1. Infection control for SARS Intensive Care UnitPrince of Wales HospitalShatinHong Kong Tutorial prepared by Charles Gomersall Version 1.0 April 8th 2003

2. Disclaimer • The procedures shown in this tutorial reflect current practice in Prince of Wales Hospital ICU and are based on our current understanding of SARS • The author, the Prince of Wales Hospital and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this tutorial

3. Warning • Attention to infection control is vital • The agent that causes SARS is highly contagious and may cause life-threatening illness • Many healthcare workers, both old and young have been affected and some have died

4. In Wash hands Mask Goggles Cap Gown Wash hands Gloves Out Cap Gown Wash hands Goggles Mask Wash hands Outside mask Wash hands Personal

5. In • Wash hands • Mask • Goggles • Cap • Gown • Wash hands • Gloves

6. In • Wash hands • Mask • Goggles • Cap • Gown • Wash hands • Gloves

7. Wash hands • Palm to palm • Palm to back, fingers interlaced • Palm to palm, fingers interlaced • Fingers clasped • Thumbs • Fingers to palm • Forearms

8. Wash hands • Palm to palm • Palm to back, fingers interlaced • Palm to palm, fingers interlaced • Fingers clasped • Thumbs • Fingers to palm • Forearms

9. Wash hands • Palm to palm • Palm to back, fingers interlaced • Palm to palm, fingers interlaced • Fingers clasped • Thumbs • Fingers to palm • Forearms

10. Wash hands • Palm to palm • Palm to back, fingers interlaced • Palm to palm, fingers interlaced • Fingers clasped • Thumbs • Fingers to palm • Forearms

11. Wash hands • Palm to palm • Palm to back, fingers interlaced • Palm to palm, fingers interlaced • Fingers clasped • Thumbs • Fingers to palm • Forearms

12. Wash hands • Palm to palm • Palm to back, fingers interlaced • Palm to palm, fingers interlaced • Fingers clasped • Thumbs • Fingers to palm • Forearms

13. Mask • Use N95 or N100 mask • Surgical masks do NOT provide protection • Check fit of mask each time it is used • place both hands over the mask and exhale vigorously • if air leaks around the nose adjust the nosepiece • if air leaks at mask edges, reposition the straps for a better fit • recheck

14. In • Wash hands • Mask • Goggles • Cap • Gown • Wash hands • Gloves

15. In • Wash hands • Mask • Goggles • Cap • Gown • Wash hands • Gloves

16. In • Wash hands • Mask • Goggles • Cap • Gown • Wash hands • Gloves

17. In • Wash hands • Mask • Goggles • Cap • Gown • Wash hands • Gloves

18. In • Wash hands • Mask • Goggles • Cap • Gown • Wash hands • Gloves

19. In • Wash hands • Mask • Goggles • Cap • Gown • Wash hands • Gloves

20. Ready • Wash hands • Mask • Goggles • Cap • Gown • Wash hands • Gloves

21. Inside • Change gloves between patients • Change gloves before using phone, computers, writing notes etc • Wash your hands whenever you change your gloves • Do not touch your face or eyes

22. Out • Cap • Gown • Remove gloves • Wash hands • Goggles • Mask • Wash hands • Outside mask • Wash hands

23. Out • Cap • Gown • Remove gloves • Wash hands • Goggles • Mask • Wash hands • Outside mask • Wash hands

24. Out • Cap • Gown • Remove gloves • Wash hands • Goggles • Mask • Wash hands • Outside mask • Wash hands

25. Out • Cap • Gown • Remove gloves • Wash hands • Goggles • Mask • Wash hands • Outside mask • Wash hands

26. Out • Cap • Gown • Remove gloves • Wash hands • Goggles • Mask • Wash hands • Outside mask • Wash hands

27. Out • Cap • Gown • Remove gloves • Wash hands • Goggles • Mask • Wash hands • Outside mask • Wash hands

28. Out • Cap • Gown • Remove gloves • Wash hands • Goggles • Mask • Wash hands • Outside mask • Wash hands

29. Out • Cap • Gown • Remove gloves • Wash hands • Goggles • Mask • Wash hands • Outside mask • Wash hands

30. Out • Cap • Gown • Remove gloves • Wash hands • Goggles • Mask • Wash hands • Outside mask • Wash hands

31. Eating and drinking • Always wash your hands first • Use your own utensils • Sit at least 1m apart • Do not talk • Do not cough or sneeze when not wearing a mask

32. Respiratory • No nebulizers or Venturi masks • No non-invasive ventilation • Minimize circuit breaks • HMEF • Bacterial filter • Scavenging

33. Respiratory • No nebulizers or Venturi masks • No non-invasive ventilation • Minimize circuit breaks • HMEF • Bacterial filter • Scavenging

34. Respiratory • No nebulizers or Venturi masks • No non-invasive ventilation • Minimize circuit breaks • HMEF • Bacterial filter • Scavenging

35. Respiratory • No nebulizers or Venturi masks • No non-invasive ventilation • Minimize circuit breaks • HMEF • Bacterial filter • Scavenging

36. Respiratory • No nebulizers or Venturi masks • No non-invasive ventilation • Minimize circuit breaks • HMEF • Bacterial filter • Scavenging

37. Respiratory • No nebulizers or Venturi masks • No non-invasive ventilation • Minimize circuit breaks • HMEF • Bacterial filter • Scavenging

38. Urine • Direct urine flow against the wall of the collecting jug to avoid splashes

39. Urine • Turn on water to flush away urine

40. Urine • Carefully empty the urine onto the side of the sluice to avoid splashes

41. Urine • Clean up any spills immediately with sodium hypochlorite solution

42. Remember • This disease is highly contagious • It is potentially life threatening • Your safety and the safety of your family and patients depends on your strict adherence to infection control measures