Clinical Skills|Complete and A+ Graded
Droplet Transmission
Larger particle size, organism travels and then falls to a surface (ex. sneezing)
Airborne Transmission
Smaller particle size, which enables organisms to travel long distances when suspended. Negative
pressure rooms required (ex. TB, Shingles, Measles)
Contact Precautions Microorganisms
MRSA, Influenza, Varicella/Zoster, RSV (kids, respiratory virus), Giardia (intestinal parasite), Lice,
Scabies
MDRO Precautions Microorganisms
VRE (Vancomycin Resistant Enterococcus), Multi-Drug Resistant Acinetobacter, KPC's (Klebsiella
pneumoniae carbapenemase), ESBLs (Extended spectrum beta lactamase) producers, Other multi-
drug resistant organisms
Contact Enteric Precautions Microorganisms
C diff, Hep A, Rotavirus, Shigella, Norovirus, Salmonella, Campylobacter
Special considerations for C Diff
Must use soap and water. Hand sanitizer does not work
Droplet Precautions Microorganisms
Influenza (also use contact precautions), Neisseria meningitis (ALL patients with possible meningitis
for the first 24 hours), Pertussis (Whopping cough), Mumps, Rubella, Group A strep
Airbone Infection Isolation/AFB Precautions Microorganisms
TB, Measles, Varicella, Zoster, Smallpox, Avian Flu
PPE for Contact, Contact enteric, MDRO
Gown and gloves
PPE for C Diff
Handwashing
PPE for Droplet
Facemask
PPE for Airborne
N95 respirator
Sebaceous Glands
Secrete protective fatty substance (sebum) waterproof the skin and hair
, Eccrine Glands
Regulate temperature. Major sweat glands. highest density in palms, soles, head.
Apocrine Glands
In the axillae and inguinal areas, stimulated by stress. Bacterial decomposition results in body odor.
Armpit and groin area
Hidradenitis suppurativa
Disease of the apocrine glands. Armpit and groin
Physical Exam of Skin
Inspect and Palpate
Excoriations
Scratches
Ecchymosis
Bruising
Macule
Flat, small spot with color change, up to 1 cm
freckle, cafe au lait
Patch
Flat, larger than macule, larger than 1 cm
Vitiligo
Papule
Elevated lesion, up to 1 cm in diameter
Plaque
Elevated lesion, +1 cm
Psoriasis
Nodule
+.5 cm, firmer and deeper than papule
Rheumatoid nodule
Wheal
Irregular, transient, localized edema
hive, TB test
Vesicle
Droplet Transmission
Larger particle size, organism travels and then falls to a surface (ex. sneezing)
Airborne Transmission
Smaller particle size, which enables organisms to travel long distances when suspended. Negative
pressure rooms required (ex. TB, Shingles, Measles)
Contact Precautions Microorganisms
MRSA, Influenza, Varicella/Zoster, RSV (kids, respiratory virus), Giardia (intestinal parasite), Lice,
Scabies
MDRO Precautions Microorganisms
VRE (Vancomycin Resistant Enterococcus), Multi-Drug Resistant Acinetobacter, KPC's (Klebsiella
pneumoniae carbapenemase), ESBLs (Extended spectrum beta lactamase) producers, Other multi-
drug resistant organisms
Contact Enteric Precautions Microorganisms
C diff, Hep A, Rotavirus, Shigella, Norovirus, Salmonella, Campylobacter
Special considerations for C Diff
Must use soap and water. Hand sanitizer does not work
Droplet Precautions Microorganisms
Influenza (also use contact precautions), Neisseria meningitis (ALL patients with possible meningitis
for the first 24 hours), Pertussis (Whopping cough), Mumps, Rubella, Group A strep
Airbone Infection Isolation/AFB Precautions Microorganisms
TB, Measles, Varicella, Zoster, Smallpox, Avian Flu
PPE for Contact, Contact enteric, MDRO
Gown and gloves
PPE for C Diff
Handwashing
PPE for Droplet
Facemask
PPE for Airborne
N95 respirator
Sebaceous Glands
Secrete protective fatty substance (sebum) waterproof the skin and hair
, Eccrine Glands
Regulate temperature. Major sweat glands. highest density in palms, soles, head.
Apocrine Glands
In the axillae and inguinal areas, stimulated by stress. Bacterial decomposition results in body odor.
Armpit and groin area
Hidradenitis suppurativa
Disease of the apocrine glands. Armpit and groin
Physical Exam of Skin
Inspect and Palpate
Excoriations
Scratches
Ecchymosis
Bruising
Macule
Flat, small spot with color change, up to 1 cm
freckle, cafe au lait
Patch
Flat, larger than macule, larger than 1 cm
Vitiligo
Papule
Elevated lesion, up to 1 cm in diameter
Plaque
Elevated lesion, +1 cm
Psoriasis
Nodule
+.5 cm, firmer and deeper than papule
Rheumatoid nodule
Wheal
Irregular, transient, localized edema
hive, TB test
Vesicle
