Emergencies in the work of a medical worker. Algorithm of actions in the event of an emergency. Standard scheme of the control panel
The action of a nurse in an emergency
. In case of contact with biological fluid on the skin, immediately:
1.1 For 30 seconds, treat with a swab moistened with a skin antiseptic or 70% alcohol.
2 Wash twice with running water and soap, dry with a towel.
1.3 Re-treat with skin antiseptic or 70% alcohol.
2. If biological fluid gets on hands with gloves:
2.1 Treat gloves with a cloth moistened with a disinfectant.
2 Wash with running water, remove the gloves with the working surface inside.
3 Treat hands with an antiseptic or 70% alcohol, wash with running water and soap.
3. If biological fluid gets into the eyes:
Rinse with running water, rinse with 0.01% potassium permanganate solution using a disposable syringe or pipette.
4. If the biological fluid gets on the nasal mucosa:
Rinse with 0.05% potassium permanganate solution using a disposable syringe or pipette.
5. When a biological fluid gets on the oropharyngeal mucosa
Rinse with 70% alcohol or 0.05% potassium permanganate solution
6. When pricked or cut:
Wash hands without removing gloves with running water and soap.
Remove the gloves with the working surface inside and discard them in a disinfectant solution.
If blood comes from the wound, do not stop it for 1-2 minutes; if not, squeeze the blood out of the wound, wash with running water and soap.
Treat the wound with 70% alcohol, then the skin around the wound with 5% iodine solution and seal with a plaster or put on a fingertip.
7. If biological material gets on a dressing gown, clothes:
Remove clothes and soak in a disinfectant solution, the skin of hands and other parts of the body, if contaminated through clothing, after removing it, treat with 70% alcohol
Wash the surface with soap and water and re-treat with 70% alcohol.
8. If biological material gets on the surface of the wall, floor, equipment:
Twice with an interval of 15 minutes. wipe them with a 6% hydrogen peroxide solution or a 0.1% solution of purzhavel.
Treatment.
Notify the manager department for an emergency.
Find out the HIV status of the patient.
Carry out a blood test of the health worker and the patient by ELISA.
Assess the risk of infection.
At high and medium risk, start chemoprophylaxis within 72 hours at the latest.
Register an emergency in the "Journal of emergency situations with biological material".
Draw up an "Act on damage or contamination of the skin and mucous membranes with biological material."
Send the injured healthcare worker to the infectious diseases room.
Issue a referral for dispensary registration indicating the characteristics of the emergency, the degree of risk of infection, and the preventive measures taken.
Warn the affected healthcare worker that he can serve as a source of HIV infection during the entire observation period (12 months), about the need to take precautions to avoid possible transmission of HIV.
Application №2
Conclusion
Pediculosis, like many other diseases, is much easier to prevent than to cure. For this, it is only necessary to observe the rules of personal and social hygiene. Since one of the risk groups, you can...
Methods for diagnosing Helicobacter Pylori
Among the variety of methods for diagnosing Helicobacter pylori, two large groups are distinguished - invasive and non-invasive methods. Invasive methods are based on taking biopsy specimens during...
transcript
1 Algorithm of actions in the event of an emergency The health facility should keep records and analyze all cases of emergency situations with medical staff associated with the risk of nosocomial transmission of infections. Both in the event of an emergency, and in the presence of prerequisites and such a development of events, it is recommended to evaluate the effectiveness of the implemented safety measures at the workplace. If blood and biological fluids of HIV-infected people get on the skin and mucous membranes of a medical worker, it is necessary to take a set of measures to prevent HIV infection at the workplace, including first aid, prescribing antiretroviral drugs as soon as possible, examination and registration of an emergency. Actions of a medical worker in an emergency if there is a risk of HIV infection: - in case of cuts and injections, immediately remove gloves, wash hands with soap and water under running water, treat hands with 70% alcohol, lubricate the wound with 5% alcohol solution of iodine; - if blood or other biological fluids get on the skin, this place is treated with 70% alcohol, washed with soap and water and re-treated with 70% alcohol; - in case of contact with the patient's blood and other biological fluids on the mucous membrane of the eyes, nose and mouth: rinse the mouth with plenty of water and rinse with 70% ethyl alcohol solution, rinse the mucous membrane of the nose and eyes with plenty of water (do not rub); - if blood and other biological fluids of the patient get on the dressing gown, clothes: remove work clothes and immerse in a disinfectant solution or in a bix (tank) for autoclaving; - start taking antiretroviral drugs as soon as possible for post-exposure prophylaxis of HIV infection. It is necessary as soon as possible after contact to examine for HIV and viral hepatitis B and C a person who may be a potential source of infection and a person who has come into contact with him. An HIV examination of a potential source of HIV infection and a contact person is carried out by rapid testing for antibodies to HIV after an emergency with the obligatory sending of a sample from the same portion of blood for standard HIV testing in ELISA. Samples of plasma (or serum) of the blood of a person who is a potential source of infection, and a contact person, are transferred for storage for 12 months to an AIDS center of a constituent entity of the Russian Federation. The victim and the person who may be a potential source of infection should be interviewed about the carriage of viral hepatitis, STIs, inflammatory diseases of the urogenital area, and other diseases, and counseling regarding less risky behavior. If the source is infected with HIV, find out if he received antiretroviral therapy. If the victim is a woman, a pregnancy test should be done to see if she is breastfeeding. In the absence of clarifying data, post-exposure prophylaxis is started immediately, with the appearance of additional information, the scheme is adjusted. Conducting post-exposure prophylaxis of HIV infection with antiretroviral drugs: Taking antiretroviral drugs should be started within the first two hours after the accident, but no later than 72 hours. The standard regimen for post-exposure prophylaxis of HIV infection is 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 prescribe a full-fledged HAART regimen, one or two available in
3 Age form "List of persons affected in emergency situations and persons in contact with HIV, deregistered"; Informed consent form for HIV testing. The material used: SP "Prevention of HIV infection" MU "Epidemiology. Prevention of infectious diseases. Epidemiological surveillance of HIV infection. Guidelines" (approved by the Chief State Sanitary Doctor of the Russian Federation) Order of the Ministry of Health of the Republic of Tajikistan dated "On the prevention of occupational infection of medical workers with the human immunodeficiency virus" . Approved by the Order of the Ministry of Health of the Republic of Tajikistan Journal of emergency situations during medical procedures * in (name of department, institution) Started: "..." d Finished: "..." g p / p Full name of the injured medical worker Place of work, position Date and time “AS” Circumstances and nature of “AS” Availability of PPE Full name patient, address, medical history N, date and result of testing for HIV, HBV, HCV, stage of HIV infection. ARVT Amount of assistance provided to victims in "AS" the head who was informed about the "AS" Dates and results of ELISA and IB during medical examination * Next, an Act on a medical accident in a medical organization is drawn up.
