Hospitals should consider initiating a "universal respiratory etiquette" to decrease transmission of severe acute respiratory syndrome (SARS) and more-common respiratory ailments such as the flu, the Centers for Disease Control and Prevention said in a draft SARS preparedness plan. The agency's recommendations include installing plexiglass barriers at triage or registration stations to protect healthcare workers from respiratory droplets and segregating patients with respiratory symptoms by at least three feet in waiting areas. In a SARS outbreak in Toronto last year, 77% of patients in the outbreak's first phase were infected in the hospital; half of all SARS cases in Toronto were healthcare workers.
The CDC is directing all U.S. hospitals to equip for a limited number of SARS patients as part of routine operations and a large number of patients in the case of an outbreak. Hospitals should develop a written preparedness and response plan that includes procedures for surveillance and triage, patient placement, exposure reporting and staffing needs. Currently, many patient management decisions must be made before SARS is officially diagnosed, because no specific clinical or laboratory finding can reliably distinguish SARS from other respiratory illnesses early on, the CDC said. Read the CDC draft plan. -- by Julie Piotrowski