Welcome back to the channel where medical topics are made easy.
Today I’m going to show you some simple memory tricks and mnemonics that will help
you remember the different isolation precautions.
Isolation precautions show up on nursing exams, NCLEX, USMLE, and board exams, so having an
easy way to remember them is helpful, especially when it comes time to using them in practice.
You can find the PDF lecture notes and study guides for the video linked down below.
This video is filled with mnemonics and summary tables like this one,
so make sure to watch the entire video.
When we talk about isolation precautions, there are 2 main categories.
We have our standard precautions and then we have transmission-based precautions.
Standard precautions are the basic precautions used for all patients.
And transmission-based precautions are extra steps to follow in addition to the standard
precautions in order to prevent the spread of certain infections.
The transmission-based precautions can be broken down even more into 3 different categories.
They include contact, droplet, and airborne precautions.
By the end of this video you’ll know everything you need to know for these precautions and
the diseases that are included in each category.
You’ll also be given several mnemonics and tricks to remember them all.
But first what do we mean by isolation precautions?
Isolation precautions are the preventative steps needed to be taken by healthcare workers
and staff to prevent the spread or transmission of infections.
Let’s walk through each of the transmission-based precautions first and then we’ll finish
with the standard precautions that should be used with all patients.
Let’s start with airborne precautions because they’re the easiest to remember.
The diseases that require airborne precautions are
Measles, also known as rubeola,
Tuberculosis,
and Varicella-Zoster virus which causes chickenpox and shingles.
The easiest way to remember these is to use the mnemonic MTV.
We have viewers from all around the world, so for those of you who don’t know MTV is
a music television channel.
This will help you remember “M” for Measles, “T” for Tuberculosis, and “V” for Varicella.
Airborne precautions for varicella-zoster include anyone with chickenpox and those with
disseminated herpes zoster, which is shingles affecting 3 or more dermatomes.
Remember herpes zoster is shingles.
A small episode of shingles in someone who has a competent immune system does not require
airborne precautions, but they do require contact precautions.
And we’re going to see both chickenpox and shingles included in contact precautions as well.
Just so you’re aware, the Variola virus which causes smallpox is also airborne.
I didn’t include it because of its eradication, but if there is concern for smallpox or a
confirmation of smallpox, then use airborne precautions.
Or if you get a question about it on your medical or board exams, now you’re prepared for it.
It’s easy to remember because you can include it with the “V” in MTV to remember Variola.
It has also been generally recommended to treat SARS using airborne precautions.
Just make sure to follow your institutional protocols.
This again is easy to remember, just make MTV plural so its MTVs which will help you
remember “S” for SARS.
Next we have contact precautions.
The way I like to remember these is by using “ABCDEF”
This will help you remember “A” for abscess, “B” for bronchiolitis, “C” for cutaneous,
“D” for diarrhea, “E” for eyes, and “F” for funky or feisty.
Starting with abscess, this is to help you remember a large abscess with major drainage.
Not every abscess requires contact precautions, especially if it’s smaller with minimal drainage.
You can use standard precautions with minor drainage.
But if there is significant drainage, then it's recommended to use contact precautions.
Next is the “B” to help you remember bronchiolitis because the 2 more common viruses that cause
bronchiolitis require contact precautions.
The first is RSV, or respiratory syncytial virus, and the other is parainfluenza.
Moving on to “C” for cutaneous,
this is to help you remember that many diseases involving the skin use contact precautions.
This includes herpes zoster, which is shingles, and varicella which is chickenpox.
Remember chickenpox and disseminated herpes zoster also require airborne precautions.
Other cutaneous diseases requiring contact precautions include herpes simplex, impetigo,
lice, major pressure or decubitus ulcers, scabies, major staphylococcal or streptococcal
skin wounds or burns, and diphtheria which is the cutaneous form not the pharyngeal form.
The pharyngeal form will be coming up in droplet precautions next.
Next is “D” which will help you remember the diseases that cause diarrhea and require
contact precautions.
They include C. diff, norovirus, rotavirus, and hepatitis A.
Moving on to “E” for eyes.
This will help you remember conjunctivitis.
We’re talking about infectious conjunctivitis here, especially acute viral conjunctivitis
which some people also refer to as pink eye.
Remember conjunctivitis simply means inflammation of the conjunctiva.
Many things can cause conjunctivitis such as allergies, irritants, trauma, viral infections,
and bacterial infections to name a few.
Not all of these require contact precautions.
We’re mainly talking about the infectious forms, particularly viral which is commonly
caused by adenovirus.
Finally we have the “F” which stands for funky or feisty.
This is to help you remember the multidrug-resistant organisms such as MRSA and VRE.
These can be challenging to treat and contact precautions should be used to prevent transmission.
So again for contact precautions, just remember ABCDEF and that will help you remember the
major categories and diseases.
If you have another way to remember these, make sure to share it in the comments down below.
So we’ve learned MTV for airborne precautions and ABCDEF for contact precautions.
Now let’s walk through the final transmission-based category which is droplet precautions.
Let’s first look at the diseases that require droplet precautions because unfortunately
there are a lot of them.
And then I’ll show you an easy way to remember them.
The infections that require droplet precautions include mycoplasma pneumoniae, which can cause
a pneumonia commonly known as walking pneumonia.
Droplet precautions are also required for pertussis, also known as whooping cough, which
is caused by a bacteria called Bordetella pertussis.
