isolation and sterility in radiology

sequence for donning PPE

• gown first

• mask or respirator

• goggles/face shield

• gloves

  -extend gloves over isolation gown cuffs

always wash hands before and after

sequence for doffing PPE

• gloves

• googles/face shield

• gown

• mask

always wash hands before and after

transportation throughout hospital

• sheet on wheelchair/litter

• patient wearing appropriate barriers

• airborne and droplet isolation patients not to leave room unless cleared by infection control(exception to this rule is x-ray)

• isolation status: Hall Pass/EPIC

• chart placement under litter/mattress

• when retrieving patient from holding area who is insolation, you may NOT wear PPE in hallway, mask only

covid-19 precautions

• face shield/goggles

• N95

• gown

• gloves

x-ray patient in isolation

• Ideal to have a ‘clean’ and ‘dirty’ person

• Glove or unglove if possible

• Anything you touch – communicate with others!

• Clean everything once you dismiss patient

• NEVER touch console area! Always unglove!

• Equipment/detectors and items used for patients in isolation precautions:

COVER or CLEAN!

• Digital Detectors should always be covered with an isolation or bloody patient – double bag IF necessary. Be cautious when disinfection not to get into battery

• Keep things brought into the room to a minimum

• Use disposable equipment, if possible (sticky markers in trauma bay and NICU)

RH approved low level disinfectants

ALWAYS USE GLOVES WITH DISINFECTANTS

• Use only disinfectants approved by the Reading Hospital Infection Prevention and Control Committee.

• Follow the manufacturer's direction including contact time, expiration date/shelf life and strength (ready to use or is dilution required). • Select appropriate disinfectant for the situation.

 C. diff and norovirus require 2-step disinfection; general disinfection followed by bleach.

• These disinfectants are approved for use on hard non-porous surfaces, not as a sterilant/high level disinfectant on any surface or instrument that is introduced directly into the body, touches mucous membranes, comes either into or in contact with the bloodstream or normally sterile areas of the body

sani-cloth plus germicidal disposable cloth purple top

see in x-ray

Surface must remain visibly wet for TWO minutes, Let air dry.

*Use additional wipes if needed to assure continuous wet contact time.

sani-cloth plus germicidal disposable cloth(bleach)

orange top

Surface must remain visibly wet for FOUR minutes, Let air dry

Used for Additional hand and Environmental precautions(C. diff or norovirus)

*C. diff and norovirus require 2 step disinfection; general disinfection followed by bleach

clorox germicidal(bleach) liquid/spray

you will see in x-ray

Surface must remain visibly wet for FIVE minutes,Let air dry

Used for Additional hand and Environmental precautions (C. diff or norovirus)

*C. diff and norovirus require 2 step disinfection; general disinfection followed by bleach.

sani-cloth plus germicidal disposable cloth

green top

Surface must remain visibly wet for TEN minutes.

Let air dry

*Use additional wipes if needed to assure continuous wet contact time.

sani-cloth plus germicidal disposable cloth

gray top

Surface must remain visibly wet for THREE minutes.

Let air dry

*Use additional wipes if needed to assure continuous wet contact time.

sani-cloth plus germicidal disposable cloth

red top

Surface must remain visibly wet for THREE minutes.

Let air dry

*Use additional wipes if needed to assure continuous wet contact time.

airborne

• TB

• chickenpox(varicella)

• measles(rubeola)

droplet

• rubella

• mumps

• influenza

• meningitis

• RSV

• adenovirus

contact

• staphylococcus aureus

• hepatitis A

• impetigo

• varicella and varicella zoster

• methicillin resistant staphylococcus aureus(MRSA)

• vancomycin resistant enterococci(VRE)

• lice

• scabies

• respiratory syncytial virus(RSV)- for pediatrics

• multi-drug resistant organism(MDRO)

environmental contact

• c. difficile

• norovirus

• having diarrhea of unknown origin

reverse isolation- immunosuppressed

• aplastic anemia

• leukemia

• lymphoma

• AIDS

• severe burns

• leukopenia

• myelosuppression

• transplant

• cancer

enhanced

covid-19

patients who can be in isolation and sometimes under sterile field

• portable imaging

• OR

• sterile fluro procedures

• IR and cardiac cath lab

contact

gloves and gown

• purple top wipe

environmental

• gloves and gown

  -wash hands with soap and water after

• orange top, bleach wipe

droplet

• procedure mask, suggest eye protection

• purple top wipe

enhanced droplet/contact

• N-95 respirator, eye protection

• purple top wipe

airborne

• N95 respirator/PAPR, negative air pressure room, keep doors closed

• purple top wipe