Student 5Q1. Types of single isolation roomFunctional classification of isolation room.NB. An important distinguishing difference in the air pressure of the room1. Class S (standard) Room Used for known or suspected to have infection requiring contant or droplet precaution.Key features: Must have: Door, staff hand-wash basin,Ensuite bathroom. This is to facilitate good infection control precaution.Nor air pressure difference between the room and the adjacent roomTransmission based precaution:Contact or dropletE.g. of disease: 1. Gastroenteritis2.cutaneous anthrax3. Hepatitis A4.Mengingococcal disease5.URC2. Class N (negative) Room.Used for person known to have infection requiring airborne precaution. E.g. chicken-pox, measles, suspected or proven pulmonary or laryngeal tuberculosis.AIR PRESSURE.Air pressure in the room is less than in the adjacent corridor3.Class A ( Alternating ) RoomVentilation may be configured to achieve either positive or negative pressure in the room.NB. This is not recommended4. Class P ( Posive Pressure) Isolatin Room(Protective Environ/ Protective Isolation Unit/ Reverse Isolation Unit)Air pressure in the room is greater than in the adjacent corridorThis is to prevent transmission of pathogen from the outside environment to profoundly immunosuppressed person. E.g. Prevention of aspergillosis in bone-marrow transplant recipient.Fitted with HEPA filter with capacity of maintaining < 3/10,000 atmospheric particle of 0.3micron with > 12 air exchange per hour. Will remove bacteria and fungal spore. This is most effective to prevent hospital acquired aspergillosis.Isolation room shold have self-closing door and well sealed windows. Avoid false ceiling. Flooring and wall finishing can be scrubbed, non-porous and easily disinfected.A constant Positive pressure of >2.5 P between patients room and hallway should be maintained. Back-up emergency power should be available. Ward room should be regularly cleaned at least once a day. Avoid vaccuming. Any water leak should be attended to within 72 hours.

NB: for ventilation detail: see Ministry of health Malaysia 3.5.1-3.5.2 Interior of isolation room.

Q2. Sort of room for patient with AMLClass PNB: MOH Malaysia guideline: AMLSingle room is beneficialIf not available: open cubicle with isolation facilities

Q3. Precaution to be taken in entering roomNB: airm is to avoid transmitting pathogen to patient who is immune-weakened.A. Wear surgical maskB. Observe hand hygiene.scrub hand with alcohol based hand scrub before entry and after leaving roomC. Wear glove and gown provided after entering room and discarded before leavingD. Should not sit on patients bedE. No flowers: natural or artificialF. Avoid contact if possibleG. Refrain from seeing other patient or visiting patient if one had active URTI. Recent exposure to communicable infection. E.g. active shingles, recent vaccination withing 6 weeks. This is to avoid passing the pathogen to patient..patient with MRSA/OPEN PTBThis is to avoid contracting pathogens from patient.Unlike visiting a patient with AML1. Respiratory Protection: wear at least N95 respirator. Other respirator include N100 of PAPR : POWERED AIR PURIFYING RESPIRATOR.2. PPE: Personal Protective Equipment.Wear glove and gownGowns are not to be worn outside the room.Wash hands: before and after.Avoid direct contaminatin by touching patients or indirect contamination by touching contaminated objects or surface. Remove glove before leaving patients environment and wash hands immediately with soap or waterless antiseptic.3. If you have weak immunity, e.g. recently recovered from measles (rubella)or varicella(chicken pox), advised not to visit.