Antipyretics for children are prescribed by a pediatrician. But there are emergency situations for fever when the child needs to be given medicine immediately. Then the parents take responsibility and use antipyretic drugs. What is allowed to be given to infants? How can you lower the temperature in older children? What medications are the safest?
In order to reduce the risk of infection of medical personnel working in laboratories, hospitals, isolation wards, in the field with microorganisms of I-II pathogenicity groups and patients suffering from diseases caused by them, they use protective clothing - the so-called. anti-plague suits, insulating suits such as KZM-1, etc.
There are 4 main types of anti-plague suits, each of which is used depending on the nature of the work performed.
First type suit(full suit) includes pajamas or overalls, a long “anti-plague” robe, a hood or a large scarf, a cotton-gauze bandage or an anti-dust respirator or a filter gas mask, canned glasses or disposable cellophane film, rubber gloves, socks, slippers, rubber or tarpaulin boots (shoe covers), oilcloth or polyethylene apron, oilcloth sleeves, towel.
This suit is used when working with material suspected of being contaminated with a plague pathogen, as well as when working in an outbreak where patients with this infection have been identified; when evacuating to a hospital those suspected of having pneumonic plague, carrying out ongoing or final disinfection in plague foci, conducting observation of persons who have been in contact with a patient with pneumonic plague; when autopsying the corpse of a person or animal that died from the plague, as well as from the Crimean-Congo, Lassa, Marburg, and Ebola hemorrhagic fevers; when working with experimentally infected animals and a virulent culture of the plague microbe, pathogens of glanders, melioidosis, and deep mycoses; carrying out work in foci of pulmonary anthrax and glanders, as well as diseases caused by viruses classified as pathogenicity group 1.
The duration of continuous work in a type 1 anti-plague suit is no more than 3 hours, in the hot season - 2 hours.
The modern equivalent of the first type of anti-plague suit is an insulating suit (“spacesuit”), consisting of a sealed synthetic overalls, a helmet and an insulating gas mask or a set of replaceable back oxygen cylinders and a reducer that regulates the pressure of the gas supplied to the suit. Such a suit can, if necessary, be equipped with a thermoregulation system, which allows a specialist to work for a long time at uncomfortable temperatures. environment. Before removing the suit, it can be completely treated with a chemical disinfectant in the form of a liquid or aerosol.
Type 2 suit(lightweight anti-plague suit) consists of overalls or pajamas, anti-plague robe, cap or large headscarf, cotton-gauze bandage or respirator, boots, rubber gloves and towels. Used for disinfection and disinsection in the outbreak of bubonic plague, glanders, anthrax, cholera, coxiellosis; when evacuating a patient with secondary plague pneumonia, bubonic, cutaneous or septic forms of plague to a hospital; when working in the laboratory with viruses classified as pathogenicity group I; working with experimental animals infected with pathogens of cholera, tularemia, brucellosis, anthrax; autopsy and burial of the corpses of people who died from anthrax, melioidosis, glanders (in this case, they additionally wear an oilcloth or plastic apron, the same sleeves and a second pair of gloves).
Type 3 suit(pajamas, anti-plague robe, cap or large scarf, rubber gloves, deep galoshes) are used when working in a hospital where there are patients with bubonic, septic or cutaneous forms of plague; in outbreaks and laboratories when working with microorganisms classified as pathogenicity group II. When working with the yeast phase of pathogens of deep mycoses, the suit is supplemented with a mask or respirator.
Type 4 suit(pajamas, anti-plague robe, cap or small scarf, socks, slippers or any other light shoes) are used when working in an isolation ward where there are persons who have interacted with patients with bubonic, septic or cutaneous forms of plague, as well as in the territory where such a patient has been identified , and in areas threatened by plague; in foci of Crimean-Congo hemorrhagic fever and cholera; in clean departments of virological, rickettsial and mycological laboratories.
The anti-plague suit is put on in the following order:
1) work clothes; 2) shoes; 3) hood (kerchief); 4) anti-plague robe; 5) apron; 6) respirator (cotton-gauze mask); 7) glasses (cellophane film); 8) sleeves; 9) gloves; 10) towel (put in the belt of the apron on the right side).
