Definition of Isolation, Need of isolation, Types of Isolation, Mode Of Transmission Of Disease, Modes of Isolation, Types of precautions, Universal / standard precautions, Transmission based precautions, Advantages of Isolation, Disadvantages of Isolation, Isolation Ward in Hospital, Isolation Room in Hospital, Disease Wise Periods of Isolation Recommended etc.
2. “Isolation is the separation of a patient from contact with
others in order to control the spread of an infectious or
communicable disease.”
Need Of Isolation
Isolation aimed controlling and preventing the spread of
infection.
Isolation precautions are designed(like-rooms/wards) to
minimize the transmission of infection in the hospital by
using updated and skilled technology.
Isolation helps to protect patients, family members,
visitors and health care workers from the spread of
infection. 2
4. TYPES OF ISOLATION
Some signs are used to identify types of isolation
some hospital signs are disease specific and some are
category specific.
The sign is removed when isolation is no longer
required.
A checklist is also placed on the door. This list indicates
whether masks , gowns, gloves etc… are required for
persons entering the room. Any other pertinent
information is also on this sign.
4
5. patients are isolated according to the mode of
transmission of the disease.
Enteric
isolation
Wound
and
skin
isolation
Blood
isolation
Protective
Isolation
Respirato
ry
isolation
Strict
isolation
Discharge
isolation
5
Mode Of Transmission Of Disease
6. Modes of Isolation
1) Strict Isolation
Used to prevent the transmission of all highly
communicable disease that are spread by both contact and
airborne routes of transmission. Eg. Chickenpox ,Rabies.
2) Respiratory Isolation
Used to prevent transmission of organisms by means of
droplets that are sneezed or breathed into the environment.
Eg. Influenza and tuberculosis.
3) Protective Isolation
Used to prevent contact between potentially pathogenic
micro- organisms and uninfected persons who have seriously
impaired resistance.
Eg. Leukemia, who are on certain therapeutic regimens.
6
7. 4) Enteric Isolation
Used to control diseases that can be transmitted through direct or
indirect oral contact with infected feces or contaminated articles.
Transmission of infection depends on ingestion of the pathogens . Eg
Hepatitis, Dysentery.
5) Wound and Skin Isolation
Used to prevent the spread of micro - organisms found in infected
wounds (including burns and open sores) and heavily contaminated
articles.
Diseases that required precautions include
e.g.Herpes, Impetigo and ringworm.
6) Blood Isolation
Used to prevent acquisition of infection by patients and personnel
from contact with blood or items contaminated with blood .
Eg Hepatitis B virus , H.I.V/ A.I.D.S
7
8. 7) Discharge Isolation
A ) Secretion Precautions lesions
Used to prevent acquisition of infection by personnel and
patients from direct contact with wounds and secretion
contaminated articles.
Eg Conjunctivitis, Gonorrhea and Syphilis.
B) Secretion Precautions Oral
Used to prevent acquisition of infection by personnel from direct
contact with oral secretions.
Eg Herpes Areolas and Scarlet Fever.
C) Excretion Precautions
Used to prevent acquisition of infection by personnel and
patients from direct contact with fecal excretions.
Eg Polio myelitis and Staphylococcal food poisoning 8
9. TYPES OF PRECAUTIONS
9
Types of Precautions
Universal /
Standard
Precautions
Transmission
Based
Precautions
Contact
Precautions
Droplet
Precaution
Airborne
precaution
10. Universal / standard precautions
Follow standard precautions with all
patients
When we are close to or handling
blood, bodily fluids, tissues, mucous
membrane or areas of open skin we
,must use personal protective
equipments (PPE).
Depending on the anticipated exposure
types of PPE required include – gloves,
mask and goggles, aprons/gowns, shoe
covers.
It is also important to properly clean up
after ward. 10
11. Transmission based precautions
Transmission based precautions are followed in
addition to standard precautions
Some infections required more than one type of
transmission based precautions
Patient should stay in their rooms as much as
possible
They may need to wear a mask when they leave
their rooms
a) Air borne precautions-
- needed for germs present in environment
- prevent staff and visitors from infections
- needed in – Chickenpox, Measels & T.B.
bacteria
- Negative pressure rooms designed specially
- well fitted respirator mask used
11
12. b) Contact Precaution
Spread by touching directly or by objects
related to the patient
Whoever enter in room must wear gloves
and gown e.g Hepatitis B,
Conjunctivitis
c) Droplet Precaution
Prevent contact from respiratory
secretions (nose, throat, lungs)
Disease – Influenza, Pertussis and
Mumps
Need to wear surgical mask
12
13. Advantages of Isolation
Containment of infection risk.
Protection of other Patients, Visitors & staff.
Provision of a focus for training measures in respect of specific
risk of patient .
Provision of a focus to allow easier implementation of control
measures.
Source of Privacy, Dignity and Solace to some Patient.
Better sleep due to lack of disturbance.
Improved contact for families & careers.
More flexibility – rooms can be used any gender, age or clinical
condition.
24 hours admission without disruption to other patient.
More personalized contact with patients. 13
14. Disadvantages of Isolation
Increased patients dependency upon staff for support of needs.
