Emergency Journal Antisy. Causes of emergency characteristics of health workers. Actions of medical personnel in emergency situations

When damaged skin Pokrov (cut, injection):

· Remove gloves immediately and immerse them into a disinfecting solution;

· Give a blood stitch;

· Wash hands under running water;

· Treat 70 ° alcohol;

· Lubricate 5% iodine solution;

· Push the cut of the plaster.

In case of biological material in skin:

· Treat 70 ° alcohol,

· Wash thoroughly with soap,

· Re-process the skin 70 ° alcohol.

In case of biological material on the mucous eye:

· Rinse with water.

When biomaterial gets on the mucous membrane of the nose:

· Rinse with water.

If biological material gets into the oral cavity:

· Rinse with water and then rinse 70 ° alcohol.

If biological material gets on a bathrobe, PPE (screen, glasses):

· Remove contaminated clothing and immerse in a disinfecting solution or put in bix for autoclaving

· Footwear is treated with double wiping with a rag moistened in a solution of one of the disinfectants.

When entering infected material on the floor, walls, furniture, equipment and other surrounding items:

· Pour a contaminated place by any disinfecting solution with exposure according to the viral hepatitis regime.

An employee who fell into the epid-wave emergency situation immediately reports the fact, emergency situation to the head of the unit. Each case is compiled "Act of the accident at work" and the "magazine registration of accidents in production" is filled. The act is fixed by the date, place, commission in the composition of three people, F.I.O., Head of the Department (duty officer), Senior Medical Sister, Specialist in Labor Protection, Fm. persons injured during accidents, position, work experience in the specialty, localization and nature of damage, time of injury, detailed description Situations: Full name The patient, with the blood of which there was a contact, as well as the activities carried out: the method of processing the skin, mucous membranes. Describes in detail the situation, the use of personal protective equipment, compliance with safety regulations. The act is certified by signatures indicating posts and surnames.

Magazine of registration of medical accidents (prevention of HIV infection)

As soon as possible, express testing of the patient and an employee for the presence of antibodies to HIV and viral parenteral hepatitis is carried out. Then serum samples are sent to AIDS laboratory. Within 72 hours from the moment of the occurrence of AU, seek advice from a specialist of the epidemiological profile of a center or a branch of the regional center for the prevention and control of AIDS and infectious diseases, having with you data passports, insurance policy and reduss.

For the purpose of emergency prevention of HIV infection, azidothimidine is appointed (Retrovir) within 1 month.

Persons who undergoes a threat to HIV infection are under the supervision of an infectious examiner for 1 year with a mandatory examination for the presence of a HIV marker (after 3, 6 and 12 months).

"Medical sisters and midwives risk infected with HIV, hepatitis B and C, like all other people, but the risk is significantly reduced, if they are careful both in personal life and in professional activities. And it is impossible not to note how great the role of nursing staff is not only in preventing the spread of HIV and other infections in medical institutions, but also in reducing professional risk and the social consequences of the disease. "

International Council of Medical Sisters.

The risk of a professional disease of HIV infection and hepatitis B is most often susceptible to medical workers who come into contact with various biological fluids:

· Blood and its components;

· Sperm;

· Saliva;

· Vaginal secret;

· Tears;

· breast milk infected woman.

Manipulations in which may be infected with blood and other biological fluids:

· Invasive procedures;

· Contact with mucous membranes (integers and damaged);

· Contact with damaged skin of patients;

· Contact with surfaces contaminated with blood and other biological fluids.

Safety conditions Sisters in the workplace:

1. Special clothing that protects the sister from possible blood and other discharge when performing manipulations:

· Medical hail (cake);

· Disposable rubber gloves;

· Maker gauze 4-hslaya or respirator;

· Points, shields;

· Waterproof apron or bathrobe.

2. Means for the fence and delivery of laboratory material:

· Disposable syringes and needles;

· Special containers for collecting biological material;

· Containers for transportation.

· Containers for preservation purification and disinfection;

· Disposal containers;

· Disinfectants and antiseptic agents.

Safety rules Sisters in the workplace:

· Wash your hands before and after contact with the patient.

