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🛡️ सुरक्षा र संक्रमण रोकथाम (Safety & Infection Prevention) · 6 मध्ये पाठ 1 · 7 min

Contact, Droplet, Airborne: सही ढोका छान्नुहोस्

Contact, Droplet, Airborne: Pick the Right Door

😷 Measles बिरामी गइसकेपछि पनि कोठाको हावामा दुई घण्टासम्म रहन सक्छ। Influenza केही फिटको दूरीभित्र भुइँमा खस्छ। C. diff ले hand sanitizer लाई गिज्याउँछ। तीन रोग, तीन पूरै फरक कोठा।

😷 Measles can hang in the air of a room for two hours after the client leaves. Influenza falls to the floor within a few feet. C. diff laughs at hand sanitizer. Three diseases, three completely different rooms.

💡 मुख्य कुरा

Contact: gown र gloves। Droplet: कोठामा प्रवेश गर्दा surgical mask। Airborne: N95 र negative-pressure कोठा। C. diff: soap and water, कहिल्यै sanitizer मात्र होइन।

Contact: gown and gloves. Droplet: surgical mask on entering the room. Airborne: N95 and a negative-pressure room. C. diff: soap and water, never sanitizer alone.

🧠 यो किन महत्त्वपूर्ण छ

STANDARD precautions सबैमा लागू हुन्छन्: hand hygiene, शारीरिक तरल पदार्थका लागि gloves, र sharps सुरक्षा। CONTACT precautions मा gown र gloves, र private कोठा वा cohorting थपिन्छ: MRSA, VRE, Clostridioides difficile, scabies, RSV, rotavirus र चुहिने घाउहरू। C. diff का लागि SOAP AND WATER ले धुनुहोस् किनकि alcohol ले spores मार्दैन, र सफाइका लागि bleach प्रयोग गर्नुहोस्। DROPLET precautions मा कोठामा प्रवेश गर्दा लगाइने surgical mask थपिन्छ: influenza, pertussis, mumps, rubella, meningococcal meningitis, pharyngeal diphtheria र mycoplasma pneumonia; बिरामी सार्दा बिरामीले surgical mask लगाउँछन्। AIRBORNE precautions मा ढोका बन्द गरिएको negative-pressure कोठा र तपाईंलाई fit-test गरिएको N95 respirator चाहिन्छ: tuberculosis, measles (rubeola), varicella र disseminated herpes zoster। Airborne का लागि सम्झने उपाय: My Chicken Hez TB, अर्थात् measles, chickenpox, disseminated herpes zoster, tuberculosis। Varicella र disseminated zoster लाई airborne र contact दुवै precautions चाहिन्छ।

STANDARD precautions apply to everyone: hand hygiene, gloves for body fluids, and sharps safety. CONTACT precautions add a gown and gloves and a private room or cohorting: MRSA, VRE, Clostridioides difficile, scabies, RSV, rotavirus and draining wounds. For C. diff, wash with SOAP AND WATER because alcohol does not kill spores, and use bleach for cleaning. DROPLET precautions add a surgical mask, put on when entering the room: influenza, pertussis, mumps, rubella, meningococcal meningitis, pharyngeal diphtheria and mycoplasma pneumonia; the client wears a surgical mask when transported. AIRBORNE precautions require a negative-pressure room with the door closed and an N95 respirator fit-tested to you: tuberculosis, measles (rubeola), varicella and disseminated herpes zoster. A memory aid for airborne: My Chicken Hez TB, for measles, chickenpox, disseminated herpes zoster, tuberculosis. Varicella and disseminated zoster need airborne plus contact precautions.

🏥 वास्तविक जीवनमा

🚪 एक नयाँ नर्सले शंकास्पद tuberculosis भएको बिरामीलाई ढोका खुला राखेर सामान्य private कोठामा राख्छिन् र surgical mask लगाउँछिन्। दुवै छनोट असफल हुन्छन्: TB droplet nuclei सानो हुन्छन् र तैरिन्छन्; fit गरिएको N95 ले मात्र तिनलाई फिल्टर गर्छ, र negative pressure ले मात्र तिनलाई करिडोरबाट बाहिर राख्छ। परीक्षाले ठ्याक्कै यही पासो राख्छ, सुहाउँदो तर गलत mask सहित।

🚪 A new nurse puts a client with suspected tuberculosis in a regular private room with the door open and wears a surgical mask. Both choices fail: TB droplet nuclei are tiny and float; only a fitted N95 filters them, and only negative pressure keeps them out of the hallway. The exam will set exactly this trap with a plausible but wrong mask.

