varicella (chickenpox), including disseminated Zoster
Airborne Precautions =
Patients must be placed in a room with negative air pressure ventilation to prevent transmission of droplet nuclei. Without negative pressure ventilation, infectious droplet nuclei can remain suspended in air for long periods of time. Doors & windows in neg pressure isolation rooms must be kept closed at all times. Hospital personnel & visitors must wear the N95 TB respirator. For patients isolated with chickenpox or measles - persons immune to chickenpox/measles may enter an Airborne isolation room without a mask.
Patients in Airborne isolation must remain in their room except for essential studies only.
Patients must wear a paper surgical mask when leaving their room.
Droplet Precautions
(greater than 5 microns in size)
- Involves contact of the conjunctivae, or mucous membranes of the nose or mouth of a susceptible person with large droplets from a person who has clinical disease or is a carrier of a microorganism.
- include: Diphtheria, Influenza, Pertussis, Invasive N. meningitidis disease, Invasive H. influenzae disease, etc..
-Droplets are generated during sneezing, coughing, talking, & during certain procedures such as suctioning or bronchoscopy.
-Close contact (usually 3 feet or less) to the infectious person is required for transmission of the disease. Large droplets travel only short distances & do not remain suspended in the air.
-Hospital personnel & visitors must wear a paper surgical mask.
Contact Precautions
-Direct Contact - skin to skin contact, the physical transfer of microorganisms.
-Indirect Contact - contact with a contaminated intermediate object from the patient's environment.
-Illnesses include: Multi-Drug Resistant Bacteria (MRSA, VRE, etc.), enteric infections with a low infective dose or prolonged survival in the environment (C. difficile, etc.), skin infections that are highly contagious (scabies, major abscesses, impetigo, Herpes Simplex, Zoster, etc.)
-Hospital personnel & visitors must wear gloves & gowns.
-Disinfection of non-disposable, reusable patient equipment must be performed before leaving the contact isolation room & before reuse with another patient. When possible, dedicate equipment to the contact isolation room.
Neutropenic Precautions
-Precautions include ordering a neutropenic diet which avoids uncooked foods or foods more likely to carry pathological microorganisms.
-Fresh flowers, plants & vegetables are not allowed in room as they may introduce infection. -Avoid enemas, digital rectal exam, rectal tubes or NG tubes to minimize translocation of bacteria from gut
-Basic contact isolation enforced. Also avoid room or wear a mask if you have a viral syndrome or other illness.
Allo Precautions
-Allo patients are at extremely high risk of infection from early in conditioning until their counts recover post-stem cell transfusion. They remain at increased risk of infection throughout their lives due to immunosuppressive medications.
-From the second phase of conditioning strict contact isolation is enforced. Once patients become neutropenic, neutropenic isolation is enforced until counts recover. If a patient becomes infected, appropriate further precautions are taken as per usual for the given infection c diff, zoster etc… Patient may not leave the room until count recovery, they remain afebrile off antibiotics & show no evidence of GVH. When these criteria are met, they may be “recontaminated” by usual skin-to-skin contact with friends & family. They still must wear mask, gloves & gown when leaving their room. After recontamination, staff must still wear gloves & wash hands diligently. Wearing gloves does not replace the need to wash your hands. Use soap & water for visibly soiled hands, but the antimicrobial hand gel is appropriate & often superior otherwise.
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active TB - isolate in hospital? treat & give mask ? can go to work? out?
+PPD +CXR calcif nodule --> give meds and let go.
varicella ???
rubella ?
HIV -- meds & let go
syphillis w/ condylomas -- meds & let go
please add any info
Edited by peter90036 on 04/28/08 - 03:17 PM
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| arlete
Intern in 2009!!!!!
Topics: 25
Posts: 1,788
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MRSA infection: isolation in hospital
Meningitis: isolation in hospital
I think varicella and rubella, if no complications, stay home only.
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| peter90036
Forum Elite
Topics: 24
Posts: 219
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i can tell you now, this has some importance, too bad i didnt research the answers before 
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| chemamr
Moderator and PGY1
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do you have specific information about it?? answers to these questions??
thanks peter
important topic in real life...
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| peter90036
Forum Elite
Topics: 24
Posts: 219
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i thought about the subject and posted the questions,
i took the 2CK recently...and there were a couple on this subject.
for a 2CK exam they might be 'experimental' because it was very specific,
but i think for step 3 & reality might be good to know, but maybe the isolation procedures are detailed for each hospital in the handbook?
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| peter90036
Forum Elite
Topics: 24
Posts: 219
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ok, duh, yup, here it is in the UCLA & U.PENN hospital handbooks,
google is a good friend 
TOP POST IS UPDATED.
Edited by peter90036 on 04/28/08 - 03:19 PM
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