4 Approved by the Order of the Ministry of Health of the Republic of Tajikistan I APPROVE / (signature, surname, initials of the head) " " 20 m.p. ACT N ON A MEDICAL ACCIDENT IN THE INSTITUTION 1. Date and time of the medical accident (day, month, year and time of the medical accident) 2. Institution where the victim is an employee (full name, actual address, legal address, surname, initials of the head) 3. Name of the structural unit where the emergency occurred and in which structural unit the injured employee works 4. Information about the injured employee: last name, first name, patronymic gender (male, female) date of birth " " year of full years 5. Presence of pregnancy weeks or breast 6. Position held in the specified medical organization length of service in the organization, including in this position 7. Persons responsible for investigating the case of a medical accident (head of the structural unit, other officials) 8. Information about briefings (training and testing knowledge) on labor protection by profession (position) or type of work, in the performance of which an emergency occurred (day, month, year) Briefing at the workplace / primary, repeated, unscheduled, target / (underline as appropriate) by profession or type of work during which a medical accident occurred (day, month, year) Security training labor by profession or type of work, during the performance of which a medical accident occurred: from "" 20 to "" 20 (if not carried out - specify) Testing knowledge on labor protection by profession or type of work, during which a medical accident occurred
5 (day, month, year, protocol N) 9. Brief description of the place where the medical accident occurred 10. Circumstances of the medical accident, date of registration in the medical accident log deep abrasion, puncture with a contaminated needle, contamination of damaged skin and mucous membrane with infected blood or other biological fluids): 12. Information on the use of issued personal protective equipment at the time of the emergency (overalls, gloves, goggles, mask, apron) 13. Decontamination measures accident site, prevention of HIV infection of the victim 14. Causes of the medical accident (indicate the main and concomitant causes) 15. Eyewitnesses of the accident 16. Characteristics of the alleged source of infection: results of HIV testing: express diagnostics (date, result) ELISA (date, result ) IB (date, result) HIV status of the patient, registration N HIV, date of detection of HIV infection antiretroviral therapy immune status viral load HBV test results (date, result) HCV test results (date, result) epidemiological data indicating a high probability of the patient being in the "seronegative window" of the victim, including express diagnostics HIV test results (date, result) HBV test results (date, result) HCV test results (date, result) 18. Vaccination against hepatitis B in the victim (indicating date of vaccination, vaccine name, batch number, expiration date): V1 V2 V3 RV immunity to hepatitis B 19. Date and time of start, end of antiretroviral drugs, name of drugs
6 " " 20 y. AS: 1.1. FULL NAME. Date of birth 1.2. Address: - registration - residence 1.3. Contact phone 1.4. Place of work and position 1.5. Date and time "AS": 1.6. Date of circulation: 1.7. Brief description of "AS" 1.8. Measures taken: 1.9. Date of HIV testing when registering: Scheme of prescribed treatment: 2. Source “AC” data: 2.1. Full name Date of birth 2.3. Address: - registration - residence 2.4. Place of work and position: 2.5. Risk group (underline): HIV-infected (VP-), drug addict, CSW, CVHB, CVHC Rapid test (date and result): 2.7. If not examined, indicate the reason:
7 Responsible doctors: Infectionist: (full name) signature phone: Epidemiologist: (full name) signature phone: Date of completion: 20 Approved by Order of the Ministry of Health of the Republic of Tajikistan Notice of deregistration of the victim in the "AS" (to be submitted within 72 hours from the date of removal of the victim from the register by fax (843)) 1. Full name. 2. Date of birth 3. Address: - registration - residence 4. Place of work 5. Date of registration 6. Date of deregistration 7. Reason for deregistration (end of observation period, departure to another region, death, written refusal to observe , detection of HIV infection) 8. Results of laboratory observation: Dates of examination Dates and results of laboratory examination 3 months 6 months after "AS" after "AS" when registering 12 months after "AS" According to the schedule Actually
8 Responsible doctors: Infectionist: (full name) signature phone: Epidemiologist: (full name) signature phone: Date of completion: 20 Approved by the Order of the Ministry of Health of the Republic of Tajikistan Informed consent to conduct an examination for HIV infection I , (last name, first name, patronymic) of the year of birth, I hereby confirm that, based on the information provided to me, freely and without coercion, reporting on the consequences of the examination, I decided to be tested for antibodies to HIV. For this purpose, I agree to take a blood test. I certify that it has been explained to me why it is important to get tested for HIV, how the test is carried out, and the consequences of testing for HIV. I am informed that: - HIV testing is carried out at the AIDS Center and other medical institutions. Testing at my voluntary choice can be voluntary anonymous (without presenting documents and indicating the name) or confidential (upon presentation of a passport, the result will be known to the examinee and the attending physician). In public health facilities, HIV testing is free of charge; - Evidence of the presence of HIV infection is the presence of antibodies to HIV in the blood of the examined person. However, during the period between infection and the appearance of antibodies to HIV (the so-called "seronegative window, usually 3 months"), no antibodies to HIV are detected during testing and the person being examined can infect other people. - HIV infection is transmitted only in three ways: - parenteral - most often through drug use, but can also be transmitted through the use of non-sterile medical instruments, transfusion of blood components, tattooing, piercing with a contaminated instrument, use of other people's shaving and manicure accessories; - sexual intercourse without a condom; - from an HIV-infected mother to a child during during pregnancy, childbirth, and breastfeeding Subject's signature for HIV: Date:
9 Approved by Order of the Ministry of Health of the Republic of Tatarstan Year of birth Address Registration category: contact with HIV, "AS" Type of registration: Contact: - sexual, - IV "AS": - medical, - household, - ISO. Date of registration Period of dispensary observation until: Date and result of the examination for the reporting period * Submitted by the 5th day of the month following the reporting quarter (by hand). Responsible doctors: Infectionist: (full name) signature phone: Epidemiologist: (full name) signature phone: Date of completion: 20
10 Approved by the Order of the Ministry of Health of the Republic of Tajikistan List* of persons affected in the “Emergency situation” and persons in contact with HIV, deregistered for the quarter of 20 (indicate the municipality) n/a Full name Year of birth Address Type of registration: “AS »: medical, household, ISO Contact: - sexual; - intravenous (indicate with whom the VP is in contact) Date of registration Dispensary observation period until: Date and result of the HIV test before deregistration Reason for deregistration Submitted by the 5th day of the month following the reporting quarter (by hand). Responsible doctors: Infectionist: (full name) signature phone: Epidemiologist: (full name) signature phone: Date of completion: 20
Prevention of nosocomial HIV infection among medical workers N.N. Ladnaya Federal Scientific and Methodological Center for the Prevention and Control of AIDS FBSI TsNIIE Rospotrebnadzor November 24
"Prevention of HIV infection" sanitary and epidemiological rules SP 3.1.5.2826-10. Approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation No. 1 on January 11, 2011, with amendments and additions
MINISTRY OF HEALTH OF THE RYAZAN REGION ORDER OF 11.02.2013 149 On improving measures to prevent occupational infection of medical workers with HIV infection” In the Russian
DONOR QUESTIONNAIRE Donor Date of Birth Gender A GENERAL HEALTH YES NO 1 Is your general health currently good? 2 Do you have a fever, headache, sore throat, runny nose, cough?