Droplet precautions are also required for mumps, influenza or the flu, and diphtheria.
This time it’s the pharyngeal form of diphtheria.
Remember we said the cutaneous form requires contact precautions.
Droplet precautions are also required for streptococcal infections including pneumonia,
which we’ll get to shortly and streptococcal toxic shock syndrome, as well as pharyngitis
and scarlet fever in infants and young children.
Next we have meningitis that is caused by either Haemophilus influenzae type b or Neisseria.
Droplet precautions are also required for pneumonic plague, parvovirus B19 also known
as Fifth Disease, German measles, also known as rubella, adenovirus, and pneumonia.
It’s good practice to use droplet precautions for all pneumonia, which includes the streptococcal
pneumonia, mycoplasma pneumonia, and pneumonic plague we already mentioned.
Droplet precautions are also required for epiglottitis which is typically caused by
Haemophilus influenzae type b.
And finally it’s required for rhinovirus as well.
As you can see this is a long list and very difficult to remember.
So this is what I came up with.
Use the mnemonic “My perfect mum flew a dozen strong men on a plane to a park in Germany
to add a new epic rhino”
I know this may seem like a long mnemonic to remember at first, but it actually works
really well.
If you have a better way to remember this, then please share it down in the comments.
But given the long list of complicated diseases and names, this is the best I could come up
with and I think it’s actually pretty good.
Remembering this mnemonic is way easier than trying to remember all those diseases.
Let’s walk through it.
You’ll use the "My" to remember Mycoplasma
the “P-E-R” in Perfect to remember Pertussis
"Mum" to remember Mumps
"Flew" to remember the Flu or Influenza
the “D” in Dozen to remember Diphtheria
the “S-T-R” in Strong to remember Streptococcus
"Men" to remember meningitis, especially meningococcal meningitis caused by Neisseria
"Plane" to remember Plague
"Park" to remember Parvovirus B19
"Germany" to remember German measles
"Add" to remember Adenovirus
"New" to remember Pneumonia based on how its pronounced
"Epic" to remember Epiglottitis
and "Rhino" to remember Rhinovirus.
If you repeat the mnemonic enough times in your head it will stick.
And like I said before, it’s way easier to remember that mnemonic than trying to remember
all the different infections.
I put together a table to help organize the information for you.
You can download the PDF for the table and notes linked below.
You can see it includes the type of precaution, the memory trick, and the example infections
or diseases that fall in that category.
I also put together this table for you that goes over the personal protective equipment
and types of rooms the patient should be in for each precaution.
You can download the PDF for this as well below.
Remember all of the transmission-based isolation precautions are in addition to standard precautions,
which we’ll go over next.
We can see that contact precautions help prevent the transmission of infections spread by direct
or indirect contact with the patient or patient’s environment.
PPE stands for personal protective equipment.
Contact precautions require a gown and gloves be worn in addition to following standard precautions.
The gown and gloves are put on when entering the room and they're taken off when leaving the room.
This is done to contain the pathogen and prevent contamination.
Patient’s who are in contact precautions should ideally be in a single-patient room
without roommates.
Droplet precautions help prevent the transmission of infections spread through air droplets usually
by coughing, sneezing, talking, or close contact with respiratory secretions or mucous membranes.
Droplets tend to be larger in size and they don't travel as far, usually only 3-6 feet.
This is different from airborne precautions where droplets are smaller in size
and they travel much farther.
In addition to following standard precautions, a surgical mask is required for droplet precautions,
which is put on when entering the room.
And the patient should ideally be in a single-patient room.
These pathogens do not remain infectious over long distances, which is why a special room
with ventilation that we’ll see for airborne precautions is not necessary.
Finally we have airborne precautions which help prevent the transmission of diseases
that remain infectious over long distances when suspended in the air.
These infections live as tiny residue particles in the air, called droplet nuclei
and they're waiting to be inhaled.
That’s why in addition to following standard precautions, an N95 or higher level respirator
is required for airborne precautions.
The respirators are put on prior to entering the room.
Healthcare workers undergo fit-testing and education on how to use the respirators.
Patients should be in a special room called an Airborne Infection Isolation Room.
These rooms are a single-patient room with special air handling and ventilation.
It’s a negative pressure room with 6-12 air exchanges every hour depending on when
it was built, and air is released directly to the outside or recirculated through a special
filtration system.
As we mentioned before, all of these precautions are in addition to following standard precautions.
If we go back to our original diagram, we said there are 2 main categories of precautions.
We already went over transmission-based precautions, so now let’s look at standard precautions.
As we mentioned before, precautions are necessary to prevent the spread of infections.
The standard precautions are the minimum steps that should be taken with all patients to
prevent infection.
These include good hand and respiratory hygiene, which means proper hand washing before and
after patient encounters and covering your cough and sneeze.
Remember some infections require hand washing with soap and water rather than alcohol based.
These include C. diff, norovirus, and rotavirus to name a few.
Standard precautions also include the use of appropriate protective equipment as deemed
necessary depending on what it is you are doing, even if the patient is not in specific
contact, droplet, or airborne precautions.
This may include wearing a gown, gloves, face shield, mask, or eye protection.
Make sure to clean supplies and dispose of waste.
And finally, make sure to practice safety with sharp object and dispose of them properly.
Hopefully this helped clarify the different types of isolation precautions.
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You can find the lecture notes and PDF study guides for the video on our website linked
down below.
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