· Consider the blood and discharge of the patient as potentially infected.

· To consider everything that is blurred by blood or other discharges, as potentially infected.

· To reduce the risk of infection before putting on gloves to handle the skin of nail phalanx in iodine.

· If the integrity of the skin is violated, before starting the damage to damage, it is necessary to close the leafoplasty or lubricate the BF glue.

· Strictly observe the rules for removing gloves and washing hands (liquid soap and disposable towels).

· Cleaning must be carried out in latex gloves.

· When discharging bottles with medicines, test tubes with blood and its components, serum ampoules should avoid injections, cuts of gloves and hands.

· It is impossible to overflow the blood and its components without obtaining a negative response to "form 50".

· You can not use a disposable toolkit repeated.

· You can not apply a reusable toolkit that has not passed the entire processing cycle and test control on hidden blood and sterility.

· In the workplaces, there must be working containers with covers, containers with disinfection solutions for used syringes, needles, gloves, a gauze material (each container must have a clear labeling).

· Until the end of the exposure in the disinfection solution, it is strictly forbidden to disassemble medical instruments; Only after disinfection and in dense rubber gloves.

· Used needles should not bend, breaking manually or re-put the cap.

· Acute tools to be reused are placed in a separate durable treatment container.

· You can not store infected material with blood or its components in open capacities without disinfectants.

· Transportation of biological fluids should be carried out in closed containers with hermetic covers, the outer parts of the container are treated with disinfectants. Forms of directions can not be placed on test tubes. Containers must be subject to disinfection.

· For resuscitation, breathing bags should be available in order not to apply the "mouth in the mouth" or "mouth to the nose" method.

In each subdivision of the medical institution, whose staff is at risk of infection of HIV and BGB must be "first aid kit" containing the following means:

1. Ethyl alcohol 70% - 100 ml; 5% alcohol iodine solution;

2. Potassium permanganate in hollows of 50 mg. x 2 (the solution is prepared before use);

3. Distilled water - 100 ml;

4. Dressing material: bandage, wool, leukoplasty; Attacks.

· In case of biological fluid, the eyes should be rinsed with a pale pink potassium permanganate 1: 10,000, for which it is necessary to have a penetration of a drug 50 mg., Which dissolves in 500 ml. distilled water.

· In case of biological fluid, the mouth of 0.05% (50 mg of potassium permanganate and 100 ml of distilled water) should immediately rinse the mouth of 0.05%. Distilled water) permanganate potassium solution or 70% ethyl alcohol.

· When a biological fluid appeals to the nasal cavity - rinse with 0.05% potassium permanganate solution.

· If a biological fluid appeals to unprotected skin is to process its 70% ethyl alcohol, wash with water with soap and re-process alcohol. Do not rub!

· In injections and cuts through gloves:

Wash your hands in gloves with flowing water with soap,

Remove gloves and immerse in disinfection solution,

Squeeze out blood from the rank with another hand (in the glove, if there are damage to the skin),

Rinse under the jet of water with soap (do not rub!),

Procedure 70% ethyl alcohol and give dry, then lubricate 5% iodine solution, stick to adhesive plane.

· When an unprofitable leather, the injury to the injury with soap, without stopping bleeding, should be ringed with a needle or cut; Twice to handle the injury place of 5% iodine alcohol solution or 70% ethyl alcohol (after each treatment, give the solution to dry); Pack the place of injection with a leukoplasty or impose a bandage.

About the accident promptly report administrations, attract infectious examiner for consultation. All cases of injuries are recorded in the journal "Emergency situations".

Laboratory examination of persons who fell into an emergency is made through 3, 6 and 12 months.

Each patient should be considered as potentially infected HIV and other infections transmitted with blood.

Subjective examination.

The reason for petition.

Reason for the appeal to medical help. Complaints.

Patient's opinion about his health, condition.

Expected result from treatment.

The general condition of the patient.

Weakness: To what extent and long ago.

Lose weight, with what time.

Sweating.

Increase temperature: with what time, permanent or attacks, the degree of temperature rise.

The presence of dizziness, fainting states.

Availability skin itch (In which places, with which the patient has its appearance).

Bone muscular system.