Kaliningrad Regional Center for the Prevention and Control of AIDS and Infectious Diseases
HIV infection: concept, ways of transmission, prevention. HIV legislation. GKUZ "Volgograd Regional Center for the Prevention and Control of AIDS and Infectious Diseases", Volgograd
Department of Health, Moscow GBUZ Infectious Clinical Hospital 2 Regional Public Organization of Nurses of the City of Moscow "Prevention of Occupational HIV Infection" Speaker:
ON THE MANAGEMENT OF A PREGNANT WOMAN WITH HIV IN THE MEDICAL ORGANIZATION PROVIDING PRIMARY HEALTH CARE. Ryabtseva Natalya Sergeevna BUZ UR "URC AIDS and IZ" Izhevsk November 21, 2017 KEY
"Algorithm of actions in emergency situations in medical institutions, post-exposure prophylaxis." Head of the epidemiological department of the GBUZ NO "REC AIDS" NOSOVA NATALIA VLADIMIROVNA Nizhny Novgorod region 2017
REGIONAL STATE BUDGET PROFESSIONAL EDUCATIONAL INSTITUTION "BARNAUL BASIC MEDICAL COLLEGE" Work practice diary PM 01 "Medical and medical and social assistance
Informed consent to conduct a voluntary test for antibodies to HIV HOTLINE 47-03-35 Khabarovsk lane Pilotov 2 What is the purpose of testing for antibodies to HIV: Timely
REGIONAL STATE BUDGET PROFESSIONAL EDUCATIONAL INSTITUTION "BARNAUL BASIC MEDICAL COLLEGE" Work practice diary PM07 Performance of work by profession junior medical
Prevention of Occupational HIV Infection Today, in the context of a generalized HIV epidemic, healthcare workers increasingly have to provide care to HIV-infected patients.
1 Annex 2 "Informed consent for chemoprophylaxis of mother-to-child transmission of HIV infection during pregnancy, childbirth and newborn"
Prevention of HIV infection in healthcare facilities in the Krasnodar Territory Moscow, 2014 Urgency of the problem 11000 10000 9000 8000 7000 6000 5000 6614 121 5409 8050 125 6535 8666 146 6778 10018 136 10 10 10 8
Republic of Kalmykia Order No. 1001PR/111 P/133 PR dated July 23, 2012 On measures to prevent occupational infection of medical workers with human immunodeficiency viruses (HIV), hepatitis B and C
MINISTRY OF HEALTH OF THE SVERDLOVSK REGION ORDER dated February 16, 2012 N 116-p ON THE INTRODUCTION OF METHODOLOGICAL RECOMMENDATIONS "ALGORITHM OF ACTION" IN THE WORK OF HEALTH CARE INSTITUTIONS OF THE SVERDLOVSK REGION
Technique of post-exposure prophylaxis of HIV infection 1 Method of post-exposure prophylaxis of HIV infection
Regulations on the procedure for identifying contacts, their dispensary observation in the KDK and KIZ of health care institutions of the Sverdlovsk region 1. General provisions Based on the known routes of transmission of the infectious agent
On the organization of interaction between state medical organizations for the identification and dispensary observation of patients with HIV infection T.A. Sorokina, head of the department of preventive and anti-epidemic
Regulatory and legal support of the sanitary and anti-epidemic regime in medical organizations Chief nurse of the State Budgetary Institution of Healthcare "OC AIDS" Reneva Elena Alekseevna LOGO List of sanitary rules, methods
M ISTISTRY OF HEALTH CARE OF THE UDM OF THE REPUBLIC OF URT BUDGET ESTABLISHMENT OF HEALTH CARE OF THE UDMURT REPUBLIC "UDMURT REPUBLICAN CENTER FOR THE PREVENTION AND FIGHT AGAINST AIDS AND INFECTIOUS DISEASES"
To the Head of the Department of Health of the Administration of Yekaterinburg GOVERNMENT OF THE SVERDLOVSK REGION MINISTRY OF HEALTH OF THE SVERDLOVSK REGION 34-B Vayner, Yekaterinburg, 620014 Telephone (343)
The epidemiological situation of HIV infection in the Republic of Bashkortostan. Prevention of occupational HIV infection 1 Epidemiologist of the State Budgetary Healthcare Institution of the Republican Central Clinical Hospital with AIDS and IZ Ivanova I.A. Ufa, 2016 1987
YOU NEED TO KNOW TO LIVE! Brief information about HIV infection 2019 WHAT YOU NEED TO KNOW ABOUT HIV/AIDS HIV infection is a chronic infectious disease caused by the Human Immunodeficiency Virus (HIV), characterized by
Prevention of HIV infection HIV infection is a slowly progressive infectious disease resulting from infection with the human immunodeficiency virus (HIV), which attacks the immune
Infectious safety in the work of a nurse in the dressing room of the KGBUZ Children's Clinical Hospital named after A.I. A. K. Piotrovich Gora Yulia Valentinovna Dressing nurse of the urological department Sukholovskaya
HIV infection is a slowly progressive infectious disease resulting from infection with the human immunodeficiency virus. The disease affects the immune system, causing the body to become,
Prevention of Occupational HIV Infection of Healthcare Workers of GBUZ SO “OC AIDS” М.Е. Konovalova 2015 Today, in the context of a generalized epidemic of HIV infection, medical workers all
Understanding a Negative HIV Test This booklet is for people who have tested negative for HIV. It cannot replace the advice of a doctor. The purpose of the brochure is to remind
Budgetary healthcare institution of the Udmurt Republic "Udmurt Republican Center for the Prevention and Control of AIDS and Infectious Diseases" PREVENTION of the occupational route of infection
MAIN REGULATORY AND LEGAL ACTS AND NEW DOCUMENTS IN THE CONTEXT OF HIV/AIDS Deputy chief physician for organizational, methodological and preventive work Sidorova N.N. Foundation document for
TEST CONTROL in the specialty "Hygienic education" second qualification category 1. What level does prevention aimed at eliminating risk factors for diseases belong to? 2. To what
On the awareness of senior nurses on the problem of HIV infection O.S. Starodubtseva, L.R. Tsygvintseva, E.E. Tsypushkina, I.I. Oransk "Ural State Medical Academy" (GBOU VPO USMA
All-Russian action "Stop HIV/AIDS" starts in the Volgograd region In order to attract public attention to the problems of the spread of HIV infection in the Russian Federation from May 15 to 21, 2017
Prevention of HIV Infection "Be reasonable among thousands of people, only one dies of natural causes, the rest die as a result of a reckless manner of being." Maimonides Medieval Philosopher Prevention
HIV Prevention at a Glance Where is HIV located? HIV is found in many body fluids, including blood, semen, vaginal secretions, and breast milk. How is HIV transmitted? HIV is transmitted through:
RESOLUTION OF THE MINISTRY OF HEALTH OF THE REPUBLIC OF BELARUS November 8, 2017 93 On approval of the Instruction on the procedure for organizing the provision of medical care to persons infected with the immunodeficiency virus
MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION ORDER of September 16, 2003 N 442 ON APPROVAL OF REGISTRATION FORMS FOR CHILDREN BORN TO HIV-INFECTED MOTHERS For the purpose of organizing monitoring
MINISTRY OF HEALTH OF THE AMUR REGION ORDER 31.03.2014 379 Blagoveshchensk On the procedure for providing antiviral drugs In accordance with the order of the Ministry of Health and Social Development of the Russian Federation dated 05.12.2005
~Ministry of Health of the Republic of Bashkortostan (Ministry of Health of the Republic of Belarus) Department of Rospotrebnadzor in the Republic of Bashkortostai ORDER of the city of Ufa on the examination for HIV infection in the Republic of Bashkortostan
1. Natural mechanisms of transmission of nosocomial infections: 2. Artificial mechanisms of transmission of nosocomial infections: 3. Meetings of the commission for the prevention of nosocomial infections are held: 4. Medical workers performing manipulations are examined for hepatitis B:
1 About measures to prevent HIV infection There are more than 60 million HIV-infected people in the world. Cases of HIV infection are detected in all subjects of the Russian Federation. Recently, there has been an increase in the incidence
Organization of measures to prevent occupational HIV infection in medical workforces Kharchenko V.I., Malinovsky A.A. GBUZ "ICB 2 DZM" MHC AIDS Definition: Professional
The epidemic situation of HIV infection in the Republic of Belarus as of September 1, 2016 As of September 1, 2016 21,336 cases of HIV infection were registered in the Republic of Belarus, the number of people
Appendix 1 Reliable protection against hepatitis B Dear parents, know that your children are at risk of contracting hepatitis B if they are not vaccinated. Hepatitis B is a widespread viral disease characterized by
Page 1 of 9 1. Scope The instruction defines the requirements for occupational health and safety at the workplace of employees when working with blood and other biological fluids. 2. Regulatory
HIV infection you need to know about. HIV is further than you think, but closer than you think. The presentation was provided by N.V. Vasilyeva, an AIDS psychologist. HIV infection is a disease caused by a virus
OBUZ of the Ivanovo region "Center for the Prevention and Control of AIDS and Infectious Diseases" SBEI HPE IvGMA of the Ministry of Health of Russia
HIV infection: concept, ways of transmission, prevention. The epidemiological situation of HIV infection in the Volgograd region. Legal aspects of HIV testing. Prevention of occupational HIV infection
HIV Prevention Educational Program Core module: What should everyone know about HIV/AIDS? Definitions HIV: Human Immunodeficiency Virus AIDS: Acquired Immune Deficiency Syndrome
MINISTRY OF HEALTH OF THE AMUR REGION ORDER 03.02.2014 125 Blagoveshchensk On improving measures to prevent perinatal transmission of HIV infection in the Amur Region
Facts about HIV HIV/AIDS is the greatest problem facing the world. Over the past 20 years, the pandemic has claimed the lives of more than 25 million people. Over 40 million currently live with
To health! Newsletter State Institution "Svetlogorsk Zonal Center for Hygiene and Epidemiology" 7-2019 Electronic mailing list Parenteral viral hepatitis. Source of infection, ways
REPUBLICAN AIDS PREVENTION CENTER MINISTRY OF HEALTH, REPUBLIC OF ARMENIA The main directions of prevention of vertical transmission of HIV infection and their effectiveness in Armenia Speaker: Manukyan
Order of the Ministry of Health of Russia dated 16.09.03. N 442 On approval of registration forms for registration of children born to HIV-infected mothers In order to organize monitoring of children born to HIV-infected
INTERNATIONAL SCIENTIFIC AND PRACTICAL CONFERENCE "TOPICAL ISSUES OF PREVENTION OF TRANSMISSION OF HIV FROM MOTHER TO CHILD" Observation of pregnant women with HIV infection. Experience in interagency cooperation
1 HIV, HIV-INFECTION, AIDS. ROUTES OF TRANSMISSION HIV infection is a disease caused by the human immunodeficiency virus (HIV). Once in the body, HIV gradually suppresses the immune system and makes it unable to
HIV / AIDS B- VIRUS I-IMMUNODEFICIENCY H-HUMAN This is a virus that is transmitted from person to person, it gradually destroys its protective (immune) system, making it defenseless against various infections
Evaluation of the results of work on the provision of medical care to women. Evaluation of perinatal prevention of mother-to-child transmission of HIV. Interaction with medical organizations. Video selector protocol
Patient School Session 4.1 Living with HIV Outline Risk factors for HIV transmission Discordant couples, HIV and pregnancy Alternative treatment Healthy lifestyles HIV characteristics Environmentally unstable Does not survive
In case of contact with blood, biological fluids:
- ? on the skin of a medical worker - treat this place with 70% ethyl alcohol, wash with soap and water and re-treat with 70% ethyl alcohol;
- ? on the mucous membranes of the eyes and nose - rinse with plenty of water, do not rub;
- ? in the mouth and throat - rinse with plenty of water and rinse with 70% ethyl alcohol;
- ? in case of injections and cuts - immediately remove gloves, wash hands with soap and water under running water, treat hands with 70% alcohol, lubricate the wound with 5% alcohol solution of iodine. Don't rub! Apply a bactericidal adhesive plaster to the wound, put on sterile gloves (if necessary, continue working);
- ? if blood and other biological fluids of the patient get on the dressing gown, clothes - take off work clothes and immerse them in a disinfectant solution or in a bix (tank) for autoclaving;
- ? on the surface - to disinfect the used material and contaminated surfaces with disinfectants in accordance with the order for viral infection;
- ? start taking antiretroviral drugs as soon as possible for post-exposure prophylaxis of HIV infection.
In a short time after contact, it is necessary to examine for HIV infection and viral hepatitis B and C a person who may be a potential source of infection, and a person who has come into contact with him. Samples of plasma (or serum) of the blood of a person who is a potential source of infection and a contact person are transferred for storage for 12 months. to the AIDS center of the subject of the Russian Federation.
