Put on and change sterile gloves. Rules for putting on sterile gloves

Target: prevent the spread of microorganisms, ensure infectious safety.

Equipment:

Packing with sterile gloves;

Sterile tweezers;

Antiseptic;

Individual napkin (towel);

Sterile tray.

The nurse washes her hands, dries, and treats with a skin aniseptic.

He takes out a package of gloves with tweezers from the bix, puts it in a sterile tray or on the table.

Opens the package with his hands.

Takes the glove by the lapel of the left hand like that so that your fingers do not touch the inside of the lapel.

He inserts the closed fingers of his right hand into the glove and pulls it over his fingers without breaking the lapel.

Brings under the lapel of the left glove the 2nd, 3rd and 4th fingers of the right hand, dressed in a glove, so that the 1st finger of the right hand is directed towards the 1st finger on the left glove.

Holds the left glove upright with the fingers of the right hand.

Introduces left hand into a glove, closing his fingers, he pulls it on.

Straightens the lapel first on the left glove, pulling it over the sleeve.

Then, with the 2nd and 3rd fingers of the left hand, he brings under the tucked edges of the right glove and straightens the lapel onto the sleeve of the robe.

10. Rules for removing gloves

Target: ensure infection control.

Equipment:

A container with a disinfectant solution;

Individual towel (napkin);

Softening cream.

Execution sequence:

With the fingers of your right hand in a glove, make a lapel on the left glove, touching it only with outer side.

With the fingers of your left hand, make a lapel on the right glove, also touching it only from the outside.

Remove the glove from your left hand by turning it inside out and holding the lapel.

Hold the glove removed from your left hand in your right hand.

With your left hand, take the glove on your right hand by the lapel from the inside and remove the glove from your right hand, turning it inside out.

Place both gloves (the left one was inside the right one) in a container with a disinfectant solution.

Wash hands, dry.

Treat your hands with a softening cream to prevent cracks.

11. Laying the material in the bix for sterilization

Equipment:

Dressing;

Latex gloves;

Towels, diaper;

Clean rags;

Antiseptic;

Sterility indicators at 120°C, 132°C.

Execution sequence:

Wash the hands.

Put on a mask, gloves, treat them with alcohol.

Prepare the bix: wipe the inner surface of the bix and the lid with a rag moistened with an antiseptic solution twice, with an interval of 15 minutes.

Remove gloves, wash hands.

Cover the bix with a diaper.

Put a sterility indicator on the bottom of the bix.

Lay the material to be sterilized loosely, in layers, and the dressing material - in sectors.

Insert the sterility indicator into the middle layer again.

Fold the edges of the diaper inside.

Put the third indicator of sterility on top.

Close the bix lid.

Open the side openings and block the belt.

Attach a marked tag (“cotton balls”, etc.) to the handle of the bix.

Send the bix to the CSO for sterilization in an autoclave.

Stavropol 2013

1st semester

INFECTIOUS SAFETY.

INFECTION CONTROL

HAND DECONTAMINATION LEVELS

HAND WASHING TECHNIQUE

Equipment: water, liquid soap, disposable towel or napkin

To achieve a hygienic level, hands are treated with an antiseptic in the same sequence, at least 2 minutes.

PUTTING ON STERILE GLOVES

Indications: performing invasive manipulations, with possible contact with biological fluid.

Contraindications: allergic reaction to latex.

Equipment: running water, soap with a dispenser, sterile wipes, antiseptic, sterile gloves, class A and B waste.

Sequencing: TREAT HANDS AT A HYGIENIC LEVEL

Unfold the printed packaging

1. Take the right glove by the lapel with your left hand so that your fingers do not touch the outer surface of the gloves
2. Close the fingers of the right hand and insert them into the glove. Open your fingers and pull the glove over them without breaking the lapel
3. Insert fingers 2,3,4 and 5 of the right hand under the lapel of the left glove so that the 1st finger of the right hand is directed towards the 1st finger on the left glove
4. Hold the left glove 2,3, and the 4th fingers of the right hand vertically. Close the fingers of the left hand and insert into the glove.
5. Straighten the lapel on the left glove, then on the right with 2 and 3 fingers, bringing them under the lapel