Pain, localization, character of pain, intensity, consistency and frequency, connection with movement, weather change.

Reducing muscle strength (general or individual groups).

Breathing system.

Nose: breathing through the nose (free, difficult); discharge from the nose, their character, quantity; Nose bleeding.

GORTAN: a feeling of dryness, perversions, hoarseness of voice, difficulties and soreness when swallowing.

Cough: intensity, frequency, dry or wet.

Wet: character (mucous, purulent, blood presence), quantity, smell, at what time of day the largest volume, in what position.

Hemochkamye: How often and when, quantity, color (shag, dark, black).

Pain in the chest: Localization, character (stupid, sharp, stitching, noving); communication with breathing, cough, body position variable; What makes it easier for pain.

Dyspnea: constant or parotid, alone or during exercise, the intensity that increases the shortness of breath, is difficult to breathe or exhale, which facilitates shortness of breath.

Sunshine attacks (asthma): Duration, with which are related than they are facilitated.

The cardiovascular system:

Heartbeat: constant or attacks (intensity, duration, with which are connected).

Heart interruptions: constant or attacks (intensity, duration, with which are connected).

Pain in the heart: constant or attacks, their character (stitching, nunning, compressive), which are accompanied by (feeling of longing, fear of death), intensity and duration, irradiation, causes (excitement, physical exercise, food, smoking ...).

Edema (in the evening, on the lower limbs).

Digestion system.

Appetite, the perversion of appetite (to which food).

Saturation (normal, fast, constant feeling of hunger).

Thirst and the amount of fluid consumed.

Chewing and swallowing: what the difficulties are connected, what food does not pass; The use of dentures.

Heartburn: Communication with the reception and character of food than it is facilitated.

Express: character (air, sour, bitter, with a smell of rotten eggs, eaten food ...).

Stomach pain: character, localization, irradiation, connection with food intake and its character, frequency, dependence on the act of defecation.

Drinking, severity, bloating: frequency, connection with food.

Vomiting: frequency, communication with food, the nature of the vomit, the presence of blood, the smell, connection with pain, facilitates vomiting pain.

Chair: Regularity, consistency, smell, color, impurities, worms.

Establishing feces and gases: free and difficult, the presence of pain in the act of defecation, itching in the rear pass.

Uriction system.

Frequency and quantity of urination (day, at night).

Dysuric phenomena.

Violation of the urination: urine delay, slow selection, involuntary (incontinence, irritation).

Edema (in the morning, on the face).

Anamnesis of the disease.

What time he considers himself to be sick.

What preceded the disease (mental injury, overwork, supercooling ...).

The beginning of the disease (what was manifested, as he hung).

The course of the disease:

1. Sequence of manifestation and flow of individual symptoms;

2. exacerbations and their causes, duration;

3. Appeals to the doctor;

4. conducted research and their results;

5. The nature of the treatment carried out and its effectiveness;

6. Changing disability from the occurrence of the disease.

Anamnesis of life.

Place of Birth;

Social status;

Family status;

Development in childhood (lag);

Education, specialty;

Conditions of life;

Food (regulation, regularity, variety, calorie ...);

Professionally and production conditions: the beginning of employment, profession, its changes, professional harm;

Bad habits;

Allergic;

Gynecological history;

Previously transferred operations, injuries;

Epidemiological history (previously transferred infectious and venereal diseases, possible contacts).

Sources of information (specify specific sources of information).

Objective examination.

Physical data: growth, weight.

Consciousness: in consciousness (clear, confused), unconscious.

Facial expression: painful, thought-out, disturbing, suffer, wary, indifferent, calm.

Position in bed: active, passive, forced.

Condition of skin, appendages of skin and visible mucous membranes:

Color: Physiological coloring, pallor, jaggility, hyperemia, cyanosis (diffuse and local), acricyanosis (cyanosis on the lips, tip of the nose, ear sinks, end phalanges of the fingers and legs, cheeks), pigmentation.

Condition: Increased dryness, increased humidity, rash, mass, scars, trophic ulcers, breakdowns.

Eveniness and its localization.

Development of P / F Layer: Normal, increased and reduced.