Remove the suit in reverse order, immersing gloved hands in the disinfectant solution after removing each component. First, remove the glasses, then the respirator, robe, boots, hood (scarf), overalls, and lastly, rubber gloves. Shoes, gloves, and apron are wiped with cotton swabs, generously moistened with a disinfectant solution (1% chloramine, 3% Lysol). Clothes are folded with the outer (“infected”) surfaces turned inward.
Responsibilities of medical workers when identifying a patient with AIO (or suspected AIO)
Responsibilities of a resident physician at a medical institution:
1) isolate the patient inside the ward and notify the head of the department. If you suspect plague, require an anti-plague suit and the necessary preparations for treating the skin and mucous membranes, a set for collecting material for bacteriological research and disinfectants. The doctor does not leave the room and does not allow anyone into the room. The doctor performs treatment of mucous membranes and putting on a suit in the ward. To treat mucous membranes, use a solution of streptomycin (250 thousand units in 1 ml), and 70% ethyl alcohol to treat hands and face. To treat the nasal mucosa, you can also use a 1% solution of protargol, for instillation into the eyes - a 1% solution of silver nitrate, for rinsing the mouth - 70% ethyl alcohol;
2) provide care for patients with acute infectious diseases in compliance with the anti-epidemic regime;
3) collect material for bacteriological research;
4) begin specific treatment of the patient;
5) transfer persons who had contact with the patient to another room (transferred by personnel dressed in a type 1 anti-plague suit);
6) before moving to another room, contact persons undergo partial sanitization with disinfection of the eyes, nasopharynx, hands and face. Complete sanitary treatment is carried out depending on the epidemic situation and is appointed by the head of the department;
7) carry out ongoing disinfection of the patient’s secretions (sputum, urine, feces) with dry bleach at the rate of 400 g per 1 liter of secretions with an exposure of 3 hours or pour a double (by volume) amount of 10% Lysol solution with the same exposure;
8) organize protection of the premises where the patient is located from flies, close windows and doors and destroy flies with a firecracker;
9) after the final diagnosis has been established by a consultant - an infectious disease specialist, accompany the patient to the infectious diseases hospital;
10) when evacuating a patient, provide anti-epidemic measures to prevent the spread of infection;
11) after delivering the patient to the infectious diseases hospital, undergo sanitary treatment and go into quarantine for preventive treatment.
All further measures (anti-epidemic and disinfection) are organized by an epidemiologist.
Responsibilities of the head of the hospital department:
1) clarify clinical and epidemiological data about the patient and report to the chief physician of the hospital. Request anti-plague clothing, equipment for collecting material for bacteriological examination from the patient, disinfectants;
4) organize the identification of persons who were in contact with the patient or who were in the department at the time of detection of acute respiratory infections, including those transferred to other departments and discharged due to recovery, as well as medical and service personnel of the department, and hospital visitors. Lists of persons who were in direct contact with patients must be reported to the head doctor of the hospital in order to take measures to search for them, call them and isolate them.;
5) vacate one ward of the department for an isolation ward for contact persons;
6) after the arrival of ambulance transport, evacuation and disinfection teams, ensure control over the evacuation from the department of the patient, persons who interacted with the patient, and the final disinfection.
Responsibilities of the doctor on duty at the admission department:
1) by telephone, inform the chief physician of the hospital about the identification of a patient suspected of having AIO;
2) stop further admission of patients, prohibit entry and exit from the emergency department (including service personnel);
3) request stowage with protective clothing, stowage to take material for laboratory research, medicines for treating the patient;
4) change into protective clothing, collect material for laboratory testing from the patient and begin his treatment;
5) identify persons who were in contact with a patient with acute infectious diseases in the emergency department and compile lists according to the form;
6) after the arrival of the evacuation team, organize final disinfection in the reception department;
7) accompany the patient to the infectious diseases hospital, undergo sanitary treatment there and go into quarantine.
Responsibilities of the hospital chief physician:
1) set up a special post at the entrance to the building where a patient with acute respiratory infection has been identified, prohibit entry into and exit from the building;
2) stop access of unauthorized persons to the hospital territory;
3) check with the head of the department for clinical and epidemiological data about the patient. Report to the chief physician of the district (city) Center for Hygiene and Epidemiology about the identification of a patient suspected of having an acute infectious disease, and ask to refer an infectious disease specialist and (if necessary) an epidemiologist for consultation;
4) send to the department where the patient is identified (at the request of the head of the department) sets of protective anti-plague clothing, equipment for taking material from the patient for bacteriological examination, disinfectants for ongoing disinfection (if they are not available in the department), as well as medications necessary for treating the patient;
5) upon the arrival of an infectious disease specialist and an epidemiologist, carry out further measures according to their instructions;
6) ensure the implementation of measures to establish a quarantine regime in the hospital (under the methodological guidance of an epidemiologist).
