Biological Controls

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Isolation Enclosures

   ISOPORT™

Applications

Sputum Induction
Administration of Aerosolized Medications
Pentamidine Treatments
   


The ISOPORT™ is a heavy-duty vinyl enclosure that encapsulates the patient and isolates them in a negative pressure setting while aerosolized medications are being administered. For those procedures that involve instrumentation of the lower respiratory tract or induce coughing, there is an ever-increased risk that droplet nuclei are being expelled into the air and spread throughout the treatment room and facility on air currents. The ISOPORT will contain and remove these particles. 

 

 

 


ISOPORT 4X4 with MICROCON® 400-MUV

ISOPORT™

CDC Recommends Negative-pressure "Enclosures"
CDC says, "The risk may be higher in areas where patients with TB are provided care or where diagnostic or treatment procedures that stimulate coughing are performed. Nosocomial transmission ofM. tuberculosis has been associated with close contact with persons who have infectious TB and with the performance of certain procedures (e.g., bronchoscopy, endotracheal intubation and suctioning open abscess irrigation, and autopsy). Sputum induction and aerosol treatments that induce coughing may also increase the potential for transmission of M. tuberculosis".



 

 


The ISOPORT can be constructed in virtually any size


ISOPORT with Magnetic Strip Door

 


CDC Recommends Isolation Rooms

CDC says, "If a bronchoscopy is being performed for the purpose of diagnosing pulmonary disease and that diagnosis could include TB, the procedure should be performed in a room that meets TB isolation ventilation requirements".

Since many facilities may not be equipped with either the necessary number of isolation rooms, or rooms which meet the CDC guidelines, or even have a room available when needed, the ISOPORT is an ideal optional location. The advantage of the ISOPORT is that it can be assembled virtually anywhere it is needed to perform procedures that must be rendered in a negative-pressure environment.


 

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biologicalcontrols.com - Isolation Precautions
 

Recommendations for Isolation Precautions in Hospitals
(Reproduced from CDC Web site, NOT the complete text)

 

RATIONALE FOR ISOLATION PRECAUTIONS IN HOSPITALS 

Transmission of infection within a hospital requires three elements:  a source of infecting microorganisms, a susceptible host, and a means of transmission for the microorganism. 

Transmission 

Microorganisms are transmitted in hospitals by several routes, and the same microorganism may be transmitted by more than one route.  There are five main routes of transmission:  contact, droplet, airborne, common vehicle, and vectorborne.  For the purpose of this guideline, common vehicle and vectorborne transmission will be discussed only briefly, because neither play a significant role in typical nosocomial infections.

  • Contact transmission, the most important and frequent mode of transmission of nosocomial infections, is divided into two subgroups:  direct-contact transmission and indirect-contact transmission.

    • Direct-contact transmission involves a direct body surface-to-body surface contact and physical transfer of microorganisms between a susceptible host and an infected or colonized person, such as occurs when a person turns a patient, gives a bath, or performs other patient-care activities that require direct personal contact.  Direct-contact transmission also can occur between two patients, with one serving as the source of the infectious microorganisms and the other as a susceptible host.

    • Indirect-contact transmission involves contact of a susceptible host with a contaminated intermediate object, usually inanimate, such as contaminated instruments, needles, or dressings, or contaminated hands that are not washed and gloves that are not changed between patients.

  • Droplet transmission, theoretically, is a form of contact transmission.  However, the mechanism of transfer of the pathogen to the host is quite distinct from either direct or indirect - contact transmission.  Therefore, droplet transmission will be considered a separate route of transmission in this guideline.  Droplets are generated from the source person primarily during coughing, sneezing, and talking, and during the performance of certain procedures such as suctioning and bronchoscopy.  Transmission occurs when droplets containing microorganisms generated from the infected person are propelled a short distance through the air and deposited on the host's conjunctivae, nasal mucosa, or mouth.  Because droplets do not remain suspended in the air, special air handling and ventilation are not required to prevent droplet transmission;  that is, droplet transmission must not be confused with airborne transmission.