Condition of nails and hair.

Bone-muscular system: the deformation of the skeleton, joints, their pain.

Muscular tone (saved, enhanced, lowered).

Cramps.

Paralia.

Temperature of the body: within the norm, fever.

Respiratory system: ChDD, respiratory characteristic (rhythm, depth, type).

Type (chest, abdominal, mixed).

Rhythm (rhythmic, arrhythmical).

Depth (superficial, deep).

Tahipot.

Bradyp

Pathological types of breathing: Big Breath of Kussmouul, Biot Breathing, Cheyne Stokes Breathing.

Asphyxia.

Dyspnea (expiratory, inspiratory, mixed).

Normally breathing 16-20 per minute, superficial, rhythmic.

Arterial pressure: Hypertension, Norotonia, Hypertension.

Pulse: the number of shocks in min., Rhythm, filling, voltage.

Normally 60-80 strokes in min., Satisfactory filling and voltage.

The ability to eat and drink: appetite (preserved, disturbed), violation of chewing (than caused, reserves), nausea, vomiting; The amount of liquid drinking and eaten food (part of the portion), artificial nutrition.

Natural shipments.

Urea: frequency, quantity, incontinence, irrepression of urine, catheter, independently, urinary.

Chair: independent, regular, chalk character (decorated, liquid), color and presence of pathological impurities (blood, mucus, pus), incontinence of feces, cylinderInik, colostomy.

Sensual organs (hearing, vision, smell, touch, speech).

Memory (preserved, broken).

Using reserves: glasses, lenses, auditory. Apparatus, removable dentures.

Sleep (covered sleep, often wakes up, the need to sleep during the day).

Movementability: independently, with (outsiders, devices).

Topic: "Human needs in health and illness"

– in the case of cuts and injections, immediately remove the gloves, wash your hands with soap under running water, handle the hands with 70% alcohol, lubricate the wound 5% alcohol solution of iodine;

– when blood or other biological fluids in the skin, this place is treated with 70% alcohol, wash with water with soap and re-treated with 70% alcohol;

– when blood and other biological fluids in the patient on the mucous eye, nose and mouth: rinse the oral cavity with plenty of water and rinse with 70% solution ethyl alcohol, nasal mucous membrane and the eyes are rich abundantly water (do not rub);

– when blood and other biological fluids in the patient on a bathrobe, clothing: remove work clothes and immerse in a disinfecting solution or in bix (tank) for autoclaving;

– as soon as possible, taking antiretroviral drugs in order to post-contact prevention of HIV infection.

8.3.3.2. It is necessary for a short time after contact to examine on HIV and viral hepatitis B and with a person, which can be a potential source of infection and contacting him a person. An examination on HIV potential source of HIV infection and contacting person is carried out by express testing on HIV antibodies after an emergency with a mandatory direction of the sample from the same portion of blood for standard HIV testing in ELISA. The plasma (or serum serum) samples of a person, which is a potential source of infection, and a contact person, are transmitted for storage within 12 months to the AIDS Center of the constituent entity of the Russian Federation.

The victim and the person who may be a potential source of infection, it is necessary to interview the carrier of viral hepatitis, STIs, inflammatory diseases of the urinary sphere, other diseases, to consult relatively less risky behavior. If the source is infected with HIV, find out whether it obtained antiretroviral therapy. If the victim is a woman, you need to spend a pregnancy test and find out if it does not feed the baby's breast. In the absence of clarifying data, post-contact prophylaxis is started immediately, when additional information appears, the scheme is adjusted.

8.3.3.3. Conducting post-contact prevention of HIV infection with antiretroviral drugs:

8.3.3.3.1. The reception of antiretroviral drugs should be started within the first two hours after the accident, but no later than 72 hours.

8.3.3.3.2. Standard post-contact prevention diagram of HIV infection - Lopinavir / Ritonavir + Zidovudine / Lamivudine. In the absence of these drugs, any other antiretroviral drugs can be used to start chemoprophylaxis; If it is impossible to immediately assign a full-fledged Waart scheme, the reception of one or two available drugs begins. The use of nevirapine and abacavir is possible only in the absence of other drugs. If the only of the existing drugs is neviurapin, only one dose of the drug should be prescribed - 0.2 g (re-receiving it is unacceptable), then a complete chemoprophylaxis is prescribed during other drugs. If the chemoprophylaxis has begun using abacavir, it should be conducted as quickly as possible to study on the reaction of hypersensitivity to it or replace abacavir to another nita.

