What precautions should be taken by healthcare providers regarding coronavirus disease 2019 (COVID-19) patients?

Updated: Jun 16, 2020
  • Author: Medscape Drugs & Diseases; more...
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Answer

Standard Precautions assume that every person is potentially infected or colonized with a pathogen that could be transmitted in the healthcare setting. [1, 2, 3, 4, 5]

Healthcare professionals (HCPs) who enter the room of a patient with known or suspected coronavirus disease 2019 (COVID-19) should adhere to Standard Precautions and use a respirator or facemask, gown, gloves, and eye protection. 

When available, respirators (instead of facemasks) are preferred; they should be prioritized for situations where respiratory protection is most important and for the care of patients with pathogens requiring Airborne Precautions (eg, tuberculosis, measles, varicella). Information about the recommended duration of Transmission-Based Precautions is available in Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings (Interim Guidance).

HCPs should perform hand hygiene before and after all patient contact and contact with potentially infectious material, as well as before putting on and after removing personal protective equipment (PPE), including gloves. 

HCPs should perform hand hygiene by using alcohol-based hand rub (ABHR) with 60-95% alcohol or washing hands with soap and water for at least 20 seconds. If hands are visibly soiled, use soap and water before returning to ABHR.

Healthcare facilities should ensure that hand hygiene supplies are readily available to all personnel in every care location.

Employers should select appropriate PPE and provide it to HCPs in accordance with OSHA PPE standards (29 CFR 1910 Subpart I).

Put on a respirator or facemask (if a respirator is not available) before entry into the patient room or care area.

N95 respirators or respirators that offer a higher level of protection should be used instead of a facemask when performing or present for an aerosol-generating procedure (AGP). For guidance on extended use of respirators, refer to Strategies for Optimizing the Supply of N95 Respirators.

Put on eye protection (ie, goggles or a disposable face shield that covers the front and sides of the face) upon entry to the patient room or care area. Personal eyeglasses and contact lenses are NOT considered adequate eye protection. Remove eye protection before leaving the patient room or care area.

Put on clean, non-sterile gloves upon entry into the patient room or care area. Change gloves if they become torn or heavily contaminated. Remove and discard gloves when leaving the patient room or care area, and immediately perform hand hygiene.

Put on a clean isolation gown upon entry into the patient room or area. Change the gown if it becomes soiled. Remove and discard the gown in a dedicated container for waste or linen before leaving the patient room or care area. Disposable gowns should be discarded after use. Cloth gowns should be laundered after each use.

Any reusable PPE must be properly cleaned, decontaminated, and maintained after and between uses.


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