Infection control for SARS

Intensive Care UnitPrince of Wales Hospital

ShatinHong Kong

Tutorial prepared by Charles GomersallVersion 1.0

April 8th 2003

Disclaimer

• The procedures shown in this tutorial reflect current practice in Prince of Wales Hospital ICU and are based on our current understanding of SARS

• The author, the Prince of Wales Hospital and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this tutorial

Warning

• Attention to infection control is vital– The agent that causes SARS is highly

contagious and may cause life-threatening illness

– Many healthcare workers, both old and young have been affected and some have died

Personal

• In1. Wash hands2. Mask3. Goggles4. Cap5. Gown6. Wash hands7. Gloves

• Out1. Cap2. Gown3. Wash hands4. Goggles5. Mask6. Wash hands7. Outside mask8. Wash hands

In

1. Wash hands2. Mask3. Goggles4. Cap5. Gown6. Wash hands7. Gloves

In

1. Wash hands2. Mask3. Goggles4. Cap5. Gown6. Wash hands7. Gloves

Wash hands

1. Palm to palm2. Palm to back,

fingers interlaced3. Palm to palm,

fingers interlaced4. Fingers clasped5. Thumbs 6. Fingers to palm7. Forearms

Wash hands

1. Palm to palm2. Palm to back,

fingers interlaced3. Palm to palm,

fingers interlaced4. Fingers clasped5. Thumbs 6. Fingers to palm7. Forearms

Wash hands

1. Palm to palm2. Palm to back,

fingers interlaced3. Palm to palm,

fingers interlaced4. Fingers clasped5. Thumbs 6. Fingers to palm7. Forearms

Wash hands

1. Palm to palm2. Palm to back,

fingers interlaced3. Palm to palm,

fingers interlaced4. Fingers clasped5. Thumbs 6. Fingers to palm7. Forearms

Wash hands

1. Palm to palm2. Palm to back,

fingers interlaced3. Palm to palm,

fingers interlaced4. Fingers clasped5. Thumbs 6. Fingers to palm7. Forearms

Wash hands

1. Palm to palm2. Palm to back,

fingers interlaced3. Palm to palm,

fingers interlaced4. Fingers clasped5. Thumbs 6. Fingers to palm7. Forearms

Mask

• Use N95 or N100 mask• Surgical masks do NOT provide protection• Check fit of mask each time it is used

– place both hands over the mask and exhale vigorously

– if air leaks around the nose adjust the nosepiece

– if air leaks at mask edges, reposition the straps for a better fit

– recheck

In

1. Wash hands2. Mask3. Goggles4. Cap5. Gown6. Wash hands7. Gloves

In

1. Wash hands2. Mask3. Goggles4. Cap5. Gown6. Wash hands7. Gloves

In

1. Wash hands2. Mask3. Goggles4. Cap5. Gown6. Wash hands7. Gloves

In

1. Wash hands2. Mask3. Goggles4. Cap5. Gown6. Wash hands7. Gloves

In

1. Wash hands2. Mask3. Goggles4. Cap5. Gown6. Wash hands7. Gloves

In

1. Wash hands2. Mask3. Goggles4. Cap5. Gown6. Wash hands7. Gloves

Ready

1. Wash hands2. Mask3. Goggles4. Cap5. Gown6. Wash hands7. Gloves

Inside

• Change gloves between patients• Change gloves before using phone,

computers, writing notes etc• Wash your hands whenever you change

your gloves• Do not touch your face or eyes

Out

1. Cap2. Gown3. Remove gloves4. Wash hands5. Goggles6. Mask7. Wash hands8. Outside mask9. Wash hands

Out

1. Cap2. Gown3. Remove gloves4. Wash hands5. Goggles6. Mask7. Wash hands8. Outside mask9. Wash hands

Out

1. Cap2. Gown3. Remove gloves4. Wash hands5. Goggles6. Mask7. Wash hands8. Outside mask9. Wash hands

Out

1. Cap2. Gown3. Remove gloves4. Wash hands5. Goggles6. Mask7. Wash hands8. Outside mask9. Wash hands

Out

1. Cap2. Gown3. Remove gloves4. Wash hands5. Goggles6. Mask7. Wash hands8. Outside mask9. Wash hands

Out

1. Cap2. Gown3. Remove gloves4. Wash hands5. Goggles6. Mask7. Wash hands8. Outside mask9. Wash hands

Out

1. Cap2. Gown3. Remove gloves4. Wash hands5. Goggles6. Mask7. Wash hands8. Outside mask9. Wash hands

Out

1. Cap2. Gown3. Remove gloves4. Wash hands5. Goggles6. Mask7. Wash hands8. Outside mask9. Wash hands

Out

1. Cap2. Gown3. Remove gloves4. Wash hands5. Goggles6. Mask7. Wash hands8. Outside mask9. Wash hands

Eating and drinking

• Always wash your hands first• Use your own utensils• Sit at least 1m apart• Do not talk• Do not cough or sneeze when not

wearing a mask

Respiratory

• No nebulizers or Venturi masks

• No non-invasive ventilation

• Minimize circuit breaks

• HMEF• Bacterial filter• Scavenging

Respiratory

• No nebulizers or Venturi masks

• No non-invasive ventilation

• Minimize circuit breaks

• HMEF• Bacterial filter• Scavenging

Respiratory

• No nebulizers or Venturi masks

• No non-invasive ventilation

• Minimize circuit breaks

• HMEF• Bacterial filter• Scavenging

Respiratory

• No nebulizers or Venturi masks

• No non-invasive ventilation

• Minimize circuit breaks

• HMEF• Bacterial filter• Scavenging

Respiratory

• No nebulizers or Venturi masks

• No non-invasive ventilation

• Minimize circuit breaks

• HMEF• Bacterial filter• Scavenging

Respiratory

• No nebulizers or Venturi masks

• No non-invasive ventilation

• Minimize circuit breaks

• HMEF• Bacterial filter• Scavenging

Urine

• Direct urine flow against the wall of the collecting jug to avoid splashes

Urine

• Turn on water to flush away urine

Urine

• Carefully empty the urine onto the side of the sluice to avoid splashes

Urine

• Clean up any spills immediately with sodium hypochlorite solution

Remember

• This disease is highly contagious• It is potentially life threatening• Your safety and the safety of your

family and patients depends on your strict adherence to infection control measures