Jeopardy to patients care through inappropriate restriction to
investigations & rehabilitation.
Additional cost such as construction, equipment, staff & time.
Staff stress especially in one-to-one nursing of isolated patients.
Insufficient use of hospital space.
Single rooms are expensive.
Under staff wards can lead to negative outcomes.
14
15. Isolation Ward in Hospital
In hospitals and other medical facilities an Isolation Ward is a separate
ward used to isolate patients suffering from infectious diseases.
Several wards for individual patients are usually placed together in an
isolation unit.
15
16. Isolation Room in Hospital
Isolation rooms create barriers between people & germs.
These type of isolations help to prevent the spread of germs in the Hospitals.
Anybody who visits in a Hospital patients who has Isolation sign outside
their door should stop at the nurse’ s station before entering the patients
room.
Concise information is placed on the door of isolation room at eye
level.
16
17. DISEASE WISE PERIODS OF ISOLATION RECOMMENDED
Diseases Duration of Isolation
1) Chicken Pox Until all lesions crusted usually about
6 days onset of rash
2) Measles From onset of catarrhal stage through
3rd day of rash
3) German Measles None, except that in the Ist trimester or
sexually actives, non – immune women
in child bearing years not using
contraceptive measures should not be
exposed.
17
18. 4)Cholera, Diphtheria 3 days after tetracycline
started , until 48 hours of
antibiotics ( for negative
cultures after treatment)
5) Hepatitis A 3 Weeks.
18
6) NIPAH VIRUS Isolation in separate unit ,use PPE
,Hand washing before and after
handling patient
7) SWINE FLU (H1N1 Influenza Virus) Isolation of infected individuals , use
high efficiency mask (N95 mask or
triple layer surgical mask), Hand
hygiene, use PPE and isolation- 3
days after onset.
19. 8) Influenza 3 days after onset
9) Polio 2 weeks adults, 6 weeks pediatric .
10) Tuberculosis(sputum+) Until 3 weeks of effective
chemotherapy.
11) Herpes Zoster 6 days after onset of rash.
12) Mumps Until swelling subsides.
13) Pertussis 4 weeks or until paroxysms.
14) Meningitis
15) Streptococcal
16) Pharyngitis
17) Meningococcal
Until the first 6 hours of effective
antibiotic therapy are completed.
19
20. AYURVEDIC VIEW
Ála³xkn~ xk=laLi”kkZfUu”oklkRlgHkkstukr~A
lg”k¸;k∙∙lukPpkfi oL=ekY;kuqysiukr~ AA
dq’Ba TojÜp “kks’kÜp us=kfHk’;Un ,o p A
vkSilfxZdjksxkÜp l³~dzkefUr ujkUuje~ AA
¼ lq- fu- 6@32&33½
Ála³xkn~ ----------vuqysiukr~AA
d.Mwdq’Bksina”kkÜp HkwrksUeknoz.kTojk% A
vkSilfxZdjksxkÜp l³~dzkefUr ujkUuje~ AA
¼Hkk- ç-54@49½
20
21. ISOLATION IN ANCIENT ERA
For pregnant / child birth
For intake of Rasayana (Trigarbha Kuti)
For injured person (Dhupana etc)
21
22. ISOLATION WARD FOR OBSTETRICS IN ANCIENT ERA /
AYURVEDA
Labour room – clean and pleasant place, devoid of sand, dust, bones etc
Gate should be on either east or north facing ( natural disinfection by sun and
air ventilation)
Made of wood of Bel, Tinduk, Ingudi, Bhallataka, Varun, Khadir
Well built with the help of Vastu experts
Walls painted with lime, well ventilated but fully covered with curtains. (Ch.
Sh. 8/33)
All needed things to be collected sp. Dhupan Dravyas
Specific time to enter i.e. Matriya Muhurat
Pleasant chanting of mantras
Only few expert ladies are allowed to be their. (Ch. Sh. 8/35)
22
23. ISOLATION OF PEDIATRICS WARD
Dispersion of Sarshap,Atsi,Tandul, Kanika upto Namkaran (10
days) twice daily
Kept wooded logs (Musal) on door
Regular litting of fire inside room with wood of kankantaka, tinduka
Hanging of Vacha etc Rakshoghana drayava on door
Post partum female and baby shouldn’t be kept alone, 10-12
expert ladies were allowed to enter in the room to maintain them.
With constant chanting of mantras of Atharvaveda. (Ch. Sh. 8/47)
23
24. Room Designing
I. Negative Pressure Room-patients who have air borne
infection should be in special rooms where the air is
gently suck out and not allowed to flow into the hallway.
II. Positive Pressure Room – used to protect patients with
weakened immune system from airborne contaminants.
24
25. CONCLUSION
Isolation precautions are considered an important public health
intervention. However it may adversely affect the isolated
individual, higher costs and increased hospital readmissions .
But for complete eradication isolation is mandatory e.g.In
Ayurveda Leprosy/ Kustha was counted as Mahagada but when it
was taken as infectious disease and isolation advocated only then
it was possible to eradicate , similar for T.B.
Isolation wards can play an important role for research and data
collection also.
Motive of WHO (Health for all) can only be achieved by
Isolation , precaution and preventive measures
25