Respiratory etiquette has big potential for limiting spread of germs
Lynn McNicol
WBAMC
As part of emergency
management planning for large outbreaks of diseases like severe acute
respiratory syndrome and influenza, as well as potential acts of bioterrorism
with agents like smallpox, hospitals are gearing up to “mitigate”
the impact on human life. Mitigation is any action that is taken to
eliminate or reduce harm, and it is the first step in emergency preparedness
for individuals and organizations.
Diseases like smallpox, SARS, and influenza are spread from person-to-person
primarily by respiratory droplets. Touching secretions from a sick person
or touching surfaces that have been contaminated with their secretions
can also lead to illness.
Anything we can do to break this chain of infection can help stop an
epidemic dead in its tracks. William Beaumont Army Medical Center is
implementing draft recommendations from the Centers for Disease Control
and Prevention to mitigate the risks for a large respiratory disease
outbreak in our community. As always, our patients and visitors play
a significant role in our success. Please take a moment to review the
following actions that we all must take to reduce the risks of disease
transmission:
• Visual alerts in English and Spanish will be posted at the entrance
to outpatient facilities (e.g., emergency departments, physician offices,
outpatient clinics) instructing patients and persons who accompany them
to inform healthcare personnel of symptoms of a respiratory infection
when they first register for care and to practice respiratory etiquette.
• Respiratory etiquette includes measures used to contain respiratory
secretions and they are recommended for all individuals with signs and
symptoms of a respiratory infection.
• Cover the nose/mouth when coughing or sneezing.
• Use tissues to contain respiratory secretions and dispose of
them in the nearest waste receptacle after use.
• Perform hand hygiene (e.g. hand washing with soap and water,
or waterless alcohol rub) after having contact with respiratory secretions
and contaminated objects/materials like used tissues.
• Healthcare facilities should ensure the availability of materials
for adhering to respiratory etiquette in waiting areas for patients
and visitors.
• Provide tissues and no-touch receptacles for used tissue disposal.
• Provide conveniently located dispensers of alcohol-based hand
rub; where sinks are available, ensure that supplies for hand washing
(i.e., soap, disposable towels) are consistently available.
• WBAMC will routinely offer masks to persons who are coughing.
Either procedure masks (i.e., with ear loops) or surgical masks (i.e.,
with ties) may be used to contain respiratory secretions. When space
and chair availability permit, encourage coughing persons to sit at
least three feet away from others in common waiting areas.
• Healthcare personnel will observe droplet precautions (i.e.,
wearing a surgical mask or procedure mask for close contact), in addition
to standard precautions, when examining a patient with symptoms of a
respiratory infection, particularly when fever is present. These precautions
should be maintained until it is determined that the cause of the symptoms
is not an infectious agent that requires Droplet Precautions.
“Respiratory etiquette has huge potential for limiting the spread
of infectious diseases, and in the era of SARS and other emerging infections,
should be every individual’s duty in healthcare settings to educate
and enforce,” said Maj. Sue Baum, an Infectious Disease physician
and Chief of Clinical Investigations.