Making an emergency
Established requirements:
I LP O employees must immediately report each emergency to the head of the unit, his deputy or a higher manager;
- ? injuries received by medical workers should be taken into account in each LPO and acted as an accident at work with drawing up an act on an accident at work;
- ? fill in the Register of accidents at work;
- ? it is necessary to conduct an epidemiological investigation of the cause of the injury and establish a connection between the cause of the injury and the performance of the medical worker's duties.
Occupational accident log (HIV prevention)
Infection prevention
- 1. Avoid accidental damage to the skin, injections, cuts, wounds with needles and other piercing and cutting instruments.
- 2. All manipulations with biological materials must be performed in overalls (robe, cap, washable shoes).
- 3. Use personal protective equipment (gloves, shields, respirators, sealed goggles, masks, waterproof apron) in accordance with regulatory and methodological documents and comply with safety regulations, as well as requirements for disinfection, PSO and sterilization, collection, disinfection, temporary storage and transportation of medical waste generated in healthcare facilities.
- 4. Immediately inform the administration about the accident, fill out a journal, involve an infectious disease specialist for consultation, start emergency medical prophylaxis of HIV infection no later than 24 hours after the accident.
- 5. Conduct a confidential laboratory study of the victim with a mandatory examination for markers of viral hepatitis B and C, HIV infection after three, six and 12 months.
- 6. Perform manipulations on patients in the presence of a second specialist, who, in the event of a rupture of gloves or a cut, can continue to perform it.
- 7. Before manipulations, wash hands in a hygienic way with the treatment of the skin of the nail phalanges with a skin alcohol antiseptic before putting on sterile gloves and after removing them.
Frequent use of disinfectants, which can cause irritation and dermatitis, should be avoided, which facilitates the penetration of the pathogen.
- 8. In the work it is desirable to use disposable tools.
- 9. Process instruments in accordance with the Guidelines for disinfection, pre-sterilization cleaning and sterilization of medical supplies, approved by the Ministry of Health of Russia on December 30, 1998 No. MU-287-113.
- 10. You can not wash your hands with brushes.
- 11. Forms of referrals to the laboratory cannot be placed in a test tube, they must be glued to the outside of the test tube before the blood sampling procedure (number tubes and referrals).
- 12. Health workers must be vaccinated against hepatitis B when they are hired.
An emergency situation may occur with an employee during the performance of his immediate duties. What this means for a healthcare worker and how to avoid such unpleasant situations will be discussed in this article.
Circumstances of an emergency
It is no secret that every medical worker daily performs dozens of different manipulations during the implementation process, such as:
- Performing injections;
- Disinfection of instruments;
- Operation of medical devices;
- Medical waste management;
- Accounting, storage and use;
- holding;
- and etc.
When performing the above manipulations, the medical An employee may find himself in completely different emergency situations., for example:
- contamination of the skin and mucous membranes of workers with blood and other biological fluids of patients;
- injections and cuts with piercing and cutting tools;
- scattering (spill) of medical waste of B/C classes;
- destruction of mercury-containing lamps or thermometers ( mercury pollution);
- adverse situations when working with disinfectants (accidental poisoning with a disinfectant, chemical burn, other adverse situations);
- electrical shock or other emergencies when working with medical equipment, such as installations for disinfection/ ;
- electric shock or other emergencies during cleaning activities;
- adverse effects of ozone on healthcare workers;
- destruction of germicidal lamps (mercury contamination);
- adverse effects of radiation on healthcare workers.
It is worth remembering that the occurrence of an emergency does not always lead to an accident at work. In order to distinguish between these concepts, we recommend that you read our article "".
In order to avoid such emergencies, you should follow the rules of work and when performing various activities. The employer should introduce local Instructions into the work of the personnel with a clear algorithm of action in certain situations (for example, Instructions on the rules for handling medical waste, Instructions on the rules for accounting, storage and use of disinfectants, other instructions).
For example, in his Letter No. 44-18-3461 dated October 26, 2006, he ordered his subordinate healthcare institutions to develop in each institution an instruction on labor protection when working with blood and other biological fluids of patients for instructing at the workplace with workers of the “group risk." To this Letter, the Moscow Department of Health attached an exemplary instruction.
The main rules for the work of medical personnel include the following:
- Each medical worker must observe personal hygiene measures (comply with the standard of hand treatment, work using, etc.);
- Medical workers must take precautions when working with piercing, cutting instruments, with needles;
- It must be assumed that each patient is potentially dangerous in relation to infectious diseases;
- When working in offices where medical personnel can come into contact with patients' biological fluids, there should be an "Anti-HIV" first aid kit.
- In emergency situations, carry out emergency prophylaxis;
- At the end of the work, perform the necessary manipulations:
- Place disposable instruments in a puncture-proof container;
- Items to be further used should be placed in containers for processing;
- Treat table surfaces with disinfectants.
A single composition of such a first-aid kit has not been established, but taking into account the data reflected in the above Letter, in Appendix 12 to SanPiN 2.1.3.2630-10 "Sanitary and epidemiological requirements for organizations engaged in medical activities", approved Decree of the Chief State Sanitary Doctor of the Russian Federation of May 18, 2010 No. 58 and taking into account the provisions of SP 3.1.5.2826-10 "Prevention of HIV infection", approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation dated 11.01.2011 No. 1, it can be concluded that the first-aid kit should include the following:
- 70% ethyl alcohol;
- cotton-gauze swabs;
- 5% alcohol solution of iodine;
- bactericidal plaster;
- dressing.
Article 11 Federal Law No. 52-FZ dated March 30, 1999"On the sanitary and epidemiological well-being of the population" legal entities and individual entrepreneurs are required to take preventive measures.
Very often, in the process of work of medical personnel, injections and cuts occur. In order to avoid possible infection, the employee should follow the rules for working with piercing and cutting tools, as well as know and observe safety precautions, which consist in mandatory preventive measures.
Preventive measures are carried out on the basis that each patient is regarded as a potential source of bloodborne infections (hepatitis B, C, HIV and others).
A plan of preventive measures should be drawn up in each medical organization and approved by the head of this organization. Such a requirement is contained in the "Sanitary and epidemiological requirements for organizations engaged in medical activities" (SanPiN 2.1.3.2630-10), approved by the Decree of the Chief State Sanitary Doctor of the Russian Federation of May 18, 2010 No. 58.
