Transmission-based Precautions I: Contact, Enteric, and Droplets

Transmission-based precautions are for patients known to be infected or suspected to be infected or colonized with organisms that pose a significant risk to others. Some transmission-based precautions include contact, enteric, and droplet.

Contact Precautions:

Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an environment or infected patient.

Contact precautions include the following:

• • Isolating the patient in a single room.
• • Using PPE (gloves and masks) when performing procedures involving contact.
• • Restricting patient movement out of the room.
• • Avoiding sharing patient-care equipment (thermometers or stethoscopes) among other patients without disinfecting.

Enteric precautions:

Enteric pathogens enter the body orally by consuming contaminated food or water. The second transmission mode is through contact with infected animals or their environment, and lastly, by touching an infected person's fecal matter or vomit. As a result, contact precautions should be started with the first instance of diarrhea or vomiting until there is a definitive diagnosis that the symptoms do not have an infectious cause. Enteric precautions include the following:

• • Promptly isolating the patient in a single room with closed doors.
• • Using gloves and an apron for any procedure involving contact.
• • Handwashing is compulsory when any direct contact occurs with feces or vomitus. Using alcohol-hand rub alone is insufficient.

Droplet precautions:

Use droplet precautions when treating patients with known or suspected infection or disease spread by respiratory droplets, such as those produced when a patient coughs, sneezes, or speaks. The droplets are generally respiratory secretions but can include droplets from other sources, such as projectile vomiting or explosive diarrhea. The droplets are relatively large and do not remain suspended in the air for long, so special ventilation is not usually required. The measures to prevent droplet transmission include the following.

• • Isolate the infected patient in a room with closed doors.
• • Use PPE such as gloves and an apron for any procedure involving contact.
• • Put a face mask on the patient as well.
• • Avoid the movement of the patient outside the room unless medically necessary.