In a healthcare setting, additional precautions should be applied when patients have a known or suspected infectious agent that may not be contained using Standard Precautions alone. These additional precautions should be tailored based on the infectious agent involved and the mode of transmission. For patients with suspected or known EVD in a hospital setting in the United States, the CDC recommends the addition of contact and droplet precautions, which are both transmission-based. Further precautions may also be indicated based on any additional conditions or illnesses that are suspected or diagnosed in a particular EVD patient, such as airborne precautions if tuberculosis is suspected/known.
A combination of standard, contact, and droplet precautions to prevent the transmission of EVD in hospitals must be used. Some of the critical elements2 include:
- Placing the patient in a private room with a private bathroom. The door to the room should remain closed and a log should be maintained of all persons who enter.
- Using appropriate personal protective equipment (PPE) consistently by all personnel entering the patient's room.
- Using dedicated medical equipment that is disposable whenever possible.
- Limiting the use of needles and sharps. This includes limiting phlebotomy, procedures, and other laboratory testing to only testing that is essential to the diagnostic evaluation and medical care of the patient.
- Avoiding procedures that produce aerosols (eg, sputum induction, bronchoscopy, open suctioning of airways).
- Performing frequent hand hygiene using soap and water or alcohol-based rubs. Hand hygiene should always be performed before and after patient contact, before putting on and after removing PPE, and when hands are visibly soiled (using only soap and water in this situation).
- Monitoring and managing potentially exposed personnel and visitors according to facility policies.