HEALTH NOTE

Evening Post, Volume CVIII, Issue 6, 6 July 1929, Page 17

HEALTH NOTE

HOME ISOLATION

INFECTIOUS DISEASES

(Contributed by the 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 bo sunny, well ventilated, and free from unnecessary furniture, curtains, mats, etc. It should, if .possible, bo 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 usei 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 hnen.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 overall, 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 reach1 to the ..elbows,- where they should b& 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 infe'e- ; tion is removed. The following' will indicate the main points of these requirements: ■ '■■'■ ■■■... Attention to Hands.—The importance of adequate hand-scrubbing' cannot bo over-estimated. Before . removing her gown, and after attending in any way to the patient, the hand's 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 re--noved and hung up, and then the handwashing completed. The water should be immediately 'emptied into the covered pail and fresh water'placed in 1 the basin. The hands and ■ forearms should then bo' 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 every- ; where, should be used. After use these towels should be placed in a coy- ; ered pail or 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 shonia 'be used a second time without being ; washed. The hands should be washed , each time, the attendant leaves the p room to visit other parts^of the house. , Anyone else who enters the room should ! n!so wash their.:bands before" "leaving. Special care should be given to the hands if at any time they become soiled with .excretions; ■ • ■ • : Dishes.—The patient's dishes should !bo 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 at- , tondant or nurse must do nothing else . about the kitchen until their hands are washed. The patient's tray 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 sctasido for the purpose, and kept in the patient's bedroom. The basket of clothes should be brought out and tho clothes immediately sterilised cither by boiling or soaking in antiseptic solution for one hour. If no'basket is available tho soiled clothes should be wrapped in a clean sheet before removal from patient's room. • When emptied tho basket or other receptacle should. bo immediately returned to the isolation, room. .- . -■'-.■ Disposal of Excreta and Refuse.—,, Where there-is water:carriago sewerage system, excreta can bo emptied directly in the lavatory. Great care must be exercised to see that the scat : 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 ot 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 'ibe 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 bo 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, i The attendant need no' be strictly confined to tlie room if slic, 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 .anything that is removed from the sick room must bo regarded as infected and treated, as such. .- : Books ana Toys.—Only such books as can be burned should be used in the sick room, and the toys should bo 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 usnal precautions about washing the hands. Releaso 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. AH 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 ah-. ' As one of the objects of the technique outlined above has been-to destroy infection as it arises during the course of the disease, tho necessity of a terminal fumigation of the room largely disappears if the technique has been- thoroughly carried out.' • ■ . The room and furniture should be. thoroughly washed, , and if possible scrubbed, and air 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, diphthei-ik, 'sometimes carry the germs in their hoses 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 theother children T haye been sent away from home .during the course of the illness, it is, advisable 'not to let them return home until1 a 'week has elapsed after quarantine'has been lifted. ■ ■•.-' ■•■■'..■-: The following antiseptic, solutions are recommended: ' "-:' Lysol—One teaspoqnful to ,;pint of water—for keeping nail brusli in, Vrashin o hands in, 'oaking linen in,-etc; ■ Carbolic Acid—l part in: 20 ;6f water, for disinfecting excreta, washing--over bedsteads, wire mattresses,.' etc.",'•-.-•■ ; Chloride of Lime—For-, disinfecting excreta. •':.-. ■■ : ■- . ;'■ Formaline—J-pint to about.* 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. ;-..-. - - ■