下列哪些疾病或狀況需要實施「空氣傳染防護措施」(Airborne Precautions)?(選所有適合的)
Which of the following conditions require the implementation of Airborne Precautions? (Select all that apply.)
- AActive pulmonary tuberculosis✓ 正解活動性肺結核
- BDisseminated herpes zoster (shingles)✓ 正解播散性帶狀疱疹(皮帶瘡)
- CRubeola (measles)✓ 正解麻疹
- DVaricella (chickenpox)✓ 正解水痘
- EMycoplasma pneumoniae黴漿菌肺炎
空氣傳染防護適用於可經由微小飛沫核(<5μm)在空氣中長期漂浮並遠距離傳播的疾病。經典四大金剛為:結核病(TB)、麻疹(Rubeola)、水痘(Varicella)以及瀰漫性帶狀疱疹(Disseminated Shingles)。這些病人在院內必須安置於負壓隔離病房(AIIR),人員進入需配戴 N95。臨床思路應區分空氣傳染與飛沫傳染的顆粒大小差異。選項 E(黴漿菌肺炎)屬於較大的飛沫傳染(Droplet),僅需距離 3 呎以上並戴一般外科口罩即可。瀰漫性皰疹(B)與水痘(D)同時需要空氣加接觸傳染防護,這也是 SATA 考題中的常見陷阱。
Airborne Precautions apply to diseases transmitted via small droplet nuclei (<5 microns) that can remain suspended in the air for long periods and travel over distances. The classic four are: tuberculosis (TB), measles (Rubeola), varicella (chickenpox), and disseminated shingles. These patients must be placed in an Airborne Infection Isolation Room (AIIR) with negative pressure, and staff must wear an N95 respirator. The clinical reasoning hinges on distinguishing particle size between airborne and droplet routes. Option E (Mycoplasma pneumoniae) is droplet-transmitted via larger particles and only requires maintaining a 3-foot distance and a surgical mask. Disseminated shingles (B) and varicella (D) require both Airborne and Contact Precautions, a common pitfall in SATA-type questions.
美國 NCLEX 考試中,Varicella 與 Disseminated Shingles 必考空氣傳染;台灣臨床上對於水痘的隔離規定一致,但在負壓病房資源不足時,有時會先安置於單人房並關閉空調循環作為替代措施。