Isolation Precautions and Types of PPE: Nursing Mnemonics
Isolation precautions made easy! Standard vs transmission-based precautions with mnemonics to remember contact, droplet, and airborne diseases! Great for nursing, NCLEX, USMLE, and more!
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Isolation Precautions Made Easy!
Welcome to another lecture where medical topics are made easy!
You’ve come to the right spot to learn everything you need to know about isolation precautions.
You will learn easy memory tricks and mnemonics to remember the different types of isolation precautions and the diseases that fall into each category!
Make sure to read until the end where there are summary tables of all the information!
You can download the PDF notes above!
What Are Isolation Precautions?
Preventing the spread of infections is important, especially in healthcare facilities.
That is why there are precautions in place to help prevent the transmission of diseases.
These precautions are called isolation precautions.
By definition, isolation precautions are the preventative steps needed to be taken by healthcare workers and staff to prevent the spread or transmission of infections and diseases.
Types of Isolation Precautions
Isolation precautions can be divided into 2 main categories:
Standard Precautions
Transmission-Based Precautions
Standard Precautions
Standard precautions are the basic minimum steps that should be taken with all patients in order to help prevent the spread of infections.
Standard precautions include proper hand and respiratory hygiene, the use of protective equipment as appropriate, proper use of sharp objects, among others.
Standard precautions are easy to remember and most of them are common sense.
We will come back to these at the end of this post!
Transmission-Based Precautions
Transmission-based precautions are extra steps that must be taken, in addition to following the standard precautions, in order to prevent the transmission of certain diseases.
Transmission-based precautions typically require some form of personal protective equipment (PPE).
There are 3 main types of transmission-based precautions:
Airborne Precautions
Contact Precautions
Droplet Precautions
Let’s first walk through each of the transmission-based precautions, and then we will finish with the standard precautions that should be taken with all patients.
Types of Isolation Precautions: There are 2 main categories of isolation precautions including standard and transmission-based. Transmission-based precautions include contact, droplet, and airborne.
Airborne Precautions
Mode of Transmission: Droplet nuclei that remain infectious over long distances when suspended in the air
PPE: N95 or Higher Level Respiratory
Type of Room: Airborne Infection Isolation Room (AIIR)
Airborne precautions help prevent the transmission of diseases that remain infectious over long distances when suspended in the air.
Airborne infections live as tiny residue particles in the air, called droplet nuclei, and they are waiting to be inhaled.
That is why in addition to following standard precautions, an N95 or higher level respirator must be worn for airborne precautions.
The respirators are put on prior to entering the room.
Healthcare workers undergo fit-testing and education on how to use the respirators.
Patients who require airborne precautions should be placed in a special room called an Airborne Infection Isolation Room (AIIR).
AIIRs are single-patient rooms with special air handling and ventilation.
They are negative pressure rooms with 6-12 air exchanges every hour depending on when the facility was built.
Air is released directly to the outside or recirculated through a special filtration system.
Diseases Requiring Airborne Precautions
The diseases that require airborne precautions include:
Measles (Rubeola)
Tuberculosis
Varicella-Zoster (Chickenpox and Disseminated Herpes Zoster)
How can we easily remember these diseases?
Read on!
Mnemonic = MTV
The easy way to remember the diseases that require airborne precautions is to use the mnemonic “MTV”.
For those not familiar, MTV is a music television channel.
This will help you remember “M” for Measles, “T” for Tuberculosis, and “V” for varicella-zoster.
Measles
Tuberculosis
Varicella-Zoster
Remember the varicella-zoster virus causes chickenpox (varicella) and shingles (herpes zoster).
Airborne precautions for varicella-zoster are required for anyone with chickenpox (varicella) and those with disseminated herpes zoster, which is shingles affecting 3 or more dermatomes.
Herpes zoster (shingles) alone does not necessarily require airborne precautions.
Herpes zoster that is localized to 1 or 2 dermatomes in someone with a competent immune system does not require airborne precautions, but they do require contact precautions.
In fact, both chickenpox and shingles require contact precautions which we will see shortly.
Be Aware…
Variola, which is the virus that causes smallpox, also requires airborne precautions.
It was not included above because of its eradication, but if smallpox is suspected or confirmed then airborne precautions should be used.
It’s easy to remember because you can include it with the “V” in MTV to remember Variola.
It has also been generally recommended to treat SARS using airborne precautions.
Make sure to follow your institutional protocols.
This again is easy to remember.
Simply make MTV plural so it is MTVs, which will help you remember “S” for SARS.
Airborne Precaution Example Diseases and Mnemonic: PPE for nursing and staff include an N95 respirator mask and a negative pressure room. Infections include TB, shingles, and measles.