Ethyl alcohol solution 70% - 50.0

Ioda alcohol solution 5% - 10.0

Sterile cotton balls in hermetic packaging

The actions of the medical worker at emergency.

In each medical and preventive institution, an algorithm of the actions of medical personnel should be developed during an emergency and on the basis of:

Sanitary and epidemiological rules SP 3.1.5. 2826-10 "Prevention of HIV infection"

Information letter dated 01.11.2010 "The procedure for the postcontact prevention of HIV infection in medical and preventive institutions of the Udmurt Republic".

Preventive measures in case of infectiously dangerous biological infected HIV liquids on the skin and mucous membranes, as well as in injections and cuts:

In accordance with paragraph 8.3.3.1. SP 3.1.5. 2826-10:

In the case of cuts and injections immediately:

Remove gloves

Wash hands with soap under running water,

Handle hands 70% alcohol,

Grease the wound 5% alcohol iodine;

When blood or other biological fluids for skin:

This place is treated with 70% alcohol,

Wash with water with soap and re-treated with 70% alcohol;

When blood and other biological fluids in the patient on the mucous eye, nose and mouth:

Rash cavity to rinse with plenty of water

Rinse with 70% solution of ethyl alcohol,

The mucous membrane of the nose and the eyes are rich enough with water (do not rub);

When blood and other biological fluids of the patient on a bathrobe, clothing:

Remove work clothes and immerse in a disinfecting solution or in bix (tank) for autoclaving;

Note:

As soon as possible, taking antiretroviral drugs in order to post-contact prevention of HIV infection.

Survey of the affected health worker after an emergency.

In accordance with paragraph 8.3.3.2. SP 3.1.5. 2826-10 It is necessary as soon as possible after contact to examine on HIV and viral hepatitis B and with a person who can be a potential source of infection and contacting him a person. An examination on HIV potential source of HIV infection and contacting person is carried out by express testing on HIV antibodies after an emergency with a mandatory direction of the sample from the same portion of blood for standard HIV testing in ELISA. Samples of a plasma (or serum) of a person's blood, which is a potential source of infection, and a contact person, are transmitted for storage for 12 months in Buz Ur "URTS AIDS and from".

Conducting post-contact prevention of HIV infection with antiretro-virus drugs, in accordance with SP 3.1.5. 2826-10:

Paragraph 8.3.3.3: The decision to carry out the post-contact prevention of HIV infection is adopted by a doctor responsible for conducting patients with HIV infection in the LPU, where an emergency occurred. On the weekend, holidays And in the night shift, the duty officer of the department, where an emergency occurred, with the subsequent direction of the affected employee for consultation in the BUZ URTS "URTS AIDS and from" to the infectious doctor for the correction of ARVT.

Paragraph 8.3.3.3.1: The reception of antiretroviral drugs should be started within the first two hours after the accident, but no later than 72 hours.

In each LPU, a specialist responsible for storage of ARVP should be determined by order of the main doctor, the place of storage of ARVP with ensuring their availability around the clock, including at night and weekends.

Paragraph 8.3.3.3.2: Standard post-contact prevention diagram of HIV infection - Lopinavir / Ritonavir + Zidovudine / Lamivudine. In the absence of these drugs, any other antiretroviral drugs can be used to start chemoprophylaxis; If it is impossible to immediately assign a full-fledged Waart scheme, the reception of one or two available drugs begins. The use of nevirapine and abacavir is possible only in the absence of other drugs. If the only of the existing drugs is neviurapin, only one dose of the drug should be prescribed - 0.2 g (re-receiving it is unacceptable), then a complete chemoprophylaxis is prescribed during other drugs. If the chemoprophylaxis has begun using abacavir, it should be conducted as quickly as possible to study on the reaction of hypersensitivity to it or replace abacavir to another nita.

