2020 CDC COVID-19 Guidelines Knowledge Check

Management Guidelines for Coronavirus SARS CoV-2 Pandemic

What do the Centers of Disease Control and Prevention (CDC) state about disinfecting a hospital room that was occupied by a patient with COVID-19 infection?

The 2020 CDC Guidelines contain new information for healthcare professionals about the COVID-19 (SARS CoV-2) pandemic. This guideline knowledge check provides up-to-date comprehensive recommendations for the management and treatment of persons suffering COVID-19 and the PPE and disinfecting guidelines for healthcare centers and professionals in the front line of the war against this pandemic.

Note: New COVID-19 content has been added to the Resuscitation, Critical Care, and/or Infectious Disease chapters of all Med-Challenger board review and CME courses for all major specialties for physician, nurses and PAs.

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Today’s Guideline Knowledge Check question comes from the desk of Med-Challenger Emergency Medicine Editor-in-Chief, Andrea Eberly, MD, FAAEM.

Try this COVID-19 presentation case and find out if you’re following the 2020 CDC COVID-19 guidelines for management of coronavirus SARS CoV-2.

A critically ill patient with a known positive COVID-19 test arrives in respiratory failure and is intubated in the emergency department after a failed attempt at high flow oxygenation. There are no critical care beds open in the hospital, so the patient remains in a resuscitation room with closed doors for 4 hours.

After he is admitted, what type of cleaning and disinfection does the CDC recommend for a room occupied by a patient with COVID-19 infection?

Answer Options:

The CDC recommends special airborne cleaning and disinfection procedures for COVID-19 virus.

The CDC recommends double cleaning and disinfection of surfaces and a HEPA-filter air-exchange procedure for COVID-19 virus.

The CDC recommends cleaning and disinfection procedures between patients only if the infectious patient occupied the room for more than 6 hours.

The CDC recommends routine cleaning and disinfection procedures for COVID-19 virus.

See the Answer:

The correct answer is:

The CDC recommends routine cleaning and disinfection procedures for COVID-19 virus.

Key Point:

The CDC recommends routine cleaning and disinfection procedures after a patient with COVID-19 virus infection has occupied a health care room and prior to another patient occupying the same room. Products approved by the Environmental Protection Agency (EPA) for emerging viral pathogens should be used; see List N: Disinfectants for Use Against SARS-CoV-2

Explanation:

A study from Singapore documented viral RNA on nearly all surfaces tested (handles, light switches, bed and handrails, interior doors and windows, toilet bowl, sink basin) in the isolation room of a patient with symptomatic mild COVID-19 prior to routine cleaning. Viral RNA was not detected on similar surfaces in the rooms of two other symptomatic patients after routine cleaning (with sodium dichloroisocyanurate).

Viral RNA detection does not necessarily indicate the presence of infectious virus. Nonetheless, disinfection between patients is critically important for containing the COVID-19 pandemic.

Various disinfectants (including ethanol at concentrations between 62 and 71 percent) have been shown to inactivate a number of coronaviruses related to SARS-CoV-2 within one minute.

References:

McIntosh, K. Coronavirus disease 2019 (COVID-19). UpToDate. Coronavirus disease 2019 (COVID-19) (Accessed March 27, 2020)

Centers for Disease Control and Prevention. Interim Infection Prevention and Control Recommendations for Patients with Confirmed 2019 Novel Coronavirus (2019-nCoV) or Patients Under Investigation for 2019-nCoV in Healthcare Settings. February 3, 2020.

https://www.cdc.gov/coronavirus/2019-nCoV/hcp/infection-control.html (Accessed March 27, 2020).

Ong SWX, Tan YK, et al. Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient. JAMA 2020 Mar 4. doi: 10.1001/jama.2020.3227. [Epub ahead of print]

Van Doremalen N et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020 Mar 17; [e-pub].

covid-19 coronavirus SARS-cov-2 guideline update and COVID-19 guidelines review

About Guideline Knowledge Checks:

With each update of national clinical practice guidelines, some recommendations change and many remain unchanged. Med-Challenger Guideline Knowledge Checks help you know both what is new and what has stayed the same in the most recent guidelines pertinent to each medical specialty.

About the Author:

Andrea Eberly, MD, FAAEM graduated from the David Geffen Medical School of Los Angeles (UCLA) and completed her residency in Emergency Medicine at the University Medical Center, Tucson, Arizona. After working as an attending physician in Tucson, she followed a recruiting call to the island of Guam, where she served in various roles, including as the director of the emergency department, the EMS Medical Director of Guam, and the Director of the 911 Call System. She has maintained her emergency medicine board certification through three cycles of American Board of Emergency Medicine Board Exams (last in 2014), all three with the help of Med-Challenger.

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