TRANSMISSION-BASED

PRECAUTIONS
• Transmission-Based Precautions are the second tier of basic
infection control and are to be used in addition to Standard
Precautions for patients who may be infected or colonized
with certain infectious agents for which additional
precautions are needed to prevent infection transmission.

Source: Guideline for Isolation Precautions

 RANDOM QUESTION

1. Jellyfish sting, intervention

a. Acetic acid
b. Salicylate acid
c. Ogie Alc acid
• Vinegar is used to stop the venom in stingers. Caution: Do
not use ammonia, urine, rubbing alcohol, fresh water or ice.
They all can trigger the release of more venom. If you don't
have vinegar, move on to scraping off the stingers.
 CATEGORIES OF TRANSMISSION BASED
PRECAUTIONS ON THE BASIS OF MODES ARE
THE FOLLOWING:
• CONTACT PRECAUTIONS
• DROPLET PRECAUTIONS
• AIRBORNE PRECAUTIONS
• BLOODBORNE PRECAUTIONS
 CONTACT PRECAUTION
• Used for clients with infections that are transmitted by either
direct contact, which is touching the infected client; or indirect
contact, which is touching a surface, like a contaminated
doorknob, and then touching your own eyes, nose, or mouth.

• Purpose: Prevent transmission of infectious agents spread by

direct or indirect contact with patient or their environment
 EXAMPLE
• . Illnesses requiring contact precautions may include, but are not
limited to: presence of stool incontinence (may include patients with
norovirus, rotavirus, or Clostridium difficile), draining wounds,
uncontrolled secretions, pressure ulcers, presence of generalized rash,
or presence of ostomy tubes and/or bags draining body fluids.
 PPE FOR CONTACT PRECAUTIONS
• GLOVES
• Wear gloves when touching the patient and the patient’s immediate environment or belongings
• Remove gloves promptly after use and discard before touching non-contaminated items or
environmental surfaces, and before providing care to another patient
• Wash hands immediately after removing gloves

• GOWNS
• Wear a fluid resistant, non-sterile gown if substantial contact with the patient or their
environment is anticipated
• Do not wear the same gown for the care of more than one patient
 ROOM

• Private room or cohort, (room) patients infected or

colonized with the same organism
• Prioritize placement of patients in an exam room if they
have stool incontinence, draining wounds and/or skin
lesions that cannot be covered, or uncontrolled
secretions
 HOW CONTACT TRANSMISSION OCCURS:

• CONTACT TRANSMISSION CAN OCCUR IN TWO WAYS:

• DIRECT CONTACT TRANSMISSION

• INDIRECT CONTACT TRANSMISSION
 DIRECT CONTACT TRANSMISSION
• Involves body-surface to body-surface contact and physical
transfer of microorganisms between a susceptible person
(host) and an infected or colonized person.

• More often occurs between a health care worker and a

patient than between patients.
 INDIRECT CONTACT TRANSMISSION

• Involves contact of susceptible person (host) with a contaminated intermediate

object such as needles, dressings, gloves or contaminated (unwashed) hands.

• Disease is more likely to develop following direct or indirect contact transmission

when the pathogen is highly virulent or has a low infectious dose or the patient or
health care worker is immunocompromised.

• Poor hand hygiene is most often cited as a cause of contact transmission.

•Ensure appropriate patient placement in a single
patient space or room if available in acute care
hospitals. In long-term and other residential settings,
make room placement decisions balancing risks to
other patients. In ambulatory settings, place patients
requiring contact precautions in an exam room or
cubicle as soon as possible.
•Use personal protective equipment (PPE)
appropriately, including gloves and gown. Wear a
gown and gloves for all interactions that may involve
contact with the patient or the patient’s environment.
Donning PPE upon room entry and properly discarding
before exiting the patient room is done to contain
pathogens.
•.
•Limit transport and movement of patients outside
of the room to medically-necessary purposes.  When
transport or movement is necessary, cover or contain
the infected or colonized areas of the patient’s body.
Remove and dispose of contaminated PPE and perform
hand hygiene prior to transporting patients on Contact
Precautions. Don clean PPE to handle the patient at the
transport location.
•Use disposable or dedicated patient-care
equipment (e.g., blood pressure cuffs). If common use
of equipment for multiple patients is unavoidable,
clean and disinfect such equipment before use on
another patient.
•Prioritize cleaning and disinfection of the rooms of
patients on contact precautions ensuring rooms are
frequently cleaned and disinfected (e.g., at least daily
or prior to use by another patient if outpatient setting)
focusing on frequently-touched surfaces and
equipment in the immediate vicinity of the patient
 QUESTION
2. Antidote for WARFARIN
A. Vitamin K
B. Protamine Sulfate
C. IKAWFARIN
• Vitamin K1 is the only effective antidote for long-term management,
but it takes several hours to reverse anticoagulation
.