Emergency registration is carried out in accordance with the established requirements in accordance with SP 3.1.5. 2826-10:

Paragraph 8.3.3.3.3:

1. Employees of LPU should immediately report every emergency case to the head of the unit, his deputy or higher leader;

2. Injuries received by health workers, and entrusted at least 1 day of disability or transfer to another job should be taken into account in each LPU and to be activated as an accident in production with the compilation of an accident at the production (in 3 copies), The basis of the Decree of the Ministry of Labor of the Russian Federation of October 24, 2002 No. 73 "On approval of the forms of documents necessary for investigating and accounting accidents in production, and provisions on the peculiarities of investigating accidents in production in certain sectors and organizations"

3. You should fill out a journal of registration of accidents at work;

4. It is necessary to perform an epidraseland of the cause of injury and establish the connection of the cause of injury with the performance of the health worker;

5. All other emergency situations are recorded in the "LPU emergency registration journal" with the execution of an emergency certificate in 2 copies.

Paragraph 8.3.3.3.4:

All LPUs should be provided or have access to express tests for HIV and antiretroviral drugs if necessary. The stock of antiretroviral drugs should be stored in any LPU with such a calculation so that the examination and treatment can be organized within 2 hours after an emergency. The LPU should define a specialist responsible for storing antiretroviral drugs, place their storage with access, including at night and weekends.

Paragraph 5.6:

The survey for HIV infection of the affected health worker is carried out with mandatory up to - and post-advise on the prevention of HIV infection.

Paragraph 5.7:

Consultation should be carried out by a trained specialist (preferably a doctor-infectious doctor, an epidemiologist or psychologist) and include the basic provisions for HIV testing, possible consequences Testing, determination of the presence or absence of individual risk factors, awareness assessment of awareness of HIV prevention issues, providing information on HIV transmission paths and methods for protection against HIV infection, types of help available for infected HIV.

Paragraph 5.8:

When conducting a dotesting counseling, it is necessary to fill out the form of informed consent to conduct an examination on HIV infection in two copies, one form is issued to the hand to the examined, the other persists in the LPU.

Observation of contacting receiving chemoprophylaxis of HIV infection.

A medical professional or a person affected by an emergency after an episode of emergency contact with the source of infection should be observed within 12 months at the infectiosistian doctor of Buz UR "URTS AIDS and from" or an infectious doctor at work (places of honey. Customer service) with control terms Repeated testing for HIV, HCV, VGV in 3, 6 and 12 months after contact.

To identify undesirable phenomena associated with the reception of drugs, a laboratory survey is carried out: a general blood test, a biochemical blood test (about. Bilirubin, Alt, Ast, amylase / lipase). The recommended multiplicity of the survey: after 2 weeks, then after 4 weeks from the start of the chemoprophylaxis.

It is necessary to ensure psychological support and, if necessary, to send an infectious system for consultation to a psychologist / psychotherapist infectationist Buz Ur "URTS AIDS and from" on his request.

Precautions.

1. All manipulations, in which the contamination of hands can occur with blood, serum or other biological fluids, carry out in rubber gloves.
2. When performing manipulations, a medical worker should be dressed in a bathrobe, a hat, replaceable shoes, which is prohibited outside the manipulation offices.
3. Medical workershaving wounds on hand, exudative skin lesions or wet dermatitis, during diseases are removed from patient care and contact with items to care. If it is necessary to perform work, all damage should be closed with attacks, leucoplasty.
4. In the threat of splashing of blood or serum, the equipment of eye protection and face, protective mask, glasses, protective shields should be applied.
5. Disassembly, sink, rinsing medical instruments, pipettes, laboratory dishes, devices or apparatus, which come into contact with blood or serum, must be carried out after pre-disinfection (disinfection) and only in rubber gloves.
6. All manipulations with HIV-infected patient must be performed in the presence of a second specialist, which in case of an emergency may assist the victim, and will continue to perform manipulation.
7. A medical worker should relate to blood and other biological fluids of the body as a potentially infected material.

I. Types of emergency situations.

Orders, Regulatory Documents on HIV Prevention, Safety

medium medical staff.