📌 सम्झनुहोस्

  • Contact: MRSA, VRE, C. diff (soap and water), scabies, RSV हुँदा gown र glovesContact: MRSA, VRE, C. diff (soap and water), scabies, RSV
  • Droplet: flu, pertussis, mumps, rubella, meningococcal meningitis हुँदा surgical maskDroplet: flu, pertussis, mumps, rubella, meningococcal meningitis
  • Airborne: TB, measles, varicella, disseminated zoster: N95 र negative pressureAirborne: TB, measles, varicella, disseminated zoster: N95 plus negative pressure

📖 यस पाठका शब्दहरू

Standard precautions: निदान जे भए पनि हरेक बिरामीमा प्रयोग गरिने hand hygiene, सम्भावित सम्पर्क अनुसारको सुरक्षात्मक उपकरण, र sharps तथा injection सम्बन्धी सुरक्षित अभ्यास हुन्।

Contact precautions: MRSA, VRE, C. difficile र scabies जस्ता छुँदा सर्ने जीवाणुका लागि gown र gloves प्रयोग गर्ने उपाय हो।

Droplet precautions: influenza, pertussis, mumps, rubella वा meningococcal meningitis भएको बिरामीको कोठामा प्रवेश गर्दा लगाइने surgical mask हो।

Airborne precautions: tuberculosis, measles, varicella र disseminated zoster का लागि N95 respirator र negative-pressure कोठा प्रयोग गर्ने उपाय हो।

Negative-pressure room: हावालाई भित्र तान्ने र बाहिर निकास गर्ने कोठा हो, जसले गर्दा हावाबाट सर्ने जीवाणु करिडोरमा पुग्दैनन्।

SPIDERMAN (droplet precautions): meningococcal Sepsis, Scarlet fever, Strep throat, Parvovirus, Pneumonia (केही प्रकार), Pertussis, Influenza, Diphtheria, Epiglottitis, Rubella, Mumps, meningococcal Meningitis, Mycoplasma, Adenovirus: कोठामा प्रवेश गर्दा surgical mask चाहिने रोगहरू।

MRS. WEE (contact precautions): Multidrug-resistant organisms, Respiratory syncytial virus, Skin infections (scabies, impetigo, herpes simplex), Wound infections (पीप बग्ने), Enteric infections (C. difficile), Eye infections (भाइरल conjunctivitis): gown र gloves चाहिने रोगहरू।

✅ आफूलाई जाँच्नुहोस्

कुन बिरामीलाई negative-pressure कोठामा airborne precautions चाहिन्छ?Which client requires airborne precautions in a negative-pressure room?
  1. सक्रिय pulmonary tuberculosis भएको बिरामीA client with active pulmonary tuberculosis
  2. Pertussis र paroxysmal खोकी भएको बिरामीA client with pertussis and a paroxysmal cough
  3. बारम्बार खोक्ने influenza भएको बिरामीA client with influenza who is coughing frequently
  4. चुहिने शल्यक्रियाको घाउमा MRSA भएको बिरामीA client with MRSA in a draining surgical wound

उत्तर: A · सक्रिय pulmonary tuberculosis भएको बिरामी

Tuberculosis सानो airborne droplet nuclei बाट फैलिन्छ। Influenza र pertussis droplet हुन्; MRSA घाउको संक्रमण contact हो।

Tuberculosis spreads by tiny airborne droplet nuclei. Influenza and pertussis are droplet; MRSA wound infection is contact.

Clostridioides difficile भएको बिरामीको हेरचाह गरेपछि, कुन hand hygiene सही हो?After caring for a client with Clostridioides difficile, which hand hygiene is correct?
  1. 20 सेकेन्डसम्म alcohol-based hand rubAlcohol-based hand rub for 20 seconds
  2. Gloves मात्र पर्याप्त छGloves alone are sufficient
  3. Gloves माथि chlorhexidine wipesChlorhexidine wipes on the gloves
  4. Soap and water

उत्तर: D · Soap and water

C. diff का spores alcohol मा बाँच्छन्। Soap and water ले मिचेर धुँदा तिनलाई हटाउँछ।

C. diff spores survive alcohol. Mechanical washing with soap and water removes them.

Bacterial (meningococcal) meningitis भएको बिरामीलाई CT मा लैजानुपर्छ। सार्दा कुन precaution सही हो?A client with bacterial (meningococcal) meningitis must go to CT. Which precaution is correct during transport?
  1. बिरामीलाई surgical mask लगाइदिनेPlace a surgical mask on the client
  2. कोठा बाहिर निस्किएपछि कुनै विशेष precautions चाहिँदैनNo special precautions once outside the room
  3. कर्मचारीले N95 respirator लगाउने र बिरामीले केही नलगाउनेStaff wear N95 respirators and the client wears nothing
  4. Isolation सकिँदासम्म परीक्षा रद्द गर्नेCancel the test until isolation ends

उत्तर: A · बिरामीलाई surgical mask लगाइदिने

Meningococcal meningitis droplet हो; सार्दा droplet रोक्न बिरामीले surgical mask लगाउँछन्।

Meningococcal meningitis is droplet; the client wears a surgical mask to contain droplets during transport.

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