As the coronavirus makes its way around the world and governments struggle to contain it, doctors are put at risk each time a patient each time they see a patient exhibiting symptoms.The Centers for Disease Control produced these guidelines to keep your practice safe should a patient exhibit signs of the virus but notes that these tips are only useable in a healthcare setting. Editor's note: This slideshow was first published February 27, but we are refeaturing it due to physician audience interest.
Minimize chances for exposure
Before arrival:
- Inform patients with symptoms of respiratory infection to take proper precautions to avoid possible spread like wearing a face mask to contain their cough and follow triage procedures.
Upon arrival and during the visit:
- Ensure all patients exhibiting symptoms adhere to respiratory and hand hygiene, as well as cough etiquette and triage procedures.
- Do not allow them to wait among other patients and ensure rapid triage and isolation of the patient.
- Provide supplies for respiratory hygiene and cough etiquette, including 60%-95% alcohol-based hand sanitizer, tissues, no-tough trashcans, and facemasks entrances, waiting rooms, and patient check-ins.
Adhere to standards, part 1
Patient placement:
- All patients exhibiting symptoms should be placed in an airborne infection isolation room (AIIR) with negative air pressure compared to the surrounding rooms, air changes at least six times an hour, and exhausts to the outdoors or through a high efficiency particulate air filter before recirculation.
- If one is unavailable, the patient should be transferred to a facility with and airborne infection isolation room available.
Adhere to standards, part 2
Personal protection:
- Clean hands using alcohol-based hand sanitizer, or by washing hands with soap and water for 20 seconds.
- Healthcare workers should wear clean gloves, clean isolation gowns, respirators, and eye protection.
- If these things are reusable, they should be cleaned after each patient encounter.
- Use caution when performing procedures that can make the patient cough, perform tests in an AIIR, and patients should be kept in isolation on a case-by-case basis until further information about the virus is available.
Manage visitor access and movement in the facility
- Establish procedures for monitoring, managing, and training visitors.
- Restrict access to AIIRs containing patients showing symptoms.
- Visitors of patients confirmed to have the virus or suspected to have the virus should be screened for respiratory symptoms, informed of proper hygiene procedures, and should not be present during procedures that could make the patient cough.
- Exposed visitors should be advised to report any signs or symptoms of acute illness for at least 14 days after the visit.
Implement Engineering Controls
These include:
- physical barriers or partitions to guide patients through triage areas
- curtains between patients in shared areas
- closed suctioning systems for airway suctioning for intubated patients, as well as appropriate air-handling systems (with appropriate directionality, filtration, exchange rate, etc.).
Monitor and manage ill and exposed healthcare personnel
- Public health officials should be involved with any movement and monitoring decisions for personnel exposed to the virus.
- Sick leave policies that are not punitive, are flexible, and that conform with public health policy should be put in place.
Train and educate personnel
- Provide personnel with training on preventing transmission of infectious agents, including refresher training.
- Also train personnel on all personal protective equipment, and anyone must be medically cleared, trained, and fit tested for respiratory protection device use or alternatives.
Implement infection control
- Dedicated medical equipment should be used for infected patients and any non-dedicated or non-disposable equipment should be cleaned and disinfected.
- Environmental cleaning and disinfection procedures should be followed consistently and correctly including routine cleaning and disinfection.
Establish reporting procedures
- Create a process to inform key facility staff and public health officials of the presence of a patient suspected of being infected with the virus.