REMOVING GLOVES

1. With the fingers of the right hand in a glove, make a lapel on the left glove, touching it only from the outside
2. With the fingers of the left hand, make a lapel on the right glove, touching it only from the outside
3. Remove the glove from the left hand, turning it inside out and holding the lapel
4. Hold the left glove in the palm of the right hand
5. With your left hand, take the glove on your right hand by the lapel on the inside and remove the glove, turning it inside out, the left glove should be inside the right
6. Place both gloves in a container with disinfectant. TREAT HANDS AT A HYGIENIC LEVEL

ORDER No. 408

From 17.07.1989

"On measures to reduce the incidence of viral hepatitis in the country"

Ø Viral hepatitis is a group of infectious diseases with a primary lesion of the liver, occurring with severe intoxication, jaundice, hemorrhages.

Ø There are hepatitis A, B, C, D, E.

Ø Hepatitis A, E is transmitted by water, food, contact and household routes, the incubation period is 7-35 days, mainly children, adults in areas with impaired water supply (Central Asia) are ill, the last 7-10 days of the incubation period are most contagious.

Ø Hepatitis B, C, D is transmitted with blood, sexually, transplacentally, the incubation period is 6 weeks - 6 months, mainly health workers who are in contact with Hbs carriers, drug addicts, prostitutes, patients with mass blood transfusions, are most contagious 2-8 weeks before manifestations of the disease.

Ø Stages of disinfection for hepatitis - current and final.

1. Excretions of a patient with hepatitis A and E should be covered with dry bleach on

60 minutes at the rate of 1:5, with hepatitis B and C - for 90 minutes.

2. Dishes of patients after use, immerse in a 1% solution of chloramine

for 60 minutes or 3% solution for 30 minutes.

3. Immerse linen before washing for 2 hours in a solution of 3% chloramine from

calculation of 1 liter of solution for 5 kg of laundry.

4. Immerse care items in 1% chloramine solution for 60 minutes or 3%

chloramine solution - for 30 minutes.

5. Bedding after the discharge of the patient is subjected to

processing in a disinfection chamber.

6. Premises, pieces of furniture, equipment to be processed 1%

chloramine solution at least 2 times a day during wet

7. Garbage pour 10% bleach solution.

8. Sprinkle blood waste with dry bleach at the rate of 1:5.

9. Immerse rubber gloves after use in a 3% solution

chloramine for 60 minutes.

10. Wipe the hands of personnel with a 0.5% solution of chloramine, then rinse with running water and soap, dry and treat with 70% alcohol.

Subsequently, this order was supplemented by orders No. 245 (1991), No. 123 (2003) and the Sanitary Rules "Prevention of viral hepatitis".

ORDER No. 223

Order No. 288 (03/23/76)

On the approval of the instructions on the sanitary and anti-epidemic regime of hospitals and on the procedure for the implementation by the bodies and institutions of the sanitary and epidemiological service of the state sanitary supervision of the sanitary condition of medical institutions.

I. General provisions.

1. This Instruction It is intended for chief physicians and staff of hospitals, polyclinics, maternity hospitals, clinics, institutes and other medical institutions.

2. The organization and implementation of a set of sanitary and hygienic measures are aimed at preventing and combating nosocomial infections caused by various pathogenic and conditionally pathogenic microorganisms (staphylococci, Klebsiella, Pseudomonas aeruginosa, Proteus, and others).

3. The sanitary and anti-epidemic regime in infectious diseases hospitals and in the infectious diseases departments of general hospitals is established in accordance with the current Instruction on the regime of infectious diseases hospitals and infectious diseases departments of general city hospitals; in surgical departments - in accordance with the Provisional guidelines on the organization and implementation of a complex of sanitary and hygienic measures in surgical departments.

4. Responsibility for the organization and implementation of a complex of sanitary and hygienic measures in the hospital rests with the head physician of the medical institution.

5. The head nurse of the department instructs the middle and junior medical personnel on the implementation of a set of sanitary and anti-epidemic measures in the department (hospital).

II. Sanitary and hygienic regime in the admissions department.

6. The doctor examines all those entering the admission department for the timely identification of patients suspected of an infectious disease, their immediate isolation and transfer to the appropriate infectious disease hospitals(branches).

7. For this purpose, the patients examine the skin, throat, measure the temperature. Wooden spatulas are destroyed after a single use, and metal ones are boiled for 15 minutes. Thermometers are completely placed in a vessel with a disinfectant solution.