Responsibilities of a local clinic physician conducting outpatient visits:
1) immediately stop further admission of patients, close the doors of your office;
2) without leaving the office, by phone or through visitors waiting for an appointment, call one of the medical workers of the clinic and inform the chief physician of the clinic and the head of the department about the identification of a patient suspected of having an acute infectious disease, demand an infectious disease consultant and the necessary protective clothing, disinfectants, medications , installation for taking material for bacteriological examination;
3) change into protective clothing;
4) organize protection of the office from flies, immediately destroy flying flies with a firecracker;
5) compile a list of persons who were in contact with the patient with acute infectious diseases at the reception (including while waiting for the patient in the corridor of the department);
6) carry out ongoing disinfection of the patient’s secretions and water after washing dishes, hands, care items, etc.;
7) on the instructions of the chief physician of the clinic, upon arrival of the evacuation team, accompany the patient to the infectious diseases hospital, then undergo sanitary treatment and go to quarantine.
Responsibilities of a local clinic physician visiting patients at home:
1) by hand or by telephone, inform the chief physician of the clinic about the identification of a patient suspected of having an acute respiratory infection, and take measures to protect yourself (put on a gauze mask or respirator);
2) prohibit the entry and exit of unauthorized persons from the apartment, as well as the communication of the patient with those living in the apartment, except for one caregiver. The latter must be provided with a gauze mask. Isolate the patient's family members in the free areas of the apartment;
3) before the arrival of the disinfection team, prohibit the removal of things from the room and apartment where the patient was;
4) allocate individual dishes and patient care items;
5) compile a list of persons who were in contact with the sick person;
6) prohibit (prior to current disinfection) pouring the patient’s secretions and water into sewers or cesspools after washing hands, dishes, household items, etc.;
7) follow the instructions of the consultants (epidemiologist and infectious disease doctor) who arrived at the outbreak;
8) on the instructions of the chief physician of the clinic, upon arrival of the evacuation team, accompany the patient to the infectious diseases hospital, then undergo sanitary treatment and go to quarantine.
Responsibilities of the chief physician of the clinic:
1) clarify the clinical and epidemiological data about the patient and report to the district administration and the chief physician of the regional Center for Hygiene and Epidemiology about the identification of a patient suspected of OI. Call an infectious disease specialist and an epidemiologist for consultation;
2) give instructions:
– close the entrance doors of the clinic and post a post at the entrance. Prohibit entry and exit from the clinic;
– stop all movement from floor to floor. Place special posts on each floor;
– place a post at the entrance to the office where the identified patient is located;
3) send to the office where the identified patient is located, protective clothing for the doctor, equipment for taking material for laboratory testing, disinfectants, medications necessary for treating the patient;
4) before the arrival of the epidemiologist and infectious disease specialist, identify persons who had contact with the patient from among the visitors to the clinic, including those who left it by the time the patient was identified with acute respiratory infections, as well as medical and service personnel of the outpatient clinic. Compile lists of contact persons;
5) upon the arrival of the infectious disease specialist and epidemiologist, carry out further activities in the clinic according to their instructions;
6) after the arrival of the ambulance transport and disinfection team, ensure control over the evacuation of the patient, persons who were in contact with the patient (separately from the patient), as well as the final disinfection of the clinic premises.
When the chief physician of the clinic receives a signal from the local therapist about identifying a patient with acute respiratory infections at home:
1) clarify clinical and epidemiological data about the patient;
2) report to the chief physician of the regional Center for Hygiene and Epidemiology about the identification of a patient suspected of having AIO;
3) take an order to hospitalize the patient;
4) call consultants to the outbreak - an infectious disease specialist and an epidemiologist, a disinfection team, and ambulance transport for hospitalization of the patient;
5) send protective clothing, disinfectants, medicines, and equipment to the outbreak to collect diseased material for bacteriological examination.