Contact Precautions
Mode of Transmission: Direct or indirect contact with the patient or patient’s environment
PPE: Gown and Gloves
Type of Room: Ideally a single-patient room
Contact precautions help prevent the transmission of infections spread by direct or indirect contact with the patient or patient’s environment.
Contact precautions require a gown and gloves be worn in addition to following standard precautions.
The gown and gloves are put on when entering the room and taken off when leaving the room.
This is done to contain the pathogen and prevent contamination.
Patients who are in contact precautions should ideally be in a single-patient room without roommates.
What diseases require contact precautions?
Let’s start with the mnemonic first!
Mnemonic = ABCDEF
The way you can remember the diseases that require contact precautions is to use the mnemonic “ABCDEF”.
This will help you remember the following:
Abscess
Bronchiolitis
Cutaneous
Diarrhea
Eyes
Funky/Feisty
Diseases Requiring Contact Precautions
The ABCDEF method provides you with the major categories that require contact precautions, which will allow you to think of the following diseases:
Abscess (Major Drainage)
Bronchiolitis (RSV and Parainfluenza)
Cutaneous (Herpes Zoster, Varicella, Herpes Simplex, Impetigo, Lice, Major Pressure/Decubitus Ulcers, Scabies, Major Staph/Strep Skin Wounds/Burns, Cutaneous Diphtheria)
Diarrhea (C. diff, Norovirus, Rotavirus, Hepatitis A)
Eyes (Conjunctivitis - Acute, Viral)
Funky/Feisty (Multidrug-Resistant Organisms - i.e. MRSA and VRE)
Let’s walk through the ABCDEF method and their diseases:
A = Abscess
“A” stands for Abscess.
This will help you remember large abscesses with major drainage require contact precautions.
Not every abscess however requires contact precautions.
Standard precautions can be used for smaller abscesses with minimal drainage.
If there is significant drainage, then it is recommended to use contact precautions.
B = Bronchiolitis
“B” stands for Bronchiolitis.
This will help you remember bronchiolitis because the 2 more common viruses that cause bronchiolitis require contact precautions.
They include RSV (respiratory syncytial virus) and parainfluenza.
C = Cutaneous
“C” stands for cutaneous.
This will help you remember that many diseases involving the skin require contact precautions.
Examples include herpes zoster (shingles) and varicella (chickenpox).
Remember we said chickenpox and disseminated herpes zoster also require airborne precautions.
Localized herpes zoster requires contact precautions and not airborne precautions.
Other cutaneous diseases requiring contact precautions include herpes simplex, impetigo, lice, major pressure or decubitus ulcers, scabies, major staphylococcal or streptococcal skin wounds or burns, and cutaneous diphtheria.
D = Diarrhea
“D” stands for diarrhea.
This will help you remember the diseases that cause diarrhea and require contact precautions.
They include C. diff, norovirus, rotavirus, and hepatitis A.
E = Eyes
“E” stands for eyes.
This will help you remember conjunctivitis.
Contact precautions are recommended for infectious conjunctivitis, especially acute viral conjunctivitis (pink eye).
Conjunctivitis simply means inflammation of the conjunctiva.
Remember from our medical terminology lecture on suffixes that “-itis” means inflammation.
Many conditions can cause conjunctivitis including allergies, irritants, trauma, viral infections, and bacterial infections to name a few.
However, not all of these require contact precautions.
It’s mainly the infectious forms, particularly viral which is commonly caused by adenovirus.
F = Funky/Feisty
“F” stands for funky or feisty.
This will help you remember multidrug-resistant organisms (MDROs) such as MRSA and VRE.
MDROs can be challenging to treat and contact precautions should be taken to prevent transmission.
Recap
Use the mnemonic ABCDEF to remember the major categories and diseases that require contact precautions.
If you have another way to remember the diseases, make sure to share it in the comments down below!
Contact Precaution Example Diseases and Mnemonic: PPE for nursing and staff include a gown and gloves. Infections include MRSA and C. diff.
Droplet Precautions
Mode of Transmission: Air droplets that come into contact with mucous membranes via coughing, sneezing, talking, or close contact with respiratory secretions/mucous membranes
PPE: Surgical Mask
Type of Room: Ideally a single-patient room
Droplet precautions help prevent the transmission of infections spread through air droplets by coughing, sneezing, talking, or close contact with respiratory secretions or mucous membranes.
Droplets tend to be larger in size and do not travel as far, usually only 3-6 feet.
This is different from airborne precautions where droplet nuclei are smaller in size and travel much farther.
In addition to following standard precautions, a surgical mask is required for droplet precautions.
The mask is put on when entering the room, and the patient should ideally be in a single-patient room.
Pathogens in the droplet precaution category do not remain infectious over long distances, which is one of the reasons why an airborne infection isolation room is not required.
Diseases Requiring Droplet Precautions
Let’s first review the diseases that require droplet precautions because unfortunately there are quite a few of them.