8. Examination of the patient is carried out on a couch covered with oilcloth; after receiving each patient, the oilcloth is wiped with a rag moistened with a solution of a disinfectant.

9. If a patient is found with a suspected infectious disease, the furniture and objects that the patient came into contact with, as well as the room where he was, are subjected to disinfection.

10. When examining a patient in the emergency department, it is necessary to pay attention to the presence of pediculosis. In case of detection of pediculosis, the patient, the room and objects with which the patient has come into contact, are subject to special disinfestation treatment. Each patient who has been diagnosed with pediculosis is reported to the sanitary and epidemiological station at the patient's place of residence; make an appropriate note in the medical history.

11. The patient in the admission department undergoes complete sanitization: takes a shower or bath (as directed by the doctor); cuts nails, etc. For washing, the patient receives a disinfected washcloth.

12. Sanitary treatment is carried out in a specially designated room, in which the access system must be observed, excluding oncoming flows of patients.

13. After passing sanitization the patient receives clean hospital linen, a bathrobe (pajamas), slippers.

Note: With the permission of the head physician of the medical institution, the patient is allowed to use his own underwear, which must be changed strictly according to the schedule of the institution.

14. Transportation of infectious patients from the emergency room to the departments is carried out on a specially allocated gurney.

15. The patient's clothes and shoes are put in an individual bag. Bags are stored on racks in a specially designated room.

16. The reception department is provided with a sufficient amount of:

a) bath soap;

b) washcloths for individual use, the number of which is determined throughput medical institution per day;

c) dishes for separate storage of clean and used washcloths. On dishes for washcloths there should be appropriate inscriptions “clean”, “used”;

d) hair clipper, straight razor or safety razor, fine comb;

e) nail clippers or scissors;

f) cotton wool, tweezers, denatured alcohol;

g) tips for enemas and utensils for their disinfection and storage in pure form with appropriate marking;

h) buckets with tight-fitting lids, galvanized iron pans;

i) detergents, disinfectants and disinfectants.

17. After each use, washcloths for washing patients, bathtubs, hair clippers, combs, razors and razors, nail clippers and scissors, tweezers, enema tips, spittoons, bedpans and urinals are disinfected according to the modes.

18. Use for washing hands laundry soap(2-fold soaping) in small packaging (for one-time use). After examining the patient with infectious disease or suspected of it, hands are disinfected for 2 minutes with a 0.2% solution of chloramine or a 0.1% solution (peracetic acid) of Deoxon-1.

19. Wearing caps that completely cover the hair is mandatory for medical personnel.

20. The admission department is cleaned at least 2 times a day with a wet method using disinfectants. The cleaning equipment of the reception department is marked. A bucket and a rag are kept in the lavatory, intended for mopping only in the lavatory. For cleaning doors window frames, window sills, etc. should be separate rags stored elsewhere. The use of this equipment for other purposes is strictly prohibited. After use, the cleaning material is disinfected.

III. Sanitary and hygienic regime in the departments.

21. Before the patient enters the ward, the bed, bedside table, the support for the bedpan is wiped with a rag moistened with a disinfectant solution. The bed is covered with bedding that has undergone chamber processing according to the regime for vegetative forms.

22. Individual care items are allocated to the patient: a spittoon, drinking bowl, a mug or glass, a bedpan, etc., which are thoroughly washed after use. After the patient is discharged, personal care items are disinfected.

23. Upon admission to the hospital, the patient is given the right to take personal hygiene items into the ward.

24. Patients with pediculosis, initially treated in the emergency room, are taken under special supervision and re-treated in the department until they are completely desutured.

25. Each patient takes a hygienic bath in the department at least once every 7-10 days (if there are no medical contraindications to this).

26. Change of underwear and bed linen produced at least once every 7-10 days (after the passage of the bath and, in addition, the linen is changed every time in case of contamination).

27. When changing underwear and bed linen, it is carefully collected in cotton bags or in containers with a lid. Do not dump used laundry on the floor in open bins. Sorting and disassembly of dirty linen is carried out in a specially designated room. After changing linen, the floor and objects in the ward are wiped with a rag soaked in a disinfectant solution.

