مكافحة العدوى والعزل

Transmission-based precautions

PPE order

• Donning: gown → mask or respirator → goggles or face shield → gloves.
• Doffing: gloves → goggles or face shield → gown → mask or respirator (outside the room) → hand hygiene.

Hand hygiene & asepsis

• Hand hygiene before and after every patient contact is the single most effective way to prevent healthcare-associated infection.
• Use soap and water (not alcohol rub) when hands are visibly soiled and for C. difficile or norovirus (spores).
• Medical asepsis: hands held lower than the elbows. Surgical scrub: hands held higher than the elbows.
• Chain of infection: agent → reservoir → portal of exit → mode of transmission → portal of entry → susceptible host.
• A sneeze over a sterile field, or reaching across it, contaminates it — set up a new field.

Tuberculosis quick facts

• Mantoux (PPD) read at 48–72 h. Positive: ≥ 5 mm (HIV, close contacts, immunosuppressed), ≥ 10 mm (recent immigrants, health workers, other risk groups), ≥ 15 mm (no risk factors).
• BCG vaccination can cause a false-positive skin test. The definitive test is sputum culture (early-morning samples).
• Isoniazid: peripheral neuropathy (give vitamin B6) and hepatotoxicity. Rifampin: orange body fluids. Ethambutol: optic neuritis.
• Directly observed therapy (DOT) ensures adherence and prevents drug resistance.