DROPLET PRECAUTIONS
• Droplet precautions
• Taken when caring for a client with an infectious condition
transmitted via droplets.
• This means every time the client talks, coughs, or sneezes, loads of
tiny droplets containing the pathogen are sprayed out. These droplets
can land on another person’s mouth, nose, or eyes, allowing the
pathogen to enter a new person.
 EXAMPLES
• Some examples of these pathogens include:✅
• mumps
• rubella and influenza virus
• diphtheria
• Streptococcus
• Pertussis

Droplet precautions are similar to airborne ones, with the exception that you only need to apply a
face shield and simple face mask when you are closer than one meter, or three feet, to the client.
PERSONAL PROTECTIVE EQUIPMENT (PPE) FOR DROPLET PRECAUTIONS

• Masks and Respirators

• Wear a facemask, such as a procedure or surgical mask, for close
contact (within 3 feet of the patient) with the patient; the facemask
should be donned upon entering the exam room
•Source control: put a mask on the patient.

•Ensure appropriate patient placement in a single

room if possible. In acute care hospitals, if single rooms
are not available, utilize the recommendations for
alternative patient placement considerations in the
Guideline for Isolation Precautions. In long-term
care and other residential settings, make decisions
regarding patient placement on a case-by-case basis
considering infection risks to other patients in the room
and available alternatives. In ambulatory settings, place
patients who require Droplet Precautions in an exam
room or cubicle as soon as possible and instruct
patients to follow Respiratory Hygiene/Cough Etiquette
recommendations.
•Use personal protective equipment (PPE)
appropriately. Don mask upon entry into the patient room
or patient space.

•Limit transport and movement of patients outside of

the room to medically-necessary purposes. If transport or
movement outside of the room is necessary, instruct patient
to wear a mask and follow Respiratory Hygiene/Cough
Etiquette.
 AIRBORNE PRECAUTIONS

• Refer to clients infected with pathogens transmitted via the airborne

route.
• This means that they can survive and travel through the air over long distances
and for an extended period of time, usually several hours to days.
 EXAMPLES
• These pathogens include:
• Mycobacterium tuberculosis
• measles
• varicella virus (chicken pox)
• possibly SARS-CoV-2, or severe acute respiratory syndrome coronavirus 2,
which is the virus that causes COVID-19
In all these cases, the client should be isolated in an airborne infection isolation room,
otherwise known as a negative pressure room, with the door closed. These rooms have
a ventilation system that allows air to flow in but not out of the room to prevent cross-
contamination between rooms. Then, before this air gets released in the outside
environment, it passes through a special barrier called a HEPA filter to completely
remove all the pathogens.
Before entering an airborne precaution isolation room, make sure to put on a fit-
tested high-filtration respirator.
If possible, all procedures should be carried out in this room. But if it's absolutely
necessary to transport the client, they should wear a surgical mask.
PERSONAL PROTECTIVE EQUIPMENT (PPE) FOR AIRBORNE PRECAUTIONS

• Masks and Respirators

• Wear an N95 Respirator
Prior fit-testing that must be repeated annually and fit-check / seal-check
prior to each use.
OR
Powered Air-Purifying Respirator (PAPR)
• The respirator should be donned prior to room entry and removed after
exiting room
•Source control: put a mask on the patient.
•Ensure appropriate patient placement in an
airborne infection isolation room (AIIR) constructed
according to the Guideline for Isolation Precautions. In
settings where Airborne Precautions cannot be
implemented due to limited engineering resources,
masking the patient and placing the patient in a private
room with the door closed will reduce the likelihood of
airborne transmission until the patient is either
transferred to a facility with an AIIR or returned home.
•Restrict susceptible healthcare personnel from
entering the room of patients known or suspected to
have measles, chickenpox, disseminated zoster, or
smallpox if other immune healthcare personnel are
available.
•Use personal protective equipment (PPE)
appropriately, including a fit-tested NIOSH-approved
 N95 or higher level respirator for healthcare
personnel.
•Limit transport and movement of patients outside
of the room to medically-necessary purposes. If
transport or movement outside an AIIR is necessary,
instruct patients to wear a surgical mask, if possible,
and observe Respiratory Hygiene/Cough Etiquette.
 Healthcare personnel transporting patients who are
on Airborne Precautions do not need to wear a mask
or respirator during transport if the patient is wearing a
mask and infectious skin lesions are covered.
•Immunize susceptible persons as soon as possible
following unprotected contact with vaccine-
preventable infections (e.g., measles, varicella or
smallpox).
 BLOODBORNE PRECAUTIONS
• Blood-borne transmission of pathogens is largely due to percutaneous
injuries, which can be prevented using changes in technique, experience,
and safety devices.
• According to the OSHA database, HIV, hepatitis B and C, malaria,
measles, herpes, chickenpox, and various other bacterial infections are
known for being transmitted through blood-containing fluids and
products. 
• Blood-borne precautions include wearing gloves, a face mask, protective
eyewear or goggles, and proper handling of sharp objects with
appropriate disposal.
• Sharps disposal should be in an approved puncture-proof "sharp-only"
locked and secured bin. All sharps should not be re-capped.
• All sharps should not be bent or broken.
• Safety devices should be implemented to prevent contact with needles
and other sharps.
• These precautions apply to any blood-containing fluids, including
cerebrospinal fluid, pericardial fluid, pleural fluid, and peritoneal fluid.
• Sputum, vomit, sweat, feces, and nasal secretions do not require blood-
borne precautions unless there is visible blood noted.
• If contact with blood-containing fluids or products occurs, it is important
to immediately wash the affected area with soap and water and obtain
bloodborne infection status and immunization history from the patient.[
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