Isolation Guidelines


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  • Acquired Immunodeficiency Syndrome

    Isolation requirements

    Class I

    This is a Class 1 reportable disease.

    • Class 1: Diseases of major or public health importance which shall be reported directly to the Department of Health by telephone within 24 hours of first knowledge or suspicion.  

    Reporting hotline

    •  1-800-556-0003, 8 a.m.-5 p.m. Monday-Friday
    • To report inside Jackson telephone area or for consultative services: (601) 576-7725, 8 a.m.-5 p.m. Monday-Friday
    • Class 1 conditions may be reported nights, weekends and holidays by calling (601) 576-7400. 

    Recommendations

    These recommendations are made because of the high mortality of Acquired Immunodeficiency Syndrome (AIDS), a syndrome of viral etiology which is acquired by direct contact with a patient’s blood or body fluids.

    Procedure

    • Whenever possible, patients should be hospitalized in a private room, particularly those who are too ill to use good hygiene. It will frequently be necessary to care for AIDS patients, particularly those with pneumocystis carinii pneumonia or other serious opportunistic infections in intensive care units. If ICU care is required, an isolation room in the ICU is desirable; a bed in an open ICU may be used, however, as long as the additional requirements of blood and body fluid precautions can be observed.
    • If a patient with AIDS has another infection or condition requiring additional precautions, then these should be added according to the isolation policies in the Infection Control Manual.
    • Masks and protective goggles should be worn if aerosolization or splattering are likely to occur. Goggles should be cleaned with an alcohol pledget after use unless grossly contaminated with blood or body fluids.
    • Gowns should be worn if patient care duties are likely to result in contamination of the employee’s clothing with body fluids, blood or other excretions from the patient.
    • The use of non-sterile gloves is recommended if contact with blood or body fluids, secretions or excretions is anticipated. This recommendation is particularly important for personnel who have cuts or abrasions on their hands.
    • Handwashing should be meticiously observed. This patient should be observed regardless of the use of gloves.
    • Dressings and tissues should be placed in a paper bag and closed securely.  This bag should be disposed of in infectious medical wastes.
    • Linen should be bagged before removing from the room.
    • Needles and syringes should be disposable and should be disposed of in rigid, puncture-resistant containers.  Needles should not be recapped and should not be purposely bent or broken by hand, since accidental needle puncture may occur. The use of needle-cutting devices is not recommended.
    • Non-disposable articles contaminated with blood or body fluids should be bagged and labeled before being sent for decontamination and reprocessing.  Disposable items should be incinerated or disposed of in accordance with the hospital’s policies for disposal of waste.
    • No special procedures for dishes are necessary unless visibly contaminated with blood and/or body fluids. Nursing staff will rinse dishes/tray visibly contaminated before being returned to dietary department.
    • Patients with AIDS who are being transported require no special precautions other than Standard Precautions.  Personnel in the area to which the patient is to be taken should use Standard Precautions to be used.
    • Decontamination of surgical equipment, endoscopes, and so forth, should be accomplished by the same sterilization procedures (for such equipment used on patients with AIDS as those currently recommended for equipment used for patients with hepatitis B). If possible, surgical procedures and endoscopic procedures on AIDS patients should be scheduled at the end of a day. Invasive patient care equipment should be disposable or sterilized before reuse. Instruments that come into contact with blood, secretions, excretions, or tissue, including laryngoscope and endotracheal tubes, should be sterilized before reused.
    • To minimize the need for emergency mouth-to-mouth resuscitation, mouth pieces,  resuscitation bags, or other ventilation devices should be strategically located and available for use in areas where the need for resuscitation is predictable.
    • Patients with AIDS who require hemodialysis or peritoneal dialysis should be managed in a manner comparable to patients who are known to be carriers of  hepatitis B surface antigen (Hbsag).  Disposable components in dialysis equipment must not be reused.
    • Patients with AIDS who must undergo dental procedures should be managed just as patients known to be carriers of Hbsag. The use of protective eyewear, masks and non-sterile gloves is recommended.  Dental instruments must, be carriers of Hbsag. The use of protective eyewear, masks and non-sterile gloves is recommended. Dental instruments must, of course, be sterilized after such procedures.
    • Blood and organs of AIDS patients should not be donated.
    • If the outside of a specimen container is visibly contaminated with blood, it should be cleaned with a disinfectant, such as 1:10 dilution 5.25% sodium hypochlorite with water.
    • =Laboratory personnel should utilize gloves and handwashing when working with specimens from such patients.
    • Blood spills should be cleaned up promptly with a solution of 5.25 hypochlorite, dilute with 1:10 water or with a spill kit depending upon spill size.
    • No special precautions or procedures are necessary for terminal cleaning of the patient’s room by Housekeeping after the patient has been discharged.

    Ambulatory care setting

    These recommendations also apply to the management of patients with AIDS or suspected AIDS in ambulatory care settings, including outpatient clinics and emergency departments. Segregated examining rooms for AIDS patients are neither necessary or desirable. Outpatients with AIDS may use the same waiting areas and bathroom facilities as other patients unless the presence of infections may require special precautions.