HEALTH NOTES

Taranaki Daily News, 16 July 1929, Page 12

HEALTH NOTES

HOME ISOLATION. INFECTIOUS DISEASES. (Contributed by Department of Health.) For those in charge of infectious disease nursed at home the following is issued for their guidance. The room for the patient’s use should be sunny, well ventilated, and free from unnecessary furniture, curtains, mats, etc. It should, if possible, be near the bathroom and lavatory, and if feasible these should be given up for the patient’s use. If the bathroom is not available, then washing facilities (at least two basins) should be provided in the room. A covered pail, a good nail brush, and a piece of plain soap should be provided. The nail brush, when not in use, should be placed in .a dish and covered with some weak antiseptic solution. (See later). The room should be kept clear, and a system of moist sweeping and dusting should be instituted. A plentiful supply of old linen should be provided. This can be used instead of handkerchiefs, and can be burnt when used. If handkerchiefs are used they should be soaked in antiseptic (see later) before being removed from the room.

NURSE OR ATTENDANT. If possible a trained nurse should be engaged, otherwise one member of the family should be exclusively detailed for nursing duties. The nurse should wear washable clothing with elbowlength sleeves, and an over all, head covering, and pair of slippers provided. The overall should be kept hanging up just inside the room door, and should be put on whenever the nurse enters the room and taken off whenever she leaves. The same applies to the head covering and slippers. The overall should extend from the neck to the ankles, and the sleeves should reach to the elbows, where they should be close-fitting. The chief duty of the nurse, apart from the attention required by the patient, is to so carry out her isolation procedure that the danger of the other members of the family acquiring infecion is removed. The following will indicate the main points of these requirements; Attention to hands.—The importance of adequate hand-scrubbing cannot be over-estimated. Before removing her gown, and after attending in any way to the patient, the hands and forearms should be carefully and thoroughly scrubbed. The hands should be scrubbed for at least two minutes. If the gown is to be removed, then they should be scrubbed for one minute, the gown removed and hung up, and then the handwashing completed. The water should be immediately emptied into the covered pail and fresh water placed in the basin. The hands and forearms should then be thoroughly rinsed for one minute in an antiseptic solution (see later) which is kept in the other basin. For wiping the hands, paper towels, which are obtainable everywhere, should be used. After use these towels should be placed in a covered pail oi’ into a paper bag which is pinned on to the wall. This bag when full can be removed with its contents and burned. No cloth towels should be used a second time without being washed. The hands should be washed each time the attendant leaves the room to visit other parts of the house. Anyone else who enters the room should also wash their hands before leaving. Special cars should be given to the hands if at any time they become soiled with excretions. Dishes. —The patient’s dishes should be immediately taken to the kitchen and placed in a pan of water and boiled. A special pan should be kept for the purpose, so that the attendant may bring out infected dishes and put them into the pan at once. The attendant or nurse must do nothing else about the kitchen until her hands are washed. The patient’s try should be kept in the bedroom all the time. If desired, the patient’s dishes may be kept separate. In this case they should be washed and stored apart from other dishes. Soiled clothing. —All soiled clothing should immediately be placed in a basket or galvanised iron receptacle or bag set aside for the purpose, and kept in the patient’s bedroom. The basket of clothes should be brought out. and the clothes immediately sterilised either by boiling or soaking in antiseptic solution for one hour. If no basket is available the soiled clothes should be wrapped in a clean sheet before removal from patient’s room. When emptied the basket or other receptacle should be immediately returned to the isolation room.

Disposal of excreta and refuse. Where there is water-carriage sewerage system, excreta can be emptied directly in the lavatory. Great care must be exercised to see that the seat is not splashed, and, except in diseases like typhoid fever, dysentery, etc., the excreta may be emptied into the ordinary privy.

FURTHER PRECAUTIONS. In diseases like typhoid fever, an equal quantity of 1 in 20 carbolic, or chloride of lime, should be added and all masses broken down, and the whole allowed to stand for one hour. The excreta can then be emptied down a water lavatory or buried so that not more than six to twelve inches of soil covers them. The bedpan or chamber should be cleansed and “scalded” after each use. All scraps of food, soiled paper, etc., should be immediately disposed of by burning. A paper bag pinned on to the wall will be found useful for depositing such things as linen soiled with sputa, etc. The bag and contents can then be removed and the whole burned. It is very important that all discharges of the nose and throat be disposed of at once. In cases of scarlet fever, diphtheria, measles, particular care

must be taken in the disposal of discharges from nose and throat. The attendant need not be strictly confined to the room if she is careful in her technique. Regular exercise in the open air is necessary for her own protection. Care should be taken not to inhale the patient’s breath, or allow him to cough in one’s face. No article of food that has been in the sick room should be eaten by others, and anytliiiur that is removed from the sick room must be regarded as infected and treated as such.

Books and toys. —Only such books as can be burned should be used in the sick room, and the toys should be of such a kind that they can be readily and completely sterilised, otherwise they should be burned.

Visitors. —As a rule visitors should not be permitted, but if necessity demands that persons other than the nurse should enter the room, then they should wear a gown and take the usual precautions about washing the hands. Release from isolation. —The patient should have a complete hot bath, using plenty of soap and water, and fresh clothing should be put on. All dishes and utensils should be boiled; all blankets should be soaked in disinfectant and then washed. All boilable clothing should be boiled. Articles like eiderdown quilt should be exposed to direct sunshine for at least six hours. Toilet articles, hot waterbottles, and other rubber goods which might be injured by antiseptics should be washed with soap and water and put out in the sun and air. As one of the objects of the technique outlined above has been to destroy infection as it arises during the course of the disease, the necessity of a terminal fumigation of the room largely disappears if the technique has been thoroughly cairied out.

The room and furniture should be thoroughly washed, and if possible scrubbed, and all windows opened so that the room gets a good airing. It is as well to air the room for two days before it is again used, and carpets, mattresses, pillows, etc., should be well “sunned” and aired.

Children who have just recovered from certain infectious diseases, such as scarlet fever, diphtheria, sometimes carry the germs in their noses and throats, so that for two or three weeks after release from quarantine the child should sleep by itself and certainly should not sleep with other children. If the other children have been sent away from home during the course of the illness, it is advisable not to let. them return home until a week has elapsed after quarantine has been lifted. The following antiseptic solutions are recommended: Lysol.—One teaspoonful to pint of 'water —for keeping nail brush in, washing hands in, soaking linen in, etc. Carbolic acid. —One part in 20 of water, for disinfecting excreta, washing over bedsteads, wire mattresses, etc. Chloride of lime. —For disinfecting excreta. Formaline.—Half pint to about 4 gallons of water—for fumigation by spraying, disinfection of excreta, soaking blankets, linen, etc. Formaline has the advantage of not being harmful to most articles.