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Aerosol-generating medical procedures (AGMPs) - are medical procedures that can generate aerosols as a result of artificial manipulation of a patient’s airway. Examples include intubation, manual ventilation, open endotracheal suctioning, CPR, bronchoscopy, sputum induction, nebulized therapy, surgery, autopsy, and non-invasive positive pressure ventilation (CPAP, BiPAP) Airborne Isolation Room – a single patient room that is equipped with special air handling (negative pressure) and ventilation capacity. Anteroom – is considered a clean area and is used to transition people in and out of the airborne isolation room when it is under negative pressure. An anteroom is used as a transitional space between the hallway and the airborne isolation room. This transition area is where the Healthcare Worker puts on their PPE when entering the Airborne isolation room. The HCW also will store all clean PPE in this area. See Anteroom Protocol Negative Pressure Room – also known as an Airborne Isolation Room; a negative pressure room that is a single-occupancy patient-care room used to isolate persons with a suspected or confirmed airborne infectious disease. N95 Respirators – specific masks that filter particles one micron in size, have a 95% filter efficiency and provide a tight facial seal with less than a 10% leak. Clinical Syndromes Requiring the Use of Controls (Including PPE) Pending Diagnosis · Acute diarrhea and / or vomiting of suspected infectious etiology: o GLOVES, SINGLE ROOM o GOWN if skin or clothing will come into direct contact with the patient or the patient’s environment and for paediatrics and incontinent/non-compliant adults · Acute respiratory infection, undiagnosed: o SINGLE ROOM/SPATIAL SEPARATION preferred, FACIAL PROTECTION, GLOVES o GOWN if skin or clothing will come into direct contact with the patient or the patient’s environment · Respiratory infection with risk factors and symptoms suggestive of Tuberculosis: o FIT-TESTED N95 RESPIRATOR, NEGATIVE PRESSURE ROOM · Suspected meningitis and/or sepsis with petechial rash: o SINGLE ROOM, FACIAL PROTECTION · Undiagnosed rash without fever: o GLOVES · Rash suggestive of varicella or measles: o NEGATIVE PRESSURE ROOM -= only immune staff to enter · Abscess or draining wound that cannot be contained: o GLOVES o GOWN if skin or clothing will come into direct contact with the patient PROCEDURE As well as Routine Practice, Airborne Precautions includes the following: Source Control a) A point of care risk assessment (PCRA) as per routine practices should be done to determine if airborne precautions are required. · Note that some diseases/conditions require two precaution categories; airborne and contact – see table above · Patients should be directed to put on a surgical/procedure mask, if tolerated when not in an airborne isolation room. · Place patients directly into an airborne isolation room with door closed. · If a facility does not have an airborne isolation room, patient to be placed into a single room; the patient should be instructed to keep the mask on and the door should remain closed. Transfer as soon as possible to a facility with an airborne isolation room. · Signage placed at the entrance to patient room. b) The following strategies should be applied to reduce the level of aerosol generation when performing aerosol-generating medical procedures (AGMPs) for patients with suspected airborne disease. · AGMPs should be limited to those that are medically necessary. · The number of personnel in the room should be limited to those required. · Consider appropriate patient sedation. · AGMPs should be performed in an airborne isolation room. · Single rooms (with the door closed and away from high-risk patients), should be used in settings where airborne isolation rooms are unavailable. · N 95 respirators should be worn by all personnel in the room during the procedure. · Closed endotracheal suction systems should be used wherever possible. · In an emergency situation when an airborne isolation room is not available; at a minimum pull the privacy curtains and all personnel to wear N95 respirator. Remove visitors and other patients from the room/area.