Medical workers should have a clear idea of \u200b\u200bwhat an emergency situation threatening them.

Emergency situations can be two types:

1. Emergency situations associated with contact with blood and other biological fluids.

2. Emergency situations associated with spilling and spraying blood and other biological fluids.

Emergency situations include:

· Skin damage honey. Tooling during manipulation, when processing

· Hit a potentially infected material on the skin, mucous

· Blood splashing under centrifugation

· Rales and punctures of gloves when carrying out manipulations when processing used tools

For the prevention of emergency situations, the SMR in professional activities should be guided by the following orders, regulatory acts:

1) Order No. 170 "On measures to improve prevention and treatment HIV infection In the Russian Federation "

2) Sanitary rules on "Safety of work with microorganisms 3-4 pathogenic groups"

3) Instructions for anti-epidemic mode in AIDS diagnostic laboratories

5) to be guided by the Regulation on the method of conducting disinfection, software, sterilization of medical products according to

6) All manipulations perform according to the developed standards, know the methods and conditions for transporting infected material

the rules of universal security measures of medical personnel from infections

Ways of infection of medical staff

Natural artificial

The most acute question is the danger of infection of medical staff with hemok contact infections, i.e. viral hepatitis and HIV infection. Unfortunately, at the moment honey. Employees do not give proper personal protection during work, mainly focusing their efforts on patient safety. Nevertheless, the nurse should always relate to patients as potentially infected, and any biological material (blood and its components) are considered as potentially infected.

7 rules of universal security measures

medpers from infections.

1. Wash your hands before and after any contact with the patient

2. All manipulations perform in rubber gloves

3. Immediately after use, the used syringes and catheters are placed in special containers "to dispose of acute items", never remove from the syringes used needles and not to produce any manipulations with them.

4. Use eye protection tools and masks to prevent possible splashes of blood and liquid selection in person

5. Use special moisture-proof clothes to protect the body from possible hitting blood splashes or liquid secretions.

6. Consider all the linen, blurred by blood or liquid discharge, as a potentially infected

7. Consider all samples laboratory analyzes How potentially infected

Aid kit Anti-AIDS

All jobs should be provided with disinfecting solution and aid kit Anti-AIDS:

This first aid kit must be equipped

1. Graduated measuring glass up to 200.0 ml - 2 pcs

2. Alcohol tincture of iodine 5% - 50.0

3. 1% solution boric acid 50.0 ml

4. 70 0 alcohol, in volume 200.0

5. Bactericidal plaster - 1 pc

6. Sterile gauze napkins 10 pcs

7. Bandage gauze sterile -2pcs

8. Pipettes Eye 2 pcs

9. VATU surgical 50.0 gr

For the presence and staffing of this first aid kit watches senior medical Sister branch.

3. Tactics of the action of health workers in the event different species emergencies, statistical data on the degree of possible infection in emergency situations

Probability of infection honey. employee
When blood, patient biological fluids in the eyes, on the nasal mucosa or the oral cavity
is 0.09%

1. When blood, the biological fluids of the patient on the mucous membrane of the eye is necessary:

1. Rinse eyes with water or 1% boric acid solution

2. Pour the solution in 2 eye baths, lower the eyes in them, and blink, rinse them for 2 minutes

3. Dry the eyes of a one-time cloth

4. Card into each eye 1-2 drops of 20% of the albuchis (in case of eye irritation)

2. If the blood injection, patient biological fluids

on nose mucosa

1. Nose rinse with water

2. Face wipe the clean disposable napkin

3. In the injury of blood, the patient's biological fluids on the oral mucosa need:

1. Dial 70% alcohol in the mouth, rinse for 2 minutes or 1% solution of boric acid

Probability of infection honey. Employee in the patient's biological fluids on open intact parts of the body is 0.05%

4. When blood, the patient's biological fluids on the intact persons of the skin of the hands, other open parts of the body, besides the face:

1. Remove blood from the skin with a tampon moistened with 70% alcohol, or 3% P-r-rum chlorine.

2. Two wash the skin area with warm water with soap, wipe dry with a towel

3. Repeated 70% alcohol

5. In the injection of blood and other biological

liquids on the skin

At the same time treat mucous eye, nose, oral cavity on the demonstrated technique