There are several basic activities and rules that must be organized in a medical organization and must be observed by employees. Therefore, every medical employee should know and observe:
- Standard for processing the hands of staff and the skin of the patient;
- If necessary, carry out sanitization of the patient in the admissions department of a medical organization;
- Meals for medical personnel should be organized in a separate room, and for patients, if possible, in a separate building;
- At the workplace, all the requirements of sanitary standards must be observed;
- Personnel must be provided with personal protective equipment (more on this in the article "");
- If hands are contaminated, they must be washed and treated with an antiseptic;
- In case of injections and cuts, it is necessary to wash your hands with gloves, remove gloves, squeeze blood out of the wound, wash your hands, treat the wound;
- If necessary, carry out emergency HIV prevention. It must be carried out in accordance with Appendix 12 "Emergency prevention of parenteral viral hepatitis and HIV infection" SanPiN 2.1.3.2630-10, but taking into account the provisions of SP 3.1.5.2826-10 "Prevention of HIV infection", in particular, it is not necessary to use permanganate potassium (potassium permanganate). This is permissible due to the fact that SP 3.1.5.2826-10 was approved eight months later than SanPiN 2.1.3.2630-10 and, therefore, have priority in terms of regulatory force.
For reference: potassium permanganate (potassium permanganate) belongs to the precursors of narcotic drugs and psychotropic substances and is included in Table III of List IV of the list of narcotic drugs, psychotropic substances and their precursors subject to control in the Russian Federation, approved by the Decree of the Government of the Russian Federation of June 30, 1998. No. 681.
- Carry out disinfection measures;
- Conduct prophylactic immunizations.
Subscribe to us
By submitting an application, you agree to the terms of processing and use of personal data.According to the Guidelines “Prevention of infection, including medical workers, with the human immunodeficiency virus at the workplace”, approved by the Ministry of Health and Social Development of Russia on August 6, 2007 No. 5961-РХ, in Russia, the following are most often at occupational risk of contracting HIV:
- Nursing staff - procedural nurses working in hospitals and departments providing care to HIV-infected patients;
- Operating surgeons and operating nurses;
- Obstetrician-gynecologists;
- Pathologists.
In this regard, it is very important for medical personnel to observe all the necessary precautions and implement a whole range of preventive measures, most of which are contained in various regulations, for example, in such as Decree of the Chief State Sanitary Doctor of the Russian Federation dated January 11, 2011 No. 1 “On approval of the joint venture 3.1.5.2826-10 "Prevention of HIV infection" (together with "SP 3.1.5.2826-10. Sanitary and epidemiological rules..."). Equally important will be the excellent knowledge of medical personnel on how to act in a particular emergency situation associated with the risk of contracting HIV infection.
| 1 | 2 |
|---|---|
| Precautionary measures |
|
| Prevention activities |
|
| Actions of a medical worker in an emergency |
Start taking antiretroviral drugs as soon as possible for post-exposure prophylaxis of HIV infection. |
For emergency prevention of the disease, people at risk of contracting HIV infection are prescribed antiretroviral drugs.
Antiretroviral drugs should be started within the first two hours after the accident, but no later than 72 hours.
All medical organizations should be provided with, or have access to, rapid HIV tests and antiretroviral drugs as needed. A stock of antiretroviral drugs should be stored in any medical organization at the choice of the health authorities of the constituent entities of the Russian Federation, but in such a way that examination and treatment can be organized within 2 hours after the emergency. The authorized health facility should identify a specialist responsible for the storage of antiretroviral drugs, a place for their storage with access, including at night and on weekends.
According to the information published in Letter No. 14-1/10/2-2018 of the Ministry of Health of Russia dated March 22, 2013, 65% of medical workers receive microtrauma of the skin every month, but no more than 10% of injuries and emergencies are officially recorded.
It is worth remembering that employees of medical organizations must immediately report each emergency case to the head of the unit, his deputy or a higher manager.
A number of methodological documents, and it is prescribed to conduct mandatory accounting and investigation of emergency situations among medical workers performing, and for each case, an entry should be immediately made in the microtrauma register or in the emergency register.
At the same time, there is no unified form of such journals. However, based on the requirements of SanPiN 2.1.3.2630-10 for information to be registered in such a journal, a medical organization can usually easily develop the form of such a journal on its own.
An emergency can happen to any healthcare worker. But it is always worth remembering that the likelihood of its occurrence can be reduced by unquestioning compliance with the requirements and the execution of all job descriptions.
Normative legal acts:
- Federal Law No. 52-FZ of March 30, 1999 “On the Sanitary and Epidemiological Welfare of the Population”;
- Decree of the Chief State Sanitary Doctor of the Russian Federation dated May 18, 2010 No. 58 on the approval of the “Sanitary and epidemiological requirements for organizations engaged in medical activities” (SanPiN 2.1.3.2630-10);
- Decree of the Chief State Sanitary Doctor of the Russian Federation dated January 11, 2011 No. 1 “On approval of SP 3.1.5.2826-10 “Prevention of HIV infection” (together with “SP 3.1.5.2826-10. Sanitary and epidemiological rules ...”).
(Reason: Sanitary norms and rules "Requirements for the organization and implementation of sanitary and anti-epidemic measures aimed at preventing the occurrence and spread of viral hepatitis", approved by the Decree of the Ministry of Health of the Republic of Belarus of February 6, 2013 No. 11, Clinical Protocol for the WHO European Region, 13 Post-exposure prophylaxis of HIV infection)
First aid after possible exposure to HIV is the action to be taken immediately after exposure. Their goal is to reduce the time of contact with infected biological fluids (including blood) and tissues and to properly treat the contact site, thereby reducing the risk of infection.
Health organization worker on emergency contact to prevent the occurrence and spread of viral hepatitis and HIV infection, the following procedure must be followed:
1. In case of damage to the integrity of the skin when working with biological material:
· wash hands with soap and water under running water and rinse the wound with plenty of water or saline;
hold the wound surface under running water (several minutes or until the bleeding stops) to allow blood to flow freely from the wound;
treat the wound with 3% hydrogen peroxide;
· It is forbidden use strong agents: alcohol, bleaching liquids and iodine, as they can irritate the wound surface and worsen the condition of the wound.
· It is forbidden squeezing or rubbing the damaged area.
· It is forbidden squeeze out blood from the wound left from the injection.
2. In case of contamination of the skin with biological material without violating their integrity:
Wash the contaminated area of the skin with plenty of water and soap and treat with an antiseptic;
· It is forbidden use strong agents: alcohol, bleaching liquids and iodine, as they can irritate the affected surface;
· It is forbidden rub or scrape the contact area.
3. In case of contact with biological material on the mucous membrane:
immediately remove the gloves with the working surface inside and immerse them in a container with a disinfectant solution or place them in a waterproof bag for subsequent disinfection;
Wash hands thoroughly with soap and water under running water and rinse (do not rub) the mucous membranes with plenty of water or saline.
Do not remove contact lenses during rinsing, as they create a protective barrier. After the eye has been washed, remove the contact lenses and process as usual; after that, they are completely safe for further use.
· It is forbidden use soap or disinfectant solution for washing.
