Universal precautions are defined as simple infection prevention control measures that reduces the risk of transmission of blood borne pathogens through exposure to blood and body fluids among patients and health care workers

1. Dr.Nidhi Ahya (Asst.Prof)
Cardio-Vascular & Respiratory PT
DVVPF College of Physiotherapy,
Ahmednagar 414111
Universal Precautions In ICU

2. OBJECTIVES
• Universal precautions
• Infection
• Spread of infection
• Prevention and control of infection
• Transmission based precautions

3. Definition:
• Universal precautions are defined as simple
infection prevention control measures that reduces
the risk of transmission of blood borne pathogens
through exposure to blood and body fluids among
patients and health care workers

4. INFECTION
• Infection is an invasion and multiplying of
pathogenic microbes in the body tissues in which
they are not usually present
• Infection occurs when a pathogen is able to
overcome the barriers of the host

5. • Nosocomial infection/ hospital-acquired infection:
development favored by hospital environment
• 10% admissions to ICU acquire nosocomial
infection
• 25% undergo mechanical ventilation develop
pneumonia
• 30% die of lung infection

6. Elements for an infection to spread
source route host

7. contact droplet vehicleairborne vector

8. MODE TYPE TRANSMISSION EXAMPLE
Contact
(Most common
route of
nosocomial)
Direct Body surface-to body
surface between host &
infected person.
•Mucus- to- mucus
•Touching
contaminated hands
HIV
Staphylococcus
aureus
Indirect Host & fomites
•Contaminated needle
& nebulizer
HIV
Droplet: discharge
large
contaminated
liquid drop in air
Travel short
distance
approx-3ft
•Coughing
•Sneezing
•Talking
Strep pneumonia
Airborne •Droplet nuclei
•Dust particles
TB, Measles
Fungal infection
Common vehicle Foodborne Hepatitis A
Waterborne Cholera
Vector borne Animal/insect Malaria

9. Spread of infection to the lungs
Nosocomial
bacterial
pneumonia
Aspirate
oropharyng
eal/gastric
secretions
Inhale
liquid
droplet,
droplet
nuclei Distant site
through
blood

10. Infection control strategy
Decrease host
susceptibility
• Difficult & less
feasible
• Immunization
• Education
Eliminating the
source of
pathogens
• General
sanitation
measures
(laundry, food
preparation,
house keeping,
ventilation)
• Specialized
equipment
processing
Interrupting the
transmission route
• Specialized
equipment
handling
• Isolation
precautions
• Use of
disposable
equipment

11. Maintenance of in-use equipment
nebulizer ventilator suction
P F E

12. Help to prevent cross infection
• Sterile fluid should be used for tracheal suction and
to fill nebulizers and bubble humidifiers
• Sterile water should be used when rinsing
equipments
• When multidose medication vials are being used,
they must be handled, dispensed and stored
according to manufacturer’s instructions
• Medications must not be used after expiry date

13. Infection control strategy
Decrease host
susceptibility
• Difficult & less
feasible
• Immunization
• Education
Eliminating the
source of
pathogens
• General
sanitation
measures
• Specialized
equipment
processing
Interrupting the
transmission route
• Specialized
equipment
handling
• Isolation
precautions
• Use of
disposable
equipment

14. Principles / barriers/ isolation precautions
• Hand washing
• Personal Protective Equipment(PPE)
• Patient placement
• Transport procedures

15. Indications:
• In prolonged contact with patient
• Taking care of immune suppressed, patients in ICU
• Before & after touching wounds
• Contact with mucous membranes, body fluids, and
secretions contaminated with blood & serous fluids

16. • Efficient hand washing means cleaning the palms
of the hands, around the wrist and the forearms,
between the fingernails, around the cuticles and
between the digits for no less than 15 seconds
• Rinsing is from forearm to fingertips
• Drying can be by cloth towels, paper towels, warm
forced air or hand activated dryer

18. • Hand antisepsis
− Wash using antimicrobial soap for 15-30 sec
− Decontaminate with waterless alcohol based hand
rubs(3ml) for 15-30 sec
• Surgical hand antisepsis:
− Done for 2-3 min
Detergent formulations –
2%-4% Chlorhexidine, 5%-75% Povidine Iodine,
1% Triclosan, 70% Alcoholic rub

19. WHY TO WEAR GLOVES??
• Protects caregivers from contamination when
contacting patients blood, body fluids, secretions,
excretion, mucous membranes or non-intact skin.
• Protects patients from acquiring infection from
colonized health personnel during invasive
procedures
• Reduces the likelihood of cross contamination
between patients via caregiver’s hand