6. In contamination of gloves with blood

1. Process with a swipon moistened with 70% alcohol.

2. Wash hands under running water

3. Remove the gloves, seeing them in Dz. 3% chlorine solution, 6% hydrogen peroxide, 0.2% sulfochlorine for 60 minutes

4. Implement the hygienic level of hand treatment, handle hands with skin antiseptic.

2 way

1. Hands in gloves omit in the desiral solution, hold

2. After throwing hands to remove the gloves carefully, seeing their dezes. solution

3. Implement the hygienic level of hand treatment, handle hands with skin antiseptic.

Probability of infection honey. HIV-infection worker with cut, hug contaminated tools is 0.3% -0.5%, viral hepatitis - 6-30%

7. If damaged damage (injections, cuts) hands are necessary:

1. Immediately remove the gloves (quickly, but gently soak in 3% p-re chlorine, 6% hydrogen peroxide, 0.2% sulfochlorine for 60 minutes)

2. Squeeze blood from the wound

3. Remove its tampon moistened with 70% alcohol

4. If the wound makes a hygienic level of hand treatment (wash your hands with soap under running water)

5. Work hands 70% alcohol

6. Treat the wound 5% r-rum iodine, stick to bactericidal adhesive plane

7. Dress on gloves, continue

8. In contamination by blood and other biological clothing fluids:

1. Accurately polluted side inside to remove a bathrobe

2. Soak in Dz. 3% solution of chlorine, 0.2% p-re sulfoclorantine for 2 hours

3. Skin under a bathrobe to treat a tampon, moistened with 70% alcohol

4. Implement the hygienic level of hand processing

5. Dress on a clean bathrobe, gloves, continue

6. After 120 minutes (2 hours), rinse the robe under running water until the smell is disappeared, pass it into the laundry

9.Freak of blood on the furniture (couch, chair), shoes

1. Rafting moistened descend. A solution of 3% chloramin, 6% peroxide, 0.2% sulfochlorine contaminated surface to rub 2 times with an interval of 15 minutes.

2. Wall after processing Soak in Dez R-re

3. Rinse under running water until the smell disappear

4. Dindle

10. When blood gets into the floor (crashed or overturned the test tube, nasal bleeding):

1. To put on gloves (if they were not dressed)

2. Limit the place of the accident

3. Pour the disinfectant solution (the concentration of the mode provided for to inactivate the hemok contact hepatitis viruses) for the exposure time

4. After exposure to assemble a broken capacity using a scoop and brush and placed in class B waste;

5. Remove gloves, dispose of security in accordance with safety requirements.

11. In case of damage to the test tube with blood during the centrifuge work:

1. Open the lid slowly, only 40 minutes after a complete stop

2. All centrifuge glasses and broken glass are placed in a disinfectant solution (concentration according to the mode provided to inactivate the hemocontact hepatitis viruses) for the exposure time.

3. The inner and outer surface of the centrifuge and cover to be treated with a napkin with a disinfectant solution with double wipe with an interval of 15 minutes.

Rules for the registration of emerged emergencies, the magazine "Accounting and registration of accidents with blood or patient bioshydroches", chemoprophylaxis.

After preventive activities, it is necessary:

1. To inform the head of the unit, his deputy or superior leader

2. Injuries received by health workers should be taken into account in each LPU and focus as an accident in production with the compilation of an accident on an accident.

3. To register accidents in the emergency log, which is stored in the workplace

Form of emergency magazine

4. Conduct a clinical risk assessment of HIV infection

· Character of damage (type of needle (hollow, solid), penetration depth, assessment of blood volume introduced with needle, tissue break degree, contact with mucous membrane, contact with damaged skin area;

· Source of infection: blood, blood products, organism fluids, oil flooded water etc.

· Characteristics of the patient of the source: stage of HIV infection, viral load

5. Conduct the chemoprophylaxis of the parenteral infection of HIV immediately.

6. Registration in GBUZ NSO "Center AIDS", is removed from the records of obtaining negative results of HIV surveys within 3,6.12 months.

Similar information.