4. In case of contamination with biological material of SGS, personal clothing, shoes:
Wash the surface of the gloves without removing them from the hands under running water with soap or a solution of an antiseptic, disinfectant;
Remove contaminated CGS, personal clothing, shoes;
· Place protective clothing, personal clothing and shoes in waterproof bags for subsequent disinfection;
remove protective gloves with a working surface inside and immerse them in a container with a disinfectant solution or place them in a waterproof bag for subsequent disinfection;
wash hands with soap and running water, after which the skin in the area of the projection of contamination of the CGS, personal clothing, shoes should be washed with plenty of water and soap and treated with an antiseptic.
5. In case of contamination of environmental objects with biological material biological contaminants on the surface of environmental objects are disinfected with a disinfectant solution and removed from the surface, followed by wet cleaning.
30. Actions when biological material gets on the floor, walls, furniture
.*if infected material gets on the floor, walls, furniture:
The contaminated area is disinfected with a disinfectant solution:
With a small amount - by 2-fold wiping with a rag moistened with a disinfectant solution
In case of abundant - remove excess moisture with a dry rag, then 2 times with a disinfectant solution
Contaminated rags - into a container with a disinfectant solution, then dispose of / into a container for medical waste group B (yellow bag)
31.HIV infection: concept, transmission routes, sources. Seroconversion window.
*HIV infection. AIDS, ways of infection, sources. "seroconversion window":
HIV- an infectious process in the human body caused by the human immunodeficiency virus (HIV), characterized by a slow course, a deep damage to the immune system (cellular immunity), the subsequent development against this background of opportunistic infections and neoplasms, leading to death.
AIDS- the terminal phase of HIV infection, which occurs in most cases after a very long period from the moment of infection with the virus.
Blood, semen and vaginal secretions represent the greatest epidemic danger.
Ways of infection:
-Natural:
1.Vertical:
Hematogenous-transplacental (through the mother's blood);
Intranatal (during childbirth through the mother's blood or vaginal secretions)
2. Contact-hemocontact:
Sexual contact (through blood, semen, vaginal secretion);
Direct contact with damaged skin or mucous membranes;
Household parenteral infection (mediated contact through common shaving, manicure devices, combs, toothbrushes, other items, the use of which is associated with damage to the skin or mucous membranes).
-Artificial (artificial) - parenteral manipulations:
In case of medical intervention (blood transfusion, transplantation, endoscopic examinations and other medical manipulations with violation of the integrity of the skin and mucous membranes)
Non-medical procedures (injecting drug use, tattoos, cosmetic procedures, etc.)
Sources: An HIV-infected person at any stage of the disease.
"Sero Conversion Window": the period when the virus is already present in the blood, but antibodies have not yet developed (the result of ELISA for HIV is negative). This period in HIV-infected people can be from 2 weeks to 3-5 months - all this time a person is contagious.
32.HIV infection: infectious dose, risks of infection. Features of the epidemic process in Minsk in recent years.
*Conditions of HIV transmission, concept of infectious dose, risks of HIV infection
For transmission to occur, HIV must be in the body fluids of the person with whom the contact has occurred;
Not all body fluids contain sufficient amounts of HIV to infect (blood, semen, and vaginal secretions represent the greatest epidemic danger);
For infection, HIV must get to the right place (into the bloodstream, mucous, damaged skin) and in the right amount.
Risk of infection with professional contact depends on contact forms and quantities of hazardous material(calculated per 10,000 contacts with an HIV source in %):
When injured sharp tool The risk of infection is on average about - 0,23%;
The risk of infection from percutaneous needle prick0,3% (3 per 1,000);
Risk of infection by contact with mucous averages around - 0,09% (9 per 10,000);
The risk of infection with blood transfusion-92,5% ;
When using shared needles and syringes for injection drugs - 0,8% .
Factors that increase the risk of infection:
Deep (intramuscular) infection;
A contaminated instrument enters a blood vessel;
Wound with a hollow needle;
A high level of viral load in the patient - the source of infection.
!!! infectious dose:
HIV - about 10,000 viral particles (visible blood drop - 0.05 ml)
Hepatitis C about 1000 viral particles (in 0.005 ml of blood)
Hepatitis B - about 100 viral particles (in 0.0005 ml of blood)
Hepatitis B infectivity 100 times higher than HIV.
-The risk of infection when stabbed with an infected needle:
For the virus hepatitis B is 30% ,
For hepatitis C -3% ,
For HIV 0,3%
*Indications for medical examination for HIV
For the list of contingents, see the presentation "HIV infection" or Appendix 2 to the order of the head physician of the ME "GK BSMP" No. 266 dated 08.05.2015. on HIV infection.
33. Algorithm of actions in the detection of pediculosis.
* When pediculosis is detected in a patient , the following requirements must be met:
The medical worker must put on an additional set of CGS (gown, oilcloth apron, cap) and PPE (gloves, mask);
An anti-pediculosis treatment of a patient, a hospitalized person should be carried out using means and materials of anti-pediculosis styling;
The clothes of the patient, the hospitalized person must be removed, placed in an oilcloth bag, irrigated with a pediculicide and immediately sent for chamber disinsection;
Disinsection of the premises and furnishings should be carried out by spraying with an aqueous solution of pediculicide from a sprayer. After exposure, pediculicide residues must be removed from treated objects and surfaces by wet cleaning. The room after disinfection should be thoroughly ventilated.
34. A patient with suspected acute intestinal infection (AII) was identified in the department. Your actions?
35. Prevention of acute intestinal infections (AII) in the department.
36. A patient with suspected viral hepatitis A has been identified in the department. What are your actions?
37. A patient with suspected tuberculosis has been identified in the department. Your actions?
38. A patient with suspected measles has been identified in the department. Your actions?
39. Disinfection of reusable medical devices.
* Disinfection of multi-use medical devices:
Disinfection using chemicals is carried out by immersing products in a solution immediately after use, preventing them from drying. Detachable products are disinfected in disassembled form. The channels and cavities of the products are filled with a disinfectant solution.
Stages: 1 - washing in a disinfectant solution (container No. 1)
2 - soaking-exposure, time set by the instruction (container No. 2)
3 - laundering of the remaining contaminants by mechanical means (ruffs, brushes, napkins)
4 - rinsing with running tap water
5 - drying
40. Pre-sterilization treatment. Purpose, methodology, quality control of PSO.
*Pre-sterilization treatment. Purpose, methodology. Quality control:
Target- removal of protein, fat and mechanical impurities, drug residues.
Methodology: 1 - soaking in a washing (disinfecting with a washing effect - disinfection combined with PSO) solution at full immersion, filling the channels and cavities (concentration, temperature, exposure according to the instructions for using the product), 2 - washing each product in the same solution (with a brush , swab, napkin, channels - with a syringe) time: 0.5 - 1 min; 3 – rinsing with drinking running water (time is not standardized) 4 – rinsing with distilled water 0.5 min; 5 - drying with hot air until the moisture disappears completely; 6 - control.