But don’t worry!
You will then be shown an easy way to remember them!
The following diseases require droplet precautions:
Mycoplasma Pneumoniae (Walking Pneumonia)
Pertussis (Whooping Cough - Bordatella pertussis)
Mumps
Influenza
Diphtheria (Pharyngeal)
Streptococcus (Pneumonia, Toxic Shock Syndrome, Pharyngitis, Scarlet Fever)
Meningitis (Haemophilus influenzae type b and Neisseria)
Plague (Pneumonic)
Parvovirus B19 (Fifth Disease)
German Measles (Rubella)
Adenovirus
Pneumonia
Epiglottitis (Haemophilus influenzae type b)
Rhinovirus
As you can see that is a long list and difficult to remember!
Let’s look at an easy way to remember all of these diseases!
Mnemonic
Use the following mnemonic to remember the diseases that require droplet precautions:
“My Perfect Mum Flew a Dozen Strong Men on a Plane to a Park in Germany to Add a New Epic Rhino”
While this may seem like a long mnemonic to remember at first, it actually works really well.
And remembering this mnemonic is a lot easier than trying to memorize the long list of complicated diseases individually!
Let’s walk through how this mnemonic works.
If you have a better way to remember all the diseases for droplet precautions, please share it in the comments down below for everyone!
“My Perfect Mum Flew a Dozen Strong Men on a Plane to a Park in Germany to Add a New Epic Rhino”
“My” = Mycoplasma
“Perfect” = Pertussis
“Mum” = Mumps
“Flew” = Influenza (Flu)
“Dozen” = Diphtheria
“Strong” = Streptococcus
“Men” = Meningitis (Meningococcal)
“Plane” = Plague
“Park” = Parvovirus B19
“Germany” = German Measles
“Add” = Adenovirus
“New” = Pneumonia
“Epic” = Epiglottitis
“Rhino” = Rhinovirus
So you can see how this mnemonic works well to remember the names of the diseases that require droplet precautions!
Again, it is much easier to remember the mnemonic than trying to memorize the list of complicated diseases!
Just repeat the mnemonic several times in your head, and it will stick!
Droplet Precaution Example Diseases and Mnemonic: PPE for nursing and staff include a surgical mask. Infections include influenza (flu) and meningitis.
Transmission-Based Precautions
Here is a table summarizing the transmission-based precautions including airborne, contact, and droplet along with their memory tricks and example diseases.
You can download the PDF for the table and notes above!
Types of Isolation Precautions Chart: Table of airborne, contact, and droplet precautions with example diseases and mnemonics.
Here is another table summarizing the transmission-based precautions including contact, droplet, and airborne along with their required PPE and type of room.
You can download the PDF for the table and notes above!
Types of Isolation Precautions Table: Chart of contact, droplet, and airborne precautions with definitions, PPE, and room type.
Standard Precautions
While the transmission-based precautions require additional steps to prevent disease transmission, there are standard precautions that must be taken for all patients regardless of their isolation status.
Remember all of the transmission-based isolation precautions are in addition to following standard precautions.
What are standard precautions?
Standard precautions are the minimum steps that should be taken with all patients to prevent the spread of infections and diseases.
Standard precautions include:
Proper Hand Hygiene
Hand washing before and after patient encounter
Proper Respiratory Hygiene
Covering your cough and sneeze
Use of Appropriate Protective Equipment
Gown, Gloves, Face Shield, Mask, Eye Protection, Etc.
Cleaning of Supplies
Disposal of Waste
Practice Sharp Object Safety
Proper Disposal of Sharp Objects
It is important to practice proper hand and respiratory hygiene by washing your hands, covering your cough, covering your sneeze, etc.
Just a reminder that some diseases require hand washing with soap and water rather than alcohol-based products or sanitizers.
These include C. diff, norovirus, and rotavirus to name a few.
While certain PPE is required when a patient is in transmission-based isolation, appropriate protective equipment should be used with all patients as a standard precaution depending on the task being performed.
Finally, make sure to properly clean supplies, dispose of waste and sharp objects, and practice sharp object safety.
Supplies, rooms, and surfaces should be cleaned, disinfected, and/or sterilized appropriately.
General, biohazard, and pharmaceutical waste should each be managed properly.
Sharp objects should be handled safely and placed in the sharps bin when finished.
Standard Precautions: Universal isolation precautions are the minimum steps to be taken with all patients to prevent the spread of diseases
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Referenceshttps://www.cdc.gov/infectioncontrol/guidelines/isolation/precautions.html#:~:text=There%20are%20three%20categories%20of,Droplet%20Precautions%2C%20and%20Airborne%20Precautions.https://www.ncbi.nlm.nih.gov/books/NBK551555/https://medlineplus.gov/ency/patientinstructions/000446.htm