Infection control for SARS Intensive Care Unit Prince of Wales Hospital Shatin Hong Kong Tutorial prepared by Charles Gomersall Version 1.0 April 8 th 2003

Disclaimer The procedures shown in this tutorial reflect current practice in Prince of Wales Hospital ICU and are based on our current understanding of SARS The author, the Prince of Wales Hospital and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this tutorial

Warning Attention to infection control is vital –The agent that causes SARS is highly contagious and may cause life- threatening illness –Many healthcare workers, both old and young have been affected and some have died

Personal In 1.Wash hands 2.Mask 3.Goggles 4.Cap 5.Gown 6.Wash hands 7.Gloves Out 1.Cap 2.Gown 3.Wash hands 4.Goggles 5.Mask 6.Wash hands 7.Outside mask 8.Wash hands

In 1. Wash hands 2. Mask 3. Goggles 4. Cap 5. Gown 6. Wash hands 7. Gloves

In 1. Wash hands 2. Mask 3. Goggles 4. Cap 5. Gown 6. Wash hands 7. Gloves

Wash hands 1. Palm to palm 2. Palm to back, fingers interlaced 3. Palm to palm, fingers interlaced 4. Fingers clasped 5. Thumbs 6. Fingers to palm 7. Forearms

Wash hands 1. Palm to palm 2. Palm to back, fingers interlaced 3. Palm to palm, fingers interlaced 4. Fingers clasped 5. Thumbs 6. Fingers to palm 7. Forearms

Wash hands 1. Palm to palm 2. Palm to back, fingers interlaced 3. Palm to palm, fingers interlaced 4. Fingers clasped 5. Thumbs 6. Fingers to palm 7. Forearms

Wash hands 1. Palm to palm 2. Palm to back, fingers interlaced 3. Palm to palm, fingers interlaced 4. Fingers clasped 5. Thumbs 6. Fingers to palm 7. Forearms

Wash hands 1. Palm to palm 2. Palm to back, fingers interlaced 3. Palm to palm, fingers interlaced 4. Fingers clasped 5. Thumbs 6. Fingers to palm 7. Forearms

Wash hands 1. Palm to palm 2. Palm to back, fingers interlaced 3. Palm to palm, fingers interlaced 4. Fingers clasped 5. Thumbs 6. Fingers to palm 7. Forearms

Mask Use N95 or N100 mask Surgical masks do NOT provide protection Check fit of mask each time it is used –place both hands over the mask and exhale vigorously –if air leaks around the nose adjust the nosepiece –if air leaks at mask edges, reposition the straps for a better fit –recheck

In 1. Wash hands 2. Mask 3. Goggles 4. Cap 5. Gown 6. Wash hands 7. Gloves

In 1. Wash hands 2. Mask 3. Goggles 4. Cap 5. Gown 6. Wash hands 7. Gloves

In 1. Wash hands 2. Mask 3. Goggles 4. Cap 5. Gown 6. Wash hands 7. Gloves

In 1. Wash hands 2. Mask 3. Goggles 4. Cap 5. Gown 6. Wash hands 7. Gloves

In 1. Wash hands 2. Mask 3. Goggles 4. Cap 5. Gown 6. Wash hands 7. Gloves

In 1. Wash hands 2. Mask 3. Goggles 4. Cap 5. Gown 6. Wash hands 7. Gloves

Ready 1. Wash hands 2. Mask 3. Goggles 4. Cap 5. Gown 6. Wash hands 7. Gloves

Inside Change gloves between patients Change gloves before using phone, computers, writing notes etc Wash your hands whenever you change your gloves Do not touch your face or eyes

Out 1. Cap 2. Gown 3. Remove gloves 4. Wash hands 5. Goggles 6. Mask 7. Wash hands 8. Outside mask 9. Wash hands

Out 1. Cap 2. Gown 3. Remove gloves 4. Wash hands 5. Goggles 6. Mask 7. Wash hands 8. Outside mask 9. Wash hands

Out 1. Cap 2. Gown 3. Remove gloves 4. Wash hands 5. Goggles 6. Mask 7. Wash hands 8. Outside mask 9. Wash hands

Out 1. Cap 2. Gown 3. Remove gloves 4. Wash hands 5. Goggles 6. Mask 7. Wash hands 8. Outside mask 9. Wash hands

Out 1. Cap 2. Gown 3. Remove gloves 4. Wash hands 5. Goggles 6. Mask 7. Wash hands 8. Outside mask 9. Wash hands

Out 1. Cap 2. Gown 3. Remove gloves 4. Wash hands 5. Goggles 6. Mask 7. Wash hands 8. Outside mask 9. Wash hands

Out 1. Cap 2. Gown 3. Remove gloves 4. Wash hands 5. Goggles 6. Mask 7. Wash hands 8. Outside mask 9. Wash hands

Out 1.Cap 2.Gown 3.Remove gloves 4.Wash hands 5.Goggles 6.Mask 7.Wash hands 8.Outside mask 9.Wash hands

Out 1. Cap 2. Gown 3. Remove gloves 4. Wash hands 5. Goggles 6. Mask 7. Wash hands 8. Outside mask 9. Wash hands

Eating and drinking Always wash your hands first Use your own utensils Sit at least 1m apart Do not talk Do not cough or sneeze when not wearing a mask

Respiratory No nebulizers or Venturi masks No non-invasive ventilation Minimize circuit breaks HMEF Bacterial filter Scavenging

Respiratory No nebulizers or Venturi masks No non-invasive ventilation Minimize circuit breaks HMEF Bacterial filter Scavenging

Respiratory No nebulizers or Venturi masks No non-invasive ventilation Minimize circuit breaks HMEF Bacterial filter Scavenging

Respiratory No nebulizers or Venturi masks No non-invasive ventilation Minimize circuit breaks HMEF Bacterial filter Scavenging

Respiratory No nebulizers or Venturi masks No non-invasive ventilation Minimize circuit breaks HMEF Bacterial filter Scavenging

Respiratory No nebulizers or Venturi masks No non-invasive ventilation Minimize circuit breaks HMEF Bacterial filter Scavenging

Urine Direct urine flow against the wall of the collecting jug to avoid splashes

Urine Turn on water to flush away urine

Urine Carefully empty the urine onto the side of the sluice to avoid splashes

Urine Clean up any spills immediately with sodium hypochlorite solution

Remember This disease is highly contagious It is potentially life threatening Your safety and the safety of your family and patients depends on your strict adherence to infection control measures