20. PRINCIPLES
• Use of a pair of plastic disposable gloves
• Cover hand cuts with a band aid before gloving
• Wash hands immediately after removing gloves
• Dispose the gloves after use

21. HOW TO WEAR???
Wear the left glove first
Bunch up the glove & pull
onto the hands
Ease the fingers

22. BOOTS
• Wearing foot wear covering entire sole protects the
entry of microbes from the contaminated floors with
blood and body fluids

24. HOW TO WEAR PPE
Thorough
hand wash
Wear the
gown
Wear the
goggles/sho
e cover/cap
Wear face
mask
Wear
gloves

25. HOW TO REMOVE PPE
Remove
gloves
Use
alcohol
hand-rub
Remove
cap & face
shield
Remove
mask
Remove
gown
Use
alcohol
hand-rub
Leave the
room
Outside
room use
hand wash

26. Patient placement
• Place patient who contaminate the environment
in a private room
• If not private rooms, Cohorting the patients
Transport of infected patients
• Limit transport
• If required make him wear appropriate barrier
protection

27. Use of disposable equipment
• Protective procedure
– Safe disposal of needles & syringes
– Safe system for hospital waste management disposal

28. DISPOSAL OF NEEDLES
• Never recap the needles
• Bending, reshaping should be prohibited
• All used reusable needles and sharps should be
deposited in thick walled puncture resistant
containers
• All used disposable syringes and needles should
be discarded into bleach solution

29. PROCESS OF DISPOSAL OF HOSPITAL WASTE
Generation Segregation Collection
Transportation Storage Disposal

30. According to the Rules waste generated in the
hospitals is classified into ten categories:
– Human Anatomical waste
– Animal waste
– Microbiology & Biotechnology waste,
– Waste sharps
– Discarded medicines and Cytotoxic drugs,
– Soiled waste
– Solid waste
– Liquid waste
– Incineration ash
– Chemical waste

31. COLOUR CODING TYPES OF
CONTAINER
•WASTE
CATEGORY
TREATMENT
OPTIONS
Yellow Plastic bags •Human anatomical
waste,
•Microbiology &
Biotechnology
waste,
•Solid
waste(contaminate
d with blood body
fluids)
Incerination/Deep
burial
Red Plastic
bags/Disinfected
containers
•Microbiology &
Biotechnology
waste,
•Solid waste,
•Waste generated
from disposable
items such as
tubing, catheters,
etc
Autoclaving/Chemi
cal Treatment

32. Blue/White
translucent
Plastic
bag/puncture
proof container
•Waste Sharps
(needles,
syringes, scalpels
blades, glass etc,
•Waste generated
from disposable
items
Autoclaving/chem
ical treatment &
destruction
Black Plastic bag •Discarded
Medicines and
Cytotoxic drugs ,
•Incineration Ash ,
•Chemical Waste
(chemicals used in
production of
biological,
chemicals, used in
disinfection, as
insecticides, etc)
Disposal in
secured landfill

33. Transmission-based(additional) precautions
Expanded precautions
• Used with patients documented or suspected to
have severe contagious infections for which
standard alone are insufficient
• Always applied in addition to standard precautions
• Types:-
− Airborne infection isolation(Airborne precautions)
− Droplet precautions
− Contact precautions

34. DISEASES PATIENT
PLACEME
NT
PPE &
HANDWAS
HING
PATIENT
TRANSPO
RT
PATIENT
CARE
EQUIPMEN
T
AIRBORNE
PRECAUTI
ON
•TB,
•Measles,
•Histoplasm
osis
•Private
room
•Safe
external air
discharge
•Door
closed
•Infection
control
•Wear N95
•Susceptible
person
should not
enter the
room
•Limited
•If required,
use
protective
devices ----
DROPLET
PRECAUTI
ON
•Pneumonia
•Influenza
•Mumps
•Rubella
•Doors can
be kept
open
•Special air
handling not
required
Wear mask
within 3 feet
____DO___
_
----
CONTACT
PRECAUTI
ON
•Hepatitis
•AIDS
---DO--- •Use gloves
and gowns
•Wash
----DO---- •single
patient or
patient

35. Summary
• Universal precautions
• Infection
• Spread of infection
• Prevention and control of infection
• Transmission based precautions

36. QUESTIONS
1. WRITE THE UNIVERSAL PRECAUTIONS.
3MARKS
2. WRITE ABOUT THE INFECTIONS. 5MARKS

37. BYE BYE TO INFECTIONS
…………………….
THANK YOU