Airborne Precautions

Airborne precautions are required to protect against airborne transmission of infectious agents.
Diseases requiring airborne precautions include, but are not limited to: Measles, Severe Acute
Respiratory Syndrome (SARS), Varicella (chickenpox), and Mycobacterium tuberculosis.
Airborne precautions apply to patients known or suspected to be infected with microorganisms
transmitted by airborne droplet nuclei.
Preventing airborne transmission requires personal respiratory protection and special ventilation
and air handling.
APT FOR HEALTH WORKERS

Additional Personal Protective Equipment (PPE) for

Airborne Precautions
Ariborne precatutions are in addition to Standard Precautions
PLUS
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

Additional Procedures
Room

Airborne Infection Isolation Room (AIIR)

At a minimum, AIIR rooms must:
o Provide negative pressure room with a minimum of 6 air exchanges per hour
o Exhaust directly to the outside or through HEPA (High Efficiency Particulate Air)
filtration

If an AIIR is not available:

o Provide a facemask (e.g., procedure or surgical mask) to the patient and place the
patient immediately in an exam room with a closed door
o Instruct the patient to keep the facemask on while in the exam room, if possible,
and to change the mask if it becomes wet
o Initiate protocol to transfer patient to a healthcare facility that has the
recommended infection-control capacity to properly manage the patient

Patient

Have patient enter through a separate entrance to the facility (e.g., dedicated isolation
entrance), if available, to avoid the reception and registration area

Instruct patient to wear a facemask when exiting the exam room, avoid coming into close
contact with other patients , and practice respiratory hygiene and cough etiquette

Once the patient leaves, the exam room should remain vacant for generally one hour
before anyone enters; however, adequate wait time may vary depending on the ventilation
rate of the room and should be determined accordingly

How airborne transmission occurs:

Airborne transmission occurs through the dissemination of either:

airborne droplet nuclei (small-particles [5 micrograms or smaller] of evaporated droplets

containing microorganisms that remain suspended in the air for long periods of time) or

dust particles that contain an infectious agent

Microorganisms carried by the airborne route can be widely dispersed by air currents and may
become inhaled by a susceptible host in the same room or over a long distance form the source
patient depending on environmental factors such as temperature and ventilation.
What is airborne transmission?

Airborne transmission refers to situations where droplet nuclei (residue from evaporated
droplets) or dust particles containing microorganisms can remain suspended in air for long
periods of time. These organisms must be capable of surviving for long periods of time outside
the body and must be resistant to drying. Airborne transmission allows organisms to enter the
upper and lower respiratory tracts. Fortunately, only a limited number of diseases are capable of
airborne transmission.

Diseases capable of airborne transmission include:

Tuberculosis

Chickenpox

Measles

MASS SYSTEM AB Disease control mechanisms

The idea of setting up make shift hospitals to combat the airborne EVD

Vision:
During a severe pandemic, the healthcare system will be overwhelmed with a surge of
patients. Initially hospitals and clinics will utilize continuity of business operations plans to
increase surge capacity. However, when the surge has exceeded the capacity of their current
business model, a flu center can be activated.
Flu centers serve as a safety valve for our communities by:

Providing a community resource for the assessment, referral and treatment of people with
influenza-like illness, and

Managing the surge in an overwhelmed healthcare system to allow the acute care
facilities to care for the more critically ill people with influenza-like illness and people
with life-threatening illnesses or injuries.

A Flu Center can be established in an existing clinic or hospital, a designated alternative care site
or mass dispensing site, or at another location within the community. For an existing healthcare
facility to be designated a flu center, the facility would adapt their services and would meet the
following criteria:

Segregate influenza-like illness (ILI) patients from others with separate entrance and exit

Segregate clinical and support staff exposed to ILI patients from others

Utilize infection control methods

Plan for increased supply and equipment demands

Consider population/service area potential ILI based on planning assumptions found on

the Minnesota Pandemic Influenza Planning Assumptions (PDF: 101KB/2 pages) page.

As a community resource, flu center plans should include serving at-risk populations as well as
uninsured and underinsured people.

Mass Dispensing Site, Flu Center or Alternative Care Site?

With limited resources, healthcare and public health must decide how to best serve the needs of
their communities. In the case of pandemic influenza, the decision to open a Mass Dispensing
Site versus an Alternative Care Site versus a Flu Center will be dependent upon the current
community picture.

If influenza vaccinations are available and local public health are planning to target large
numbers of people, then a Mass Dispensing Site may be the best choice.

If influenza-like illness is causing a significant increase in out-patient cases and the

volume load has exceeded the surge capacity of clinics and hospital emergency
departments, then a Flu Center could be the best community resource.

If influenza-like illness is causing severe medical problems requiring a significant

increase in hospitalizations, hospitals can initially increase their in-patient surge capacity
and draw on the resources of hospitals within their compact. However, once this regional
hospital in-patient surge capacity has been exceeded, then an Alternative Care Site could
be the resource to deploy.

If more than one of the above situations is present, public health and healthcare will need to
decide how to best deploy their limited resources, based on community needs and resources.
More than one type of site may be opened and/or the functions of the three different sites could
be combined into one community resource.