Responsibilities of a line ambulance doctor:
1) upon receipt of an order for the hospitalization of a patient suspected of having an acute respiratory infection, clarify the expected diagnosis by telephone;
2) when visiting a patient, put on a type protective clothing, corresponding to the expected diagnosis;
3) a specialized ambulance evacuation team must consist of a doctor and 2 paramedics;
4) evacuation of the patient is carried out accompanied by the doctor who identified the patient;
5) when transporting a patient, measures are taken to protect the vehicle from contamination by his secretions;
7) after delivering the patient to the infectious diseases hospital, the ambulance and patient care items are subject to final disinfection on the territory of the infectious diseases hospital;
6) the departure of an ambulance and a tow truck team from the hospital territory is carried out with the permission of the chief physician of the infectious diseases hospital;
7) members of the evacuation team are subject to medical supervision with mandatory temperature measurement for the entire period of incubation of the suspected disease at the place of residence or work;
9) the doctor on duty at the infectious diseases hospital is given the right, in case of detection of defects in the protective clothing of the medical personnel of the ambulance, to leave them in the hospital for quarantine for observation and preventive treatment.
Responsibilities of the epidemiologist of the Center for Hygiene and Epidemiology:
1) receive from the doctor who discovered the patient with AIO all materials regarding the diagnosis and measures taken, as well as lists of contact persons;
2) conduct an epidemiological investigation of the case and take measures to prevent further spread of the infection;
3) manage the evacuation of the patient to the infectious diseases hospital, and contact persons to the observation department (isolator) of the same hospital;
4) collect material for laboratory diagnostics (samples of drinking water, food products, samples of patient secretions) and send the collected material for bacteriological examination;
5) outline a plan for disinfection, disinfestation and (if necessary) deratization in the outbreak and supervise the work of disinfectors;
6) check and supplement the list of persons who have been in contact with the patient with ASI, indicating their addresses;
7) give instructions to prohibit or (as appropriate) permit the use of enterprises Catering, wells, latrines, sewage receivers and other communal facilities after their disinfection;
8) identify contact persons subject to vaccination and phage in the outbreak of OOI, and carry out these activities;
9) to establish epidemiological surveillance of the outbreak where a case of AIO was detected, if necessary, to prepare a proposal for imposing quarantine;
10) draw up a conclusion on the case of the disease, give its epidemiological characteristics and list the measures necessary to prevent further spread of the disease;
11) transfer all the collected material to the head of the local health authority;
12) when working in the outbreak, carry out all activities in compliance with personal protection measures (appropriate special clothing, hand washing, etc.);
13) when organizing and carrying out primary anti-epidemic measures in the outbreak of OOI - be guided by the comprehensive plan for carrying out these activities approved by the head of the regional administration.
A medical worker who has identified a patient with plague, cholera, GVL or monkeypox must change into the protective clothing transferred to him (anti-plague suit of the appropriate type), without taking off his own (except for heavily contaminated with the patient's secretions).
* Before putting on an anti-plague suit, all exposed parts of the body are treated with a disinfectant solution (0.5-1% chloramine solution) or 70 ° alcohol.
* The mucous membranes of the eyes, nose, mouth are treated with a solution of antibiotics: for plague - with streptomycin solution, for cholera - tetracycline.
* Upon contact with patients with GVL or monkeypox, the mucous membranes of the mouth and nose are treated with a weak solution (0.05%) of potassium permanganate, the eyes are washed with a 1% solution of boric acid. The mouth and throat are additionally rinsed with 70 ° alcohol or a 0.05% solution of potassium permanganate.
Primary anti-epidemic measures upon detection of a patient (corpse) suspected of being infected with plague, cholera, contagious viral hemorrhagic fevers, monkeypox.
At an appointment at a clinic (first aid station). Actions of a medical worker who identifies a patient:
1. Measures are taken to isolate the patient at the place of detection (the door to the office is closed, a post is set up on the outside upon receipt of the signal) until he is hospitalized in a specialized medical institution.
2. A medical worker, without leaving the room where the patient is identified:
A. by phone or through a courier (without opening the door), who was not in contact with the patient, notifies the head of the clinic (chief physician) of the identified patient and his condition,
B. asks for appropriate medicines, packing of protective clothing, means of personal prevention.
3. It is forbidden to take things out of the office, transfer outpatient cards to the reception until the final disinfection.
4. In the office where the patient is identified, close the doors and windows, turn off the ventilation. Ventilation holes are sealed with adhesive tape (except for cholera).