  • Airborne transmission occurs by dissemination of either airborne droplet nuclei (small-particle residue [5 um or smaller in size] of evaporated droplets containing microorganisms that remain suspended in the air for long periods of time) or dust particles containing the infectious agent.  Microorganisms carried in this manner can be dispersed widely by air currents and may become inhaled by a susceptible host within the same room or over a longer distance from the source patient, depending on environmental factors;  therefore, special air handling and ventilation are required to prevent airborne transmission.  Microorganisms transmitted by airborne transmission include Mycobacterium tuberculosis and the rubeola and caricella viruses.

Isolation precautions are designed to prevent transmission of microorganisms by these routes in hospitals.  Because agent and host factors are more difficult to control, interruption of transfer of microorganisms is directed primarily at transmission.  The recommendations presented in this guideline are based on this concept. 

Placing patient on isolation precautions, however, often presents certain disadvantages to the hospital, patients, personnel, and visitors.  Isolation precautions may require specialized equipment and environmental modifications that add to the cost of hospitalizations.  Isolation precautions may take frequent visits by nurses, physicians, and other personnel inconvenient, and they may make it more difficult for personnel to give the prompt and frequent care that sometimes is required.  The use of a multi-patient room for one patient uses valuable space that otherwise might accommodate several patients.  Moreover, forced solitude deprives the patient of normal social relationships and may be psychologically harmful, especially to children.  These disadvantages, however, must be weighed against the hospital's mission to prevent the spread of serious and epidemiologically important microorganisms in the hospital.

FUNDAMENTALS OF ISOLATION PRECAUTIONS 

A variety of infection control measures are used for decreasing the risk of transmission of microorganisms in hospitals.  These measures make up the fundamentals of isolation precautions. 

Patient Placement 

Appropriate patient placement is a significant component of isolation precautions.  A private room is important to prevent direct -or indirect- contact transmission when the source patient has poor hygienic habits, contaminates the environment, or cannot be expected to assist in maintaining infection control precautions to limit transmission of microorganisms (i.e., infants, children, and patients with altered mental status).  When possible, a patient with highly transmissible or epidemiologically important microorganisms is place in a private room with handwashing and toilet facilities, to reduce opportunities for transmission of microorganisms. 

When a private room is not available, an infected patient is placed with an appropriate roommate.  Patients infected by the same microorganism usually can share a room,  provided they are not infected with other potentially transmissible microorganisms and the likelihood of reinfection with the same organism is minimal.  Such sharing of rooms, also referred to as cohorting patients, is useful especially during outbreaks or when there is a shortage of private rooms.  When a private room is not available and cohorting is not achievable or recommended  it is very important to consider the epidemiology and mode of transmission of the infecting pathogen and the patient population being served in determining patient placement.  Under these circumstances, consultation with infection control professionals is advised before patient placement.  Moreover, when an infected patient shares a room with a noninfected patient, it also is important that patients, personnel, and visitors take precautions to prevent the spread of infection and that roommates are selected carefully. 

Guidelines for construction, equipment, air handling, and ventilation for isolation rooms have been delineated in other publications.  A private room with appropriate air handling and ventilation is particularly important for reducing the risk of transmission of microorganisms from a source patient to susceptible patients and other persons in hospitals when the microorganism is spread by airborne transmission.  Some hospitals use isolation room with an anteroom as an extra measure of precaution to prevent airborne transmission.  Adequate data regarding the need for an anteroom, however, is not available.  Ventilation recommendations for isolation rooms housing patients with pulmonary tuberculosis have been delineated with other CDC guidelines. 

HICPAC ISOLATION  PRECAUTIONS 

There are two tiers of HICPAC  isolation precautions.  In the first, and most important, tier are those precautions designed for the care of all patients in hospitals, regardless of their diagnosis or presumed infection status.  Implementation of these "Standard Precautions" is the primary strategy for successful nosocomial infection control.  In the second tier are precautions designed only for the care of specified patients.  These additional "Transmission-Based Precautions" are for patients known or suspected to be infected by epidemiologically important pathogens spread by airborne or droplet transmission or by contact  with dry skin or contaminated surfaces. 

