V. Reference basis of actions

The graph of conducting of the moist cleaning up:

• Carry the moist cleaning up of apartments (washing of floor, wiping of furniture, equipment out) out not rarer than two times per days with the use of washing and disinfectant facilities.

• Wiping of window-pane – not rarer than one time in a month.

• The general cleaning up of chamber section is conducted not rarer than one time in a month with the careful washing of walls, floor, equipment, by wiping of furniture.

• General cleaning (washing and disinfection) up of operating block, bandaging conduct not rarer than one time in a week. In addition in them the final moist cleaning up is conducted.

• The apartment with the special mode of sterility after cleaning up is exposed to the rays by stationary or movable bactericidal lamps.

Methodical pointing in relation to the change of the linen worn next to the skin.

• The beds worn next to the skin are changed in 7-10 days one time, at once after hygienical bath, or as far as a necessity, after contamination.

• A sister-hostess is responsible for the change of linen.

• It must wash all clothes, wet from sweat, drying is not recommended.

• Each time at replacement of linen watch that a sheet and shirt was well straightened, that rough folds which interfere with quiet sleep of patients did not appear, and at seriously sicking quite often are instrumental in formation of bedsores.

• Linen muddy by a blood or other excretions it is necessary to displace by a muddy surface vovnutr and transport in dense oilskin sacks in laundry. Sort linen in chambers is banned.

• Changing clothes of patients with the damaged overhead extremities – undressing begin with a healthy hand, and dressing – with a patient, the same touches lower extremities.

Methodical pointing in relation to the change of bed linen.

• Cover the bed of patient thus – over a net lay a mattress. A clean sheet the edges of which must be driven in on all length under a mattress is covered from above, for warning of formation of folds.

• For seriously sicking with incontinence of urine, excrement, if there is the no special bed, with the purpose of prevention of contamination of mattress an oilcloth is laid, fastening her or tucking in under a mattress. It can abed an oilcloth on a sheet, covering her by a diaper.

• Under a head two pillows are laid: lower from feathers, and overhead – from a fuzz. On every pillow a pillow-case is put separately. Pillows logit follows so that the lower lay straight and some came forward above overhead, and the overhead abutted against the back of bed.

• To the patient a blanket is given with a blanket cover slip, which must be cotton or woolen.

• A sick-bed must be clean, covered without folds and scars, to remake her it is needed twice in a day – in the morning and in the evening.

• Every morning shake the linen worn and bed next to the skin out and ventilate, a mattress on this time is not covered, that he got some fresh air also.

• At the change of bed linen seriously sick it is needed to show a large carefulness, not to inflict him additional pain and suffering.

• Replacement of sheet at cot cases is carried out, beginning rolling up on length to the middle, levitating a pelvis and taking away sheet, put an at this time convolute sheet under the pelvis of patient and open out him from middle to the edges. A patient is turned on a side, a sheet is displaced from one side, at once spread clean, a patient is returned on a clean sheet, take away dirty and spread clean to the end. A clean sheet is displaced on length, the feet of patient are levitated, twist up a dirty sheet and simultaneously untwist clean, the pelvis of patient is levitated, take away dirty and lay clean, the trunk of patient is levitated, take away a dirty sheet and to the end spread clean.

Help to the patient during the change of the linen worn next to the skin.

To heave up a bit a head and shoulders of patient which is found abed in position “lying on back”. To take the edge of dirty shirt and by easy motions to pull up her behind to the back of head, and at the front – to the breast. To take off a dirty shirt through a head. Carefully to lay a head and shoulders of patient on a pillow, to help a patient to heave up both hands and work hands free from a shirt. To place a dirty shirt in a sack for dirty linen. To conduct partial sanitary treatment to the patient. To dress a patient in a reverse order: at first – sleeves of shirt, and then shirt through a head. By careful motions to draw on a shirt on the back and breast, carefully to straighten the folds of shirt. To help a patient to acquire comfortable position in a bed, to conceal a patient by a blanket.

Observance of the sanitary-antiepidemic mode at the change of linen.