5. Before receiving protective clothing, a medical worker in case of suspicion of: plague, GVL (hemorrhagic viral fevers), monkeypox should temporarily close his nose and mouth with a towel or mask made from improvised materials (cotton wool, gauze, bandage). Before putting on protective clothing, open parts of the body are treated with a 0.5-1% solution of chloramine or 70-degree alcohol, and mucous membranes with a solution of streptomycin (for plague) or a weak solution of potassium permanganate (for GVL, monkeypox). When identifying a patient with suspected cholera, strictly observe the measures of personal prevention of gastrointestinal infections.
In case of cholera, it is forbidden to use washbasins (separate containers are allocated for these purposes).
6. Protective clothing (anti-plague suit of the appropriate type) is put on without taking off one's own dressing gown (except for clothing heavily contaminated with the patient's secretions).
7. When identifying a plague patient, GVL. monkeypox, the medical worker does not leave the office (if a patient with cholera is detected, the doctor or sister, if necessary, can leave the office after washing their hands and removing the medical gown) and remains with him until the arrival of the evacuation team. epidemiological teams.
8. When a patient with suspicions of cholera is identified and a laying is received, material is taken for bacteriological studies. Excretions (vomit, feces) are collected in separate containers.
9. In the office where the patient is identified, ongoing disinfection is carried out.
BACTERIOLOGICAL STUDIES OF PATHOLOGICAL MATERIAL FOR CHOLERA.
General organizational issues. When a patient suspected of being infected with plague, cholera, contagious hemorrhagic viral fevers (Ebola, Lassa and cercopithecine fevers) and monkeypox is identified, all primary anti-epidemic measures are carried out when a preliminary diagnosis is established based on clinical and epidemiological data. When establishing the final diagnosis, measures to localize and eliminate the foci of the above infections are carried out in accordance with the current orders and instructive guidelines for each nosological form.
The principles of organizing anti-epidemic measures are the same for all infections and include:
1) identification of the patient;
2) information about the identified patient;
3) clarification of the diagnosis;
4) isolation of the patient with subsequent hospitalization;
5) treatment of the patient;
6) observational, quarantine and other restrictive measures;
7) identification, isolation, emergency prophylaxis for persons who have been in contact with the patient;
8) provisional hospitalization of patients with suspected plague, cholera, GVL, monkeypox;
9) identification of those who died from unknown causes, postmortem autopsy with the collection of material for laboratory (bacteriological, virological) research, with the exception of those who died from GVL, disinfection, proper transportation and burial of corpses. Autopsy of those who died from GVL, as well as taking material from a corpse for laboratory research, is not performed due to the high risk of infection;
10) disinfection measures;
11) emergency prevention of the population;
12) medical surveillance of the population;
13) sanitary control over the external environment (laboratory study of possible factors for the transmission of cholera, monitoring the number of rodents and their fleas, conducting an epizootological examination, etc.);
14) health education.
All these activities are carried out by local health authorities and institutions together with anti-plague institutions that provide methodological guidance, advisory and practical assistance.
All medical and preventive and sanitary and epidemiological institutions must have the necessary supply of medicines for etiotropic and pathogenetic therapy; stacks for taking material from patients (corpses) for laboratory research; disinfectants and adhesive plaster packages based on gluing windows, doors, ventilation openings in one office (box, ward); means of personal prevention and personal protection(anti-plague suit type I).
The primary alarm about the identification of a patient with plague, cholera, GVL and monkeypox is made to three main authorities: the chief physician of the medical institution, the emergency medical service station and the chief physician of the territorial SES.
The chief doctor of the SES puts into action the plan of anti-epidemic measures, informs the relevant institutions and organizations about the case of the disease, including territorial anti-plague institutions.
When carrying out primary anti-epidemic measures after establishing a preliminary diagnosis, it is necessary to be guided by the following incubation periods: with plague - 6 days, cholera - 5 days, Lassa, Ebola and cercopithecine fevers - 21 days, monkeypox - 14 days.
From a patient with suspicion of cholera, material is taken by a medical worker who identified the patient, and if plague is suspected, by a medical worker of the institution where the patient is located, under the guidance of specialists from the departments of especially dangerous infections of the SES. Material from patients with GVL is taken only at the place of hospitalization by laboratory workers performing these studies. The collected material is urgently sent for analysis to a special laboratory.
