Doctors, nurses, and other health care workers must use Standard Precautions to limit the risk of spreading infection. This means that the health care workers may use gloves, gown, mask, eye protection or face shields when taking care of your child.
These precautions are required at all hospitals by Federal law to protect patients as well as health care workers. Transmission-Based Precautions [Isolation] are used along with Standard Precautions when the spread of infection might not be completely stopped when using only Standard Precautions.
The purpose of these precautions is to keep germs from spreading from your child to other patients, family members, visitors or healthcare workers.
Droplet Precautions
Certain germs can be spread by droplets that come out of the mouth during talking or coughing or from drainage from the nose. These droplets may be big enough to see or too small to be seen. Your child may be placed on droplet precautions as a safety measure if he or she has symptoms of these germs or if laboratory results show that your child has these germs.
Your child may need to be on droplet precautions even if he or she seems to be well. This is because some germs can still be spread to other people from your child. Your child will need to stay in his or her room unless taken out of the room by a staff member for testing or procedures.
Droplet precautions can be frustrating for a child. A Child Life specialist may help by providing play activities.
Ways you can help your child:
- Spend as much time as possible with your child or have a family member or friend stay.
- Plan activities with your child such as reading, playing games, music, puppet play, drawing, painting pictures, puzzles and looking at family pictures.
What Droplet Precautions means
A green sign will be posted at the entrance to the room when these precautions are needed so that everyone entering knows what to wear [Picture 1].
- Everyone [parents, family, guests, and healthcare workers] must wash their hands with soap and water or use waterless alcohol-based hand rub when entering and leaving the room.
- If parents are resting on the bedside furniture, they do not need to wear a mask. A mask needs to be worn only when the parent will be helping with the child’s care or coming in contact with the child.
- Some examples are:
- If a parent is wiping the child’s nose or suctioning the child, a mask should be worn.
- While holding your child, wear a mask.
- Family, guests, and healthcare workers must follow the precautions posted on the door to the child’s room.
Masks
- The mask must cover both your nose and mouth.
- Whenever you leave your child’s room, throw away used masks in the waste can inside his room. Do not touch the mask itself. Handle it only by the ear loops or ties.
- When your mask becomes damp replace it
with a new one.
Hand hygiene
Hand hygiene involves either washing hands with soap and water or killing germs on the hands with a waterless alcohol-based hand rub. Proper hand hygiene is one of the best ways to stop the spread of germs and prevent infections. To prevent your child or you from getting unwanted germs, wash hands with soap and water or use a waterless alcohol-based hand rub every time you enter and leave the room.
Wash your hands with soap and water at these times:
- Before eating
- When hands have dirt on them
- After changing diapers
- After using the restroom
- After contact with body fluids like blood, urine or vomit
To use the waterless alcohol-based hand rub:
- Apply the rub to the palms of your hands.
- Rub your hands together covering all surfaces.
- Rub until your hands are dry.
All doctors, nurses, and other healthcare workers know they must perform proper hand hygiene before and after touching a patient, after contact with items near the patient, before putting on gloves for a sterile procedure and after removing gloves. It is all right for you to remind them to perform hand hygiene.
It is known that COVID-19 spreads through droplet transmission. Centers for Disease Control indicates early reports suggest person-to-person transmission most commonly happens during close exposure to a person infected with COVID-19, primarily via respiratory droplets produced when the infected person coughs, sneezes, or talks. Droplets can land in the mouths, noses, or eyes of people who are nearby or possibly be inhaled into the lungs of those within close proximity. Evidence also suggests that people who are infected, but remain asymptomatic play a role in the spread of COVID-19.
Droplets are heavy, think of a wet cough, typically the heavy particle will not carry far. The droplets which are generated by a patient who is coughing, sneezing, or talking can land on surfaces and you can also contaminate yourself by touching the surface followed by touching your face.
Patients in droplet isolation require healthcare workers to wear surgical mask, gloves, and gown. During times when available PPE is limited, it is recommended, if possible, to cohort COVID positive patients, one measure to preserve limited PPE. Other diseases that require droplet precautions include seasonal flu, bacterial meningitis, and pertussis.
There is much discussion about COVID-19 also having properties which require airborne precautions due to aerosolized particles. An aerosol, which are micro-droplets, weigh much less, these may stay suspended in the air for longer period of time or even have the ability to travel by air currents. These small droplets are produced during normal breathing. Evidence also suggests that people who are infected, but remain asymptomatic play a role in the spread of COVID-19. In addition, certain medical procedures, such as collecting respiratory specimens are considered aerosol generating procedures and would require airborne precautions.
When airborne transmission is known, the isolation protocols are stricter. Precautions include wearing an N95 or higher level respirator, eye covering, gloves, and gown, and if possible, isolating the patient in a negative pressure airborne infection isolation room. Other diseases requiring airborne precautions include measles, chickenpox, and TB.
The attached picture are the recommendations for COVID. When N95 masks are in limited supply, they should be reserved for use when known aerosolized generating procedures will be performed.