Transmission-Based Precautions

Transmission-Based Precautions are designed for patients documented or suspected to be infected with highly transmissible or epidemiologically important pathogens for which additional precautions beyond Standard Precautions are needed to interrupt transmission in hospitals.  There are three types of Transmission-Based Precautions:  Airborne Precautions, Droplet Precautions, and Contact Precautions.  They may be combined for diseases that have multiple routes of transmission.  When used either singularly or in combination, they are to be used in addition to Standard Precautions. 

Airborne Precautions are designed to reduce the risk of airborne transmission of infectious agents.  Airborne transmission occurs by dissemination of either airborne droplet nuclei (small particle reside [5 um or smaller in size] of evaporated droplets that may remain suspended in the air for long periods of time) or dust particles containing the infectious agent.  Microorganisms carried in this manner can be dispersed widely by air currents and may become inhaled by or deposited on a susceptible host within the same room or over a longer distance from the source patient, depending on environmental factors;  therefore, special air handling and ventilation are required to prevent airborne transmission.  Airborne Precautions apply to patient known or suspected to be infected with epidemiologically important pathogens that can be transmitted by the airborne route. 

Droplet Precautions are designed to reduce the risk of droplet transmission of infectious agents.  Droplet transmission involves contact of the conjunctivae or the mucous membranes of the nose or mouth of a susceptible person with large-particle droplets (larger than 5 um in size) containing microorganisms generated from a person who has a clinical disease or who is a carrier of the microorganism.  Droplets are generated from the source person primarily during coughing, sneezing, or talking and during the performance of certain procedures such as suctioning and bronchoscopy.  Transmission via large-particle droplets requires close contact between source and recipient persons, because droplets do not remain suspended in the air generally travel only short distances, usually 3 ft or less, through the air.  Because droplets do not remain suspended in the air, special air handling and ventilation are not required to prevent droplet transmission.  Droplet Precautions apply to any patient know or suspected to be infected with epidemiologically important pathogens that can be transmitted by infectious droplets. 

Airborne Precautions

In addition to Standard Precautions, use Airborne Precautions, or the equivalent, for patients known or suspected to be infected with microorganisms transmitted by airborne droplet nuclei (small-particle residue [5 um or smaller in size] of evaporated droplets containing microorganisms that remain suspended in the air and that can be dispersed widely by air currents within a room or over a long distance. 

Patient Placement:
Place the patient in a private room that has:

  1. Monitored negative air pressure in relation to the surrounding areas

  2. 6 to 12 air changes per hour

  3. Appropriate discharge of air outdoors or monitored high-efficiency filtration of room air before the air is circulated to other areas in the hospital  Keep the room door closed and the patient in the room.  When a private room is not available, place the patient in a room with a patient who has active infection with the same microorganism, unless otherwise recommended, but with no other infection.  When a private room in not available and cohorting is not desirable, consultation with infection control professionals is advised before patient placement.  

Droplet Precautions 

In addition to Standard Precautions, use Droplet Precautions, or the equivalent, for a patient known or suspected to be infected with microorganisms transmitted by droplets (large-particle droplets [larger than 5 um in size] that can generated by the patient during coughing, sneezing, talking, or the performance of procedures).

EPA:
Environmental Protection Agency

   

American Lung Association

   

AAAAI:
American Academy of Allergy Asthma & Immunology

   

AANMA:
Allergy & Asthma Network Mothers of Asthmatics

   

OSHA:
US Department of Labor

   

National Safety Council
Environmental Health Center

   

ASHRAE:
American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc.

   

ACCA:
Air Conditioning Contractors of America

   

ARI:
Air Conditioning & Refrigeration Institute

   

NADCA:
National Air Duct Cleaners Association

   

NAFA:
National Air Filtration Association

 


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