IPC is a critical and integral part of clinical management of patients and should be initiated at the point of entry of the patient to hospital (typically the Emergency Department). A combination of standard, contact and droplet precautions should be practiced for all COVID-19 cases, and further precautions when performing aerosol-generating procedures (AGP).  

Standard precautions are used to prevent or minimize transmission of pathogens at all times, and should be applied to all patients in healthcare facilities irrespective of their diagnosis or status. These include hand hygiene, appropriate use of PPE, safe handling of sharps, linen and waste, disinfection of patient care articles, respiratory hygiene, occupational health and injection safety. 

Transmission-based precautions - droplet, and contact: 

  • Hand hygiene is the first and most essential aspect

  • Healthcare worker PPE consists of gloves, gown (or apron), and a medical mask.

  • Safe waste management

  • Use either disposable or dedicated equipment (e.g. stethoscopes, blood pressure cuffs and thermometers). If equipment needs to be shared among patients, clean and disinfect between each patient use.

  • Limit patient movement within the institution (e.g. where possible, use portable X-rays rather than sending the patient to the X-ray department), and ensure that patients wear medical masks when outside their rooms.

Aerosol-generating Procedures:
Aerosol precautions are required when performing aerosol-generating procedures. These include taking respiratory tract samples for SARS-CoV-2 testing (such as nasopharyngeal and oropharyngeal swabs), intubation, bronchoscopy, open suctioning of the respiratory tract, and cardiopulmonary resuscitation.  Aerosol precautions for healthcare workers: 

  • Healthcare worker PPE consists of gloves, gown (or apron), a fit-tested particulate respirator (N95 respirator), and eye protection (goggles or face shield).

  • Use an adequately ventilated single room when performing aerosol-generating procedures, with spacing between beds of at least 1-1.5 metres.

For more details, refer to the World Health Organization IPC guidelines:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/infection-prevention-and-control 

Answers extracted from: Clinical management of suspected or confirmed COVID-19 disease (Version 3, 27th March 2020)

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