When identifying patients with cholera, only those persons who communicated with them during the period clinical manifestations diseases. Medical workers who have been in contact with patients with plague, HVL or monkeypox (if these infections are suspected) are subject to isolation until the final diagnosis is established or for a period equal to the incubation period. Persons who have been in direct contact with a cholera patient, as directed by an epidemiologist, should be isolated or left under medical supervision.
Further activities are carried out by specialists from the departments of especially dangerous infections of the SES, anti-plague institutions in accordance with the current instructions and comprehensive plans.
Knowledge by a doctor of various specializations and qualifications of the main early manifestations of especially dangerous infections, constant awareness and orientation in the epidemic situation in the country, republic, region, district will allow timely diagnosis of these diseases and taking urgent anti-epidemic and therapeutic and preventive measures. Therefore, the health worker should suspect plague, cholera, HVL, or monkeypox based on clinical and epidemiological data.
Primary activities in medical institutions. Anti-epidemic measures in all medical institutions are carried out according to a single scheme in accordance with the operational plan of the institution.
The procedure for notifying the chief physician of a hospital, clinic or a person replacing him is determined specifically for each institution. Information about an identified patient to the territorial SES, higher authorities, calling consultants and evacuation teams is carried out by the head of the institution or a person replacing him.
If a patient suspected of suffering from plague, cholera, GVL or monkeypox is identified, the following primary anti-epidemic measures are carried out in a clinic or hospital:
1) measures are taken to isolate the patient at the place of his identification before hospitalization in a specialized infectious diseases hospital;
2) transportable patients are delivered by ambulance to a hospital special for these patients. For non-transportable patients, medical care is provided on the spot with a call to a consultant and an ambulance equipped with everything necessary;
3) a medical worker, without leaving the premises where the patient is identified, notifies the head of his institution about the identified patient by telephone or by messenger; requests relevant medications, stowage of protective clothing, means of personal prevention;
4) entry into and exit from a medical facility is temporarily prohibited;
5) communication between floors is stopped;
6) posts are set up near the office (ward) where the patient was, entrance doors clinics (departments) and on floors;
8) admission, discharge of patients, and visits by their relatives are temporarily suspended;
9) admission of patients for health reasons is carried out in isolated rooms;
10) in the room where the patient is identified, the windows and doors are closed, the ventilation is turned off and the ventilation holes are sealed with adhesive tape;
11) contact patients are isolated in a separate room or box. If plague, GVL or monkeypox is suspected, contacts in rooms connected through ventilation ducts are taken into account. Lists of identified contact persons are compiled (full name, address, place of work, time, degree and nature of contact);
12) before receiving protective clothing, a medical worker who suspects plague, GVL and monkeypox must temporarily cover his nose and mouth with a towel or mask made from improvised materials (bandage, gauze, cotton wool); if necessary, emergency prophylaxis is carried out for medical staff;
13) after receiving protective clothing (anti-plague suit of the appropriate type), they put it on without taking off their own, except for heavily contaminated with the patient's secretions;
14) seriously ill patients are provided with emergency medical care before the arrival of the medical team;
15) using a special stack for sampling before the arrival of the evacuation team, the health worker who identified the patient takes materials for bacteriological examination;
16) in the office (ward) where the patient is identified, current disinfection is carried out;
17) upon the arrival of a team of consultants or an evacuation team, the health worker who identified the patient follows all the orders of the epidemiologist;
18) if urgent hospitalization of the patient is required for health reasons, then the health worker who identified the patient accompanies him to a specialized hospital and follows the instructions of the doctor on duty of the infectious diseases hospital. After consultation with an epidemiologist, the health worker is sent for sanitation, and in case of pneumonic plague, GVL and monkeypox - to the isolation ward.
Protective clothing, the procedure for using a protective suit. The anti-plague suit protects medical personnel from infection by pathogens of plague, cholera, GVL, monkeypox and other pathogens of pathogenicity groups I-II. It is used when serving a patient in outpatient clinics and hospitals, during transportation (evacuation) of a patient, carrying out current and final disinfection (disinsection, deratization), when taking material from a patient for laboratory testing, during autopsy and burial of a corpse, and door-to-door visits.
