Droplet Precautions

A surgical mask stops influenza droplets — but tuberculosis floats right through. The droplet-versus-airborne distinction changes everything in isolation precautions.

Droplet precautions protect against pathogens transmitted via large respiratory droplets (≥5 micrometers) generated when a patient coughs, sneezes, talks, or undergoes suctioning. These droplets are heavy — they travel up to 3 feet (some guidelines extend to 6 feet) and then fall, so they do NOT remain suspended in air. This is the critical distinction from airborne transmission. The required PPE is a standard surgical/procedure mask worn within 3–6 feet of the patient; add eye protection/face shield when splashes or sprays are anticipated. An N95 respirator is NOT needed. The patient goes into a private room, but negative-pressure airflow is NOT required. If a private room is unavailable, cohorting with another patient who has the same organism is acceptable, with a curtain drawn between beds. Key droplet-transmitted organisms include influenza, pertussis (whooping cough), diphtheria, mumps, rubella, meningococcal meningitis, and group A streptococcal pharyngitis. During transport, the PATIENT wears a surgical mask; the nurse applies a mask when within 3–6 feet of the patient per standard droplet protocol. You apply your mask before entering the room and remove it after exiting. Droplet precautions for meningococcal meningitis may be discontinued after 24 hours of effective antibiotic therapy.

Key Distinctions

Don't confuse droplet with airborne: droplet pathogens fall within 3–6 feet and need only a surgical mask; airborne particles (<5 micrometers) stay suspended and require an N95 plus negative-pressure room. Students frequently misclassify tuberculosis, measles, and varicella as droplet — all three are airborne. Another common error: placing a patient on droplet precautions in a negative-pressure room wastes a critical resource that airborne patients need.

Clinical Pearl

Think "drops fall" — large, heavy droplets obey gravity. If the particle floats, it's airborne and needs an N95. If it falls, a surgical mask is enough.