At contamination of linen it follows to change by the biological liquids of him. Dirty bed and worn next to the skin linen is placed in a waterproof sack (linen muddy by biological liquids displace by contamination entad). In a chamber categorically it is banned to give dirty linen up on the floor or in a capacity which is not closed by a lid. String a sack and take in the special separate room intended for sorting of linen. After the extract or death of patient mattress, blanket, a pillow is handed over in a disinfection chamber for conducting of disinfection. The hygienical cleaning up of chamber is conducted with the use of disinfectant solution. In a room for sorting –sort dirty linen, to lay down him in waterproof sacks. To string sacks and send in laundry on katalke. To conduct the hygienical cleaning up of apartment of sorting room with the use of disinfection solution.

Technique of thermometry. Before measuring of temperature of body a axillary cavity preliminary dry is wiped, a patient must densely pin a shoulder against a thorax.

During conducting of thermometry in a line to the bowel of patient turns to one side, a thermometer, preliminary smeared by vaseline, is brought into the road clearance of rectum on a depth by 2-3 sm. in those case, when a temperature is measured in an oral cavity, a thermometer is placed under a language.

Duration of measuring of temperature makes 10 mines. After measuring of temperature thermometers are wiped by disinfectant solution. Thermometers are kept in the special jar or glass, on the bottom of who lay the layer of cotton wool and pour on ⅓ or on ½ volume disinfectant solution, for example a 0,2% solution of dezaktin.

Injections. Applied for the injection syringes and needles must be necessarily sterile. Before to collect in a syringe the medicine from a small bottle or ampoule, it is necessary to check up his name and make sure in the fitness of preparation. The neck of ampoule or hubcap of small bottle is wiped by an alcohol, an ampoule is unsealed, whereupon by a separate needle its content is collected in a syringe, after take this needle off, put on other by which and conduct the injection.

Technique of implementation of intradermic injection. It is necessary, that the needle (it is desirable short)entered almost parallel to the surface of skin by a cut upwards was included in a skin on a small depth (before disappearance of its road clearance), whereupon enter 0,1 ml (an insulin syringe is used) at raising of tests on bearable of preparation or anymore during conducting of local anaesthesia. At the correct technique of implementation in place of intradermic injection there is a tubercle as a "lemon crust".

Technique of implementation of hypodermic injection. After careful thrice-repeated treatment of skin by wadding marbles with an alcohol by the left hand form a skin fold, and by a right hand the prepared syringe is taken, whereupon in foundation of triangle turning out enter a needle approximately on ⅓ its lengths. After the puncture of skin shift a syringe in the left hand and slowly enter his content. A needle is quickly extracted then, and again wipe the place of prick by an alcohol and pin by a wadding marble.

Technique of implementation of intramuscular injection. At implementation of intramuscular injections a syringe with a needle long 8-10 sm with a wide road clearance is disposed athwart by the surfaces of skin and entered 7-8 sm on a depth. Right before introduction of medicinal matter it is necessary slightly to draw aside on itself the piston of syringe, to make sure, that a needle did not get in a blood vessel.

Technique of implementation of intravenous injection. For the intravenous injections more frequent all are used by the veins of elbow bend, superficial veins of forearm and brushes, sometimes — veins of lower extremities.

During conducting of venopunction under the elbow of prolate hand of patient a small oilskin pillow is placed, that the hand of patient was found in position of the maximal unbending. Higher than place of supposed punction a plait is laid on, thus with such force, that veins turned out nip only, and bloodstream in an artery was saved. For the increase of filling of vein to the patient suggest once or twice to squeeze and unclasp a brush. Skin covers in the place of injection are carefully processed by an alcohol. By the fingers of the left hand expediently some to draw on the skin of elbow bend, that enables to fix to venu and diminishes its mobility. Vein punction is usually conducted in two receptions, in the beginning pricking a skin, and then vein. At the well developed veins the puncture of skin covers and wall of vein can be produced one moment. The rightness of hit of needle in a vein is determined on appearance from the needle of drops of blood. If a needle is already connected with a syringe, for the control of its position it is necessary some to pull at a piston on itself: appearance of blood in a syringe will confirm correct position of needle. After it dismiss an imposed before plait and slowly bring the medicinal matter into a vein. After extraction of needle and second treatment of skin covers by an alcohol pin the place of injection by a sterile wadding tampon or lay on on him on 1-2 mines pressing bandage.