Depending on the nature of the work performed, the following types of protective suits are used:
First type - a full protective suit consisting of overalls or pajamas, a hood (large headscarf), anti-plague robe, cotton-gauze mask (dust respirator), goggles, rubber gloves, socks (stockings), rubber or tarpaulin boots and towels. To autopsy a corpse, you must additionally have a second pair of gloves, an oilcloth apron, and oversleeves.
This type of suit is used when working with patients with pneumonic or septic forms of plague, until a final diagnosis is made in patients with bubonic and cutaneous forms of plague and until the first negative result of a bacteriological study is obtained, as well as with GVL.
Second type - a protective suit consisting of overalls or pajamas, an anti-plague robe, a hood (large headscarf), a cotton-gauze mask, rubber gloves, socks (stockings), rubber or tarpaulin boots and a towel. Used in servicing and providing medical care to patients with monkeypox.
Third type- a protective suit consisting of pajamas, an anti-plague robe, a large scarf, rubber gloves, socks, deep galoshes and a towel. It is used when working with patients with bubonic or cutaneous form plague receiving specific treatment.
Fourth type - a protective suit consisting of pajamas, medical gown, cap or gauze scarf, socks, slippers or shoes. Used in the care of patients with cholera. When performing the toilet, the patient wears rubber gloves, and when handling discharge, a mask.
Sets of protective clothing (robe, boots, etc.) must be sized and labeled.
How to put on a suit . An anti-plague suit is put on before entering the outbreak area. Costumes must be put on slowly, in a certain sequence, carefully.
The order of putting on is as follows: overalls, socks, rubber boots, hood or large headscarf, anti-plague robe. When using a phonendoscope, it is worn in front of the headscarf. The ribbon at the collar of the robe, as well as the belt of the robe, are tied in front on the left side with a loop, after which the ribbon is secured to the sleeves.
The respirator is put on the face so that the mouth and nose are covered, for which the upper edge of the mask should be at the level of the lower part of the orbits, and the lower one should go slightly under the chin. The upper straps of the respirator are tied in a loop at the back of the head, and the lower ones - on the crown (like a sling bandage). Having put on a respirator, cotton swabs are placed on the sides of the wings of the nose.
Glasses must fit well and be checked for reliable fastening of the metal frame to the leather part; the glasses must be rubbed with a special pencil or a piece of dry soap to prevent them from fogging. After putting on the glasses, place a cotton swab on the bridge of the nose. Then gloves are put on, previously checked for integrity. A towel is placed in the waistband of the robe on the right side. During a postmortem examination of a corpse, a second pair of gloves, an oilcloth (rubberized) apron, and oversleeves are additionally put on.
Procedure for removing the suit. The anti-plague suit is removed after work in a room specially designated for this purpose or in the same room in which the work was carried out, after it has been completely disinfected. To do this, the room must have:
1) a tank with a disinfectant solution (Lysol, carbolic acid or chloramine) for disinfecting a robe, headscarf, towel;
2) a basin with hand sanitizer;
3) a jar with 70% ethyl alcohol for disinfecting glasses and a phonendoscope;
4) a pan with a disinfectant solution or soapy water to disinfect cotton-gauze masks (in the latter case, by boiling for 40 minutes).
When disinfecting a suit with disinfectants, all parts of it are completely immersed in the solution.
If the disinfection of the suit is carried out by autoclaving or in a disinfection chamber, the suit is folded, respectively, into bins or chamber bags, which are treated from the outside with a disinfectant solution.
The suit is removed slowly and in a strictly established order. After removing part of the suit, gloved hands are immersed in a disinfectant solution. The ribbons of the robe and apron, tied with a loop on the left side, make it easy to remove the suit.
Costumes are removed in the following order:
1) thoroughly wash gloved hands in a disinfectant solution for 1-2 minutes;
2) slowly remove the towel;
3) wipe the oilcloth apron with a cotton swab, generously moistened with a disinfectant solution, remove it, rolling it up from the outside inward;
4) remove the second pair of gloves and sleeves;
5) boots and galoshes are wiped with cotton swabs with a disinfectant solution from top to bottom (a separate swab for each boot);
6) without touching the exposed parts of the skin, remove the phonendoscope;
7) remove the glasses by pulling them forward and upward, backwards with both hands;
8) the cotton-gauze bandage is removed without touching its outer side;
9) untie the ties of the collar, the belt of the robe and, lowering the upper edge of the gloves, release the ties of the sleeves, remove the robe, wrapping the outer part of it inward;
10) remove the scarf, carefully collecting all its ends in one hand at the back of the head;
11) remove gloves, check them for integrity in a disinfectant solution (but not with air);
12) wash the boots again in a tank of disinfectant solution and remove them.
