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Posted: May 27th, 2023
Managing Infections in the ER
The emergency department (ED) is a high-risk setting for the transmission of infections, both among patients and health care personnel (HCP). Infections can spread through direct contact, droplet, or airborne routes, depending on the type and source of the pathogen. Therefore, infection control measures are essential to prevent or stop the spread of infections in the ED.
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Some of the basic infection control techniques that should be implemented in the ED are:
- Hand hygiene: HCP should perform hand hygiene with soap and water or an alcohol-based hand sanitizer before and after caring for every patient, after touching potentially contaminated surfaces or objects, and before putting on or taking off personal protective equipment (PPE) .
- PPE: HCP should use appropriate PPE, such as gloves, gowns, masks, eye protection, or respirators, depending on the level of exposure and the type of infection. PPE should be worn correctly and disposed of properly after use .
- Contact precautions: HCP should use contact precautions when caring for patients with known or suspected infections that can be transmitted by direct or indirect contact, such as methicillin-resistant Staphylococcus aureus (MRSA) or Clostridium difficile. Contact precautions include wearing gloves and gowns, using dedicated equipment, and placing patients in single rooms or cohorting them with similar patients .
- Droplet precautions: HCP should use droplet precautions when caring for patients with known or suspected infections that can be transmitted by respiratory droplets, such as influenza or pertussis. Droplet precautions include wearing a surgical mask, maintaining a distance of at least 3 feet from the patient, and placing patients in single rooms or cohorting them with similar patients .
- Airborne precautions: HCP should use airborne precautions when caring for patients with known or suspected infections that can be transmitted by small airborne particles, such as tuberculosis or measles. Airborne precautions include wearing a respirator, placing patients in negative pressure rooms with adequate ventilation, and limiting patient movement outside the room .
- Triage and isolation: HCP should triage patients with signs and symptoms of infection as soon as possible and isolate them from other patients and visitors. Patients with respiratory symptoms should be given a surgical mask to wear and instructed to cover their coughs and sneezes. Patients with suspected or confirmed infections that require airborne precautions should be placed in negative pressure rooms or transferred to facilities that have such rooms .
- Environmental cleaning and disinfection: HCP should ensure that the ED rooms and equipment are cleaned and disinfected regularly and thoroughly, using appropriate agents and methods. Special attention should be given to high-touch surfaces and items that may be contaminated with blood or body fluids .
- Education and training: HCP should receive ongoing education and training on infection control principles and practices, including the modes of transmission, the risk factors, the prevention strategies, and the outbreak management. HCP should also be aware of the local epidemiology and surveillance data of common infections in the ED .
By following these infection control techniques, HCP can reduce the risk of acquiring or transmitting infections in the ED and improve the quality and safety of patient care.
References:
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: Emergency department - Infectious Disease Advisor. https://www.infectiousdiseaseadvisor.com/home/decision-support-in-medicine/hospital-infection-control/emergency-department/. Accessed October 27, 2023.
: Infection Control | CDC. https://www.cdc.gov/infectioncontrol/index.html. Accessed October 27, 2023.
: For Patients | MRSA | CDC. https://www.cdc.gov/mrsa/community/patients.html. Accessed October 27, 2023.
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: Paediatric emergency triage, assessment homework help - research paper writing service and treatment. https://apps.who.int/iris/bitstream/handle/10665/204463/9789241510219_eng.pdf;sequence=1. Accessed October 27, 2023.
: Management of Potentially Infectious Exposures and Illnesses. https://www.cdc.gov/infectioncontrol/guidelines/healthcare-personnel/exposures.html. Accessed October 27, 2023.
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