Airborne precautions and isolation room requirements

What it is

Airborne respirator precautions are ordered in addition to standard precautions, not instead of them. They have three parts: the room, the mask and the door. An airborne infection isolation room is required, and that means a negative pressure room; the door is kept closed; and families and visitors need approval before entering the room.

One rule applies to all who go in, staff and visitors alike: clean hands when entering and leaving the room. The mask is not for all of them. Doctors and staff must wear a PAPR or a fitted N95 mask before entering the room, while a patient with known or suspected active pulmonary TB wears a surgical mask when outside the isolation room.

Causes and risk

The diseases that call for airborne precautions are chicken pox, disseminated herpes zoster (shingles) and measles, and, with an N-95 mask, tuberculosis, SARS and avian influenza. The six sit in the mnemonic as 3 respiratory and 3 rashes. Droplet precautions are a separate list: pertussis, bacterial meningitis for 24 hours after effective antibiotic therapy, influenza A or B, RSV, which is droplet and contact, MRSA respiratory infection, Neisseria meningitides suspected or confirmed, mumps, rubella, coxsackie and adenovirus. That list is also set as the mnemonic SPIDERMAN: S for sepsis, scarlet fever and streptococcal pharyngitis; P for parvovirus B19, pneumonia and pertussis; I for influenza; D for pharyngeal diphtheria; E for epiglottitis; R for rubella; M for mumps, meningitis, mycoplasma and meningeal pneumonia; and AN for adenovirus.