After removing the anti-plague suit, wash your hands thoroughly with warm water and soap. It is recommended to take a shower after work.
The efficiency and quality of anti-epidemic, diagnostic and therapeutic measures in the event of particularly dangerous infections largely depend on preliminary preparation medical workers. Great importance is attached to the readiness of the medical service of the polyclinic network, since it is most likely that workers at this level will be the first to encounter patients with particularly dangerous infections.
1. Infectious diseases that pose the greatest danger to the population of our country are cholera, plague, malaria, contagious viral hemorrhagic fevers: Lassa, Marburg, Ebola, monkeypox, polio caused by a wild virus, human influenza caused by a new subtype, SARS, under certain conditions – a number of zooanthroponoses (glanders, melioidosis, anthrax, yellow fever, hemorrhagic fever Junin (Argentine fever), Machupo (Bolivian fever), as well as syndromes infectious diseases of unknown etiology, posing a risk of international spread.
2.B primary activities include:
Temporary isolation with further hospitalization
Clarifying the diagnosis and calling consultants
Information about the patient in the established form
Providing the patient with the necessary assistance
Collection of material for laboratory research
Identification and registration of all contact persons
Temporary isolation of contact persons
Carrying out current and final disinfection
3. All healthcare facilities must have a supply of:
Medicines for symptomatic therapy, emergency prophylaxis, chemoprophylaxis
Personal emergency prevention products
Personal protective equipment
Disinfectants
4. In each health care facility there must be in visible and accessible places during the day:
Alert schemes
Information on storing installations for collecting material from people
Information on the storage of disinfectants and containers for their dilution and disinfection
5. Personal prevention is the most important in the system of primary anti-epidemic measures.
5.1. We cover the mouth and nose in the fireplace with a mask, towel, scarf, bandage, etc.
5.2. Disinfect open parts of the body (with chlorine-containing solutions, 70% alcohol)
5.3. Upon delivery, PPE is put on medical clothing (not contaminated with the patient’s biomaterial)
Protective clothing (anti-plague suit) is intended to protect medical personnel from infection by pathogens of plague, cholera, hemorrhagic viral fevers, monkeypox and other pathogens of I - II pathogenicity with all the main mechanisms of their transmission.
Protective clothing must be properly sized.
Duration of work in a type 1 suit is 3 hours, in hot weather - 2 hours
Various means are usedpersonal protection: limited-life overalls made of waterproof material, mask, medical gloves, boots (medical shoe covers), anti-plague suit "Quartz", protective overalls "Taychem S", other products approved for use.
Overalls;
Phonendoscope (if necessary);
Anti-plague robe;
Cotton-gauze bandage;
Glasses (pre-lubricated with a special pencil or soap);
Gloves (first pair);
Gloves (second pair);
Oversleeves;
Towel (on the right side - one end is moistened with a disinfectant solution).
Slowly, without haste, after each removed element, treat your hands with a disinfectant solution.
Towel;
Gloves (second pair);
Oversleeves;
Phonendoscope;
Protective glasses;
Cotton-gauze bandage;
Kerchief;
Gloves (first pair);
Overalls.
Emergency prevention schemes for dangerous infectious diseases
Emergency prevention is medical measures aimed at preventing people from getting sick when they become infected with pathogens of dangerous infectious diseases. It is carried out immediately after establishing the fact of infectious diseases, as well as mass infectious diseases of unknown etiology.
1.Doxycycline-0.2, 1 time per day, 5 days
2. Ciprofloxacin-0.5, 2 times a day, 5 days.
3.Rifampicin-0.3, 2 times a day, 5 days
4.tetracycline-0.5 3 times a day, 5 days
5. Trimethoprim-1-0.4, 2 times a day, 10 days
Otolaryngological and observator (treatment of patients with other
ophthalmology department pathology for vital reasons)
Holding after provisional
departments maximum period
Dental provisional hospital (treatment of patients
department with warning symptoms of particularly dangerous
diseases: plague, cholera, SARS, etc.)
Department of purulent isolation ward (under observation)
surgery contact persons with patients with acute infectious diseases)
Infectious diseases departments infectious diseases hospital (treatment of patients OOI)
