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SARS, protecting nurses and the community
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Dear Ask an RN;

What is SARS and how can we all protect ourselves from it?

Ask an RN responds;

SARS (Severe Acute Respitory Syndrome) is a severe form of pneumonia, accompanied by a fever. It’s of serious concern to health professionals right now because they do not know what germ causes the infection. Although health officials are saying that unless you have recently traveled from Hong Kong, the possibility of contracting SARS is very low, precautions are necessary to stop the possible spread of the disease.

RNAO understands that those in isolation and quarantine are making a sacrifice but we urge people to respect their civic responsibility to protect themselves and their community.

Protecting against SARS

Nurses: Nurses are urged to phone Telehealth (1-866-797-0000) for questions about SARS. For peer support, contact RNAO executive director Doris Grinspun at 1-800-268-7199 ext. 206 or e-mail her at dgrinspun@rnao.org

Health Canada has issued the following guidelines in protecting yourself:

1. Wash Your Hands

  • Do so before contact with a patient; after any direct contact with a patient and before contact with the next patient; after contact with body fluids, secretions and excretions; and after contact with items known or considered likely to be contaminated with respiratory secretions.

  • Plain soap may be used for routine handwashing.

  • Waterless antiseptic hand rinses should be available as an alternative to handwashing. However, when there is visible soiling, hands should be washed with soap and water before using a waterless antiseptic handrinse. If soap and water are unavailable, clean hands first with towelettes containing detergents.

2. Wear Gloves

  • Gloves should be used as an additional measure, not as a substitute, for handwashing.

  • Clean non-sterile gloves should be worn for all patient contact.

  • Gloves should be put on directly before contact with the patient or just before the task.

  • Gloves should be removed and hands washed prior to leaving the patient’s room.

  • Gloves should not be reused or washed.

3. Wear Masks, Eye Protection and Face Shields

  • N 95 masks (preferable) or surgical masks are recommended during all patient contact.

  • Eye protection or face shields are also recommended where there is a potential for the splattering or spraying of blood or other body substances.

  • Masks should be changed according to manufacturer’s recommendations.

4. Wear Gowns

  • Long-sleeved gowns should be worn by all health care workers if direct contact with the patient or his/her immediate environment is anticipated.

  • Gowns must be removed before leaving the patient’s room.

5. Make Patient Accommodation
The following three preferences for patient accommodation are ranked in descending order of priority:

  • Rooms with negative pressure in relation to surrounding areas with a minimum of six to nine exchanges per hour. The air should be discharged outside of the building and away from intake ducts, or through a high efficiency filter if recirculated.

  • Single patient rooms with toilet, handwashing and bathing facilities in the room.

  • Cohort placement in an area with an independent air supply and exhaust system

  • The patient’s door must be kept closed whether or not the patient is in the room.

Members of the Public:
The disease spreads from person to person. It often begins with a high fever, headache and sore throat. Other possible symptoms include loss of appetite, confusion, rash and diarrhea. Not everyone has reacted the same way.

The World Health Organization said doctors are on the lookout for those symptoms with:

  • A fever over 38º C AND

  • Cough, shortness of breath, difficulty breathing AND

  • Close contact with someone diagnosed with SARS or a history of travel to affected areas, including Toronto, Vancouver, Guangdong province in China, Hong Kong, Singapore and Hanoi, Vietnam.

The respiratory symptoms appear two to seven days after exposure. If you experience symptoms within this time period, isolate yourself and call Toronto Public Health immediately for assessment.

Who should be quarantined?
The following people should be quarantined:

  • Anyone who visited the Scarborough Hospital - Grace Division on or after March 16, and did not wear a protective mask. March 16 is the first day that health care workers who may have been ill with SARS worked in the hospital, potentially exposing patients and visitors to the illness.

  • Individuals who have come into close contact with a person with SARS and did not wear a protective mask. Close contact means having cared for, lived with, or having had direct contact with respiratory secretions and body fluids of a person with SARS.

These individuals should stay at home for 10 days in a row even if they are experiencing no symptoms. Staying at home and limiting your exposure to others is the best way to control the spread of SARS to family, friends, and co-workers.

Below are some resources about SARS and how you can protect yourself and your family:

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