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Isolation Precautions:
“Look It Up, Don’t Make It Up”
Bud Wiedermann, MD, MA
Attending in Infectious Diseases,
CNMC
Professor of Pediatrics, GWUSMHS
November 7, 2014
The single most effective measure for
preventing spread of infectious agents is
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A. Airborne isolation
B. Avoiding
nosepicking
C. Good handwashing
D. Look it up, don’t
make it up
E. Proper doffing of
personal protective
equipment
Roberta is a 6 mo girl with 2 days of runny
nose, fever, and cough, now with fast breathing.
Exam shows tachypnea, copious rhinorrhea,
and bilateral wheezing with rhonchi. Rapid RSV
test is positive. Which of the following is the
most appropriate isolation choice?
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A. Standard only
B. Standard and
contact
C. Standard, contact,
and droplet
D. Standard and
droplet
E. Standard, contact,
and airborne
Barbara is in the bay next to Roberta, with
identical history, exam, and RSV results. The
ED is overflowing, and you need more exam
room availability. Cohorting of these 2 children
is acceptable because they have the same
virus.
A. True
B. False
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Suppose Roberta’s RSV test was negative.
Which of the following is the most appropriate
isolation choice for her?
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A. Standard only
B. Standard and
contact
C. Standard, contact,
and droplet
D. Standard and
droplet
E. Standard, contact,
and airborne
David is a 3 mo boy with fever and loose,
watery stools for 2 days. His exam is pertinent
only for 3% dehydration, and his stool rotavirus
antigen test is positive. Which of the following
is the most appropriate isolation choice for
him?
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A. Standard only
B. Standard and
contact
C. Standard, contact,
and droplet
D. Standard and
droplet
E. Standard, contact,
and airborne
Pavan is a 19 yo U. Maryland student with fever,
rash, and dizziness starting this morning. His exam
is pertinent for signs of shock and a diffuse
petechial rash. He improves with fluids and
antibiotics, and CSF shows WBC 2800 (95% polys),
protein 197, glucose 20, and Gram-negative
diplococci on stain. Which of the following is the
most appropriate isolation choice for him?
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A. Standard only
B. Standard and
contact
C. Standard, contact,
and droplet
D. Standard and
droplet
E. Standard, contact,
and airborne
Of the following conditions, which does NOT
require airborne isolation (possibly with other
precautions) because it is transmitted via small
particle aerosol route?
Ebola
Measles
SARS
Smallpox
Tuberculosis
Varicella
el
ic
Va
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sis
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A.
B.
C.
D.
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F.
As of 10/18/14
MMWR 2014; 63:978
New Cases 9/28-10/18/14
MMWR 2014; 63:978
MMWR 2014; 63:978
Ebola: Identify, Isolate,
Inform
http://www.cdc.gov/vhf/ebola/pdf/ambulatory-careevaluation-of-patients-with-possible-ebola.pdf
Ebola: Identify, Isolate,
Inform
http://www.cdc.gov/vhf/ebola/pdf/ambulatory-careevaluation-of-patients-with-possible-ebola.pdf
http://www.cdc.gov/vhf/ebola/pdf/ambulatory-care-evaluation-ofpatients-with-possible-ebola.pdf
PPE in the ambulatory care setting
 No one should have direct contact with a Person Under
Investigation for Ebola without wearing appropriate PPE
 If PPE is available and direct patient contact necessary,
a single staff member (trained in proper donning and
removal of PPE) should be designated to interact with
the Person Under Investigation
 At a minimum, health care workers should use the
following PPE before direct patient contact:
 Face shield & surgical face mask, impermeable gown,
and two pairs of gloves
 The designated staff member should refrain from direct
interaction with other staff and patients in the office
until PPE has been safely removed in a designated,
confined area
 Examples of safe donning and removal of PPE should be
reviewed:
http://www.cdc.gov/hicpac/2007IP/2007ip_g.html
I practice within a health system
which has defined Ebola protocols
for my practice.
A. True
B. False
se
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If you answered “False,” I
suggest…..
Appoint an Ebola Czar in your
practice to check CDC and state
DOH web site frequently
Meet with stakeholders to
determine plan
Signage, telephone screening
PPE
Patient placement
Who you gonna call?
http://www.cdc.gov/vhf/eb
ola/index.html
Questions and Shameless
Self-Promotion
Holy Cross Peds ID Clinic
301-754-7630 Wed AM, Fri PM
Visit my blog, with the AAP
Evidence eMended (just Google it)

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