Solutions of means for PSO can be used repeatedly until signs of contamination appear, but no more than the time regulated according to the instructions.
JI quality control: the quality of PSO is assessed by setting up an azopyram test (for the presence of a residual amount of blood). Control in the CSO - daily 1% of each item (but not less than 3 units). *Method of setting a sample (azopyram) for quality control of pre-sterilization cleaning. Terms and conditions of storage of reagents, accounting of the results of formulation.
The product is wiped with a gauze cloth moistened with a reagent or 2-3 drops are dripped from a pipette; a reagent is injected into hollow products with a syringe or pipette, left for 1 minute, then poured onto a napkin.
Timing: the stock solution of azopyram in a tightly closed vial is stored in the dark, in the refrigerator - up to 2 months; at room temperature - no more than 1 month (moderate yellowing without sediment is acceptable). The azopyram reagent is prepared immediately before the test by mixing equal parts of the initial solution of azopyram and 3% hydrogen peroxide (store no more than 2 hours, at a temperature above 25 ° - no more than 30-40 minutes).
Definition of suitability azopyram reagent: 2-3 drops of the reagent are applied to the blood stain, if not later than 1 min. a violet color appears, which then turns into a lilac color, the reagent is suitable for use; if staining does not occur, do not use.
Accounting for results azopyramic test setting: if the test is positive, immediately or no later than 1 min. first appears violet, quickly turning into pink-lilac or brownish staining of the reagent (brownish in the presence of rust). Staining that occurs after 1 minute is not taken into account.
The results of the control are reflected in the journal in the form No. 366 / y.
Azopyram, in addition to hemoglobin, detects the presence of residual amounts on products:
Peroxidases of plant origin (plant residues);
Oxidizing agents (chloramine, bleach, washing powder with bleach, chromium mixture for processing dishes, etc.);
Rust (oxides and salts of iron);
In the presence of rust and the indicated oxidizing agents on the test items, a brown staining of the reagent is observed, in other cases, a pink-lilac coloration occurs.
41. Methods of sterilization. Types of sterile packages. Terms and conditions of storage of sterile products. Sterilization control methods.
* Sterilization methods. Types of sterile packages. Shelf life. Control methods:
Sterilization is carried out by physical (steam, air methods, in the environment of heated balls - glasperlenic) and chemical (use of chemical solutions, gas) methods.
Types of packaging: Air method - wet-strength bag paper, high-strength packaging paper (kraft packaging), sterilization packaging materials from ZM (USA) or without packaging in open trays. Steam method - a sterilization box with or without a filter, double soft calico packaging, parchment, unimpregnated bag paper, high-strength packaging paper, crepe paper, packaging materials from ZM (USA).
!!! On packages with sterilized products, there should be information about the date of sterilization, on sterilization boxes - about the dates of sterilization and opening, as well as the signature of the health worker.
Preservation period sterility of products sterilized in sealed paper packaging or SC with a filter - 20 days, and in any non-hermetic package and SC without a filter - 3 days. Products sterilized without packaging are placed on a "sterile table" and used during one work shift.
Multiplicity of use of kraft paper - up to 3 times (taking into account the integrity).
Specific types of foreign single-use packaging materials recommended for steam sterilization, as well as the corresponding terms for maintaining the sterility of products in them, are indicated in the methodological documents for the use of packages from these companies.
Sterilization control methods. Sterility control:
Sterilization control involves checking the parameters of sterilization modes and evaluating its effectiveness. The control of sterilization modes is carried out by 1-physical (using measuring instruments: thermometers, pressure gauges, etc.), 2-chemical (using chemical indicators), 3-bacteriological (using spore test cultures) methods. The control results are recorded in the log form No. 257/y.
Sterility control - physical and chemical - at each loading of sterilizers; bacteriological at least once a month.
42. Steam sterilization method: modes; products subject to steam sterilization; control. Rules for packing in sterilization boxes. Rules for transporting sterilization boxes after sterilization.
* Steam sterilization method: modes, products subject to steam sterilization method, control:
The sterilizing agent is saturated water steam under excess pressure and a temperature of 110-135 ° in steam sterilizers (autoclaves).
The steam method sterilizes general surgical and special instruments, devices made of corrosion-resistant metals, glass, surgical linen, dressings and sutures, rubber, latex, and certain types of plastics.
Modes:basic: 132 ° - 2 atm - 20 min; sparing: 120 ° - 1.1 atm - 45 minutes.
Control sterilization involves checking the parameters of sterilization modes and evaluating its effectiveness. The control of sterilization modes is carried out by 1-physical (using measuring instruments: thermometers, pressure-vacuum meters, etc.), 2-chemical (using chemical indicators), 3-bacteriological (using spore forms of test cultures) methods. The results of the control are recorded in the journal in the form No. 257 / y.
Rules for packing in sterilization boxes:
Surgical linen, dressings are laid parallel to the movement of steam. Sprinkle gloves with talcum powder, lay with gauze or paper, wrap each pair separately. The suture material in the form of braids, coils or is wound on glass rods, coils, wrapped in packaging material for one operation, signing the type and number. The loading density is about 75%.
Rules for transporting sterilization boxes after sterilization:
On a clean gurney, treated with a disinfectant solution, covered with a clean sheet and covered with a clean sheet on top or in a bag signed "for transporting sterile bix".
*Application of air and steam disinfection methods:
Air disinfection carry out products made of glass, metals, silicone rubber and carry out in the open on the shelves of an air sterilizer. This method can only disinfect products that are not contaminated with organic substances (because they stick to the surface of the products). Mode: temperature-120°; time - 45 minutes.
Steam disinfection method products made of glass, metals, rubber, latex, heat-resistant polymeric materials. Preliminary cleaning of products is not required. Disinfection is carried out by the action of saturated water steam under excess pressure in sterilization boxes. Mode: 110°; 0.5 atm; 20 minutes.
43. Air sterilization method: modes; products to be sterilized, control. Rules for loading air sterilizers.
* Air sterilization method: modes, products to be sterilized, control: The sterilizing agent is dry hot air 160 and 180°, sterilization is carried out in air sterilizers.
This method sterilizes: surgical, gynecological, dental instruments, including those made of corrosion-resistant metals, needles, silicone rubber products.
Before air sterilization, the products after pre-sterilization cleaning must be dried in an oven at a temperature of 85 C until visible moisture disappears.
Modes: 1) 180° - 1 hour; 2) 160° - 2.5 hours.
Control: physical (thermometer, timer); chemical (test indicators); bacteriological (spore test cultures).