28. Patients are provided free of charge with the services of a hairdresser:

a) shaving at least 2 times a week;

b) haircut according to indications.

Control over the implementation of the required regime by the hairdresser is carried out by the head nurse of the department.

Order No. 720

"Improvement medical care patients with purulent

HYGIENE BATH

INDICATIONS: lack of self-care, sanitization

CONTRAINDICATIONS: severe condition of the patient (hypertension, bleeding), after anti-pediculosis treatment.

PROBLEMS: negative attitude, psychomotor agitation

COMPLICATIONS: deterioration of the patient's condition, injury

EQUIPMENT: water, soap, towel, gloves, waterproof apron, shampoo, terry mitten or washcloth, bucket, comb, diaper, containers with disinfectants, water thermometer medical records. waste class "A", "B", handle,

HYGIENIC SHOWER

INDICATIONS: sanitization

CONTRAINDICATIONS: serious condition of the patient

PROBLEMS: refusal to manipulate, worsening condition, lack of self-care

COMPLICATIONS: deterioration, injury

EQUIPMENT: water, soap, towel, gloves, waterproof apron, shampoo, washcloth, towels, diaper, comb, containers with disinfectants, linen collection bag, medical documentation, class A, B waste, pen,

The method of washing is determined by the doctor. The presence of m / s during sanitization is mandatory. If the condition worsens while taking a hygienic bath or shower (dizziness, palpitations, pain in the heart, pallor, etc.), it is necessary to stop the procedure, inform the doctor about the worsening condition and start first aid.

PATIENT HEIGHT MEASUREMENT

Purpose: assessment of physical development.

Indications: admission to the hospital, preventive examinations.

Equipment: running water, liquid soap, towel, antiseptic, stadiometer, pen, medical history.

Problem: The patient cannot stand.

Note. If the patient is unable to stand, the measurement is taken in a sitting position. The patient should be offered a chair. The fixation points will be the sacrum and the interscapular space. Measure your height while sitting. Record the results.

Diet number 1a.

Indications for use: exacerbation of peptic ulcer during the first 8-10 days of treatment and bleeding, exacerbation of gastritis with increased secretion, burns of the esophagus.

Purpose of appointment: maximum sparing of the stomach with the exclusion of chemical, mechanical and thermal irritants.

general characteristics: exclude substances that stimulate the secretion of gastric juice. Food is given mainly in liquid and semi-liquid form. Calorie restriction is mainly due to carbohydrates. Salt is limited.

Calorie content and composition: proteins 80g, of which at least 50g of animal origin, fats 80-90g, carbohydrates 200g, calories 2000.

Diet: frequent meals (every 2-3 hours) in small portions, milk or cream at night.

Diet number 1b.

Indications for appointment: the purpose of the appointment and the general characteristics are the same as for diet No. 1a. But to the products indicated in the characteristics of diet No. 1a, their crackers are added white bread, dry biscuit, mashed cottage cheese from dairy kitchen. Increase the amount of meat and fish steam dishes.

Calorie content and composition: proteins 100g, fats 100g, carbohydrates 300g, calories 2600.

Diet: frequent meals (every 2-3 hours) in small portions, milk or cream at night.

Diet number 1.

Indications for use: peptic ulcer in the stage of subsided exacerbation, with scarring of the ulcer, as well as during remission for 2-3 months. Gastritis with increased secretion during the period of exacerbation.

The purpose of the appointment: sparing the stomach and duodenum, the exclusion of chemical and limitation of mechanical stimuli, which contributes to the process of scarring of the ulcer.

General characteristics: exclude substances that stimulate gastric secretion (strong broths from fish and meat, mushrooms, fried foods, fatty foods, coffee, spicy snacks, black bread, vegetable fiber, alcoholic drinks, raw vegetables). Food is given mostly mashed, steamed or boiled. Table salt is limited.

Calorie content and composition: proteins 100g, fats 100g, carbohydrates 400g, calories 3000.

Diet: frequent meals (6 times a day), before going to bed milk, cream or fresh kefir.

Diet number 2.

Indications for use: chronic gastritis with secret insufficiency, chronic enterocolitis without exacerbation, violation of the masticatory apparatus. The recovery period after surgery and after acute infection, as well as in cases where moderate sparing of the gastrointestinal tract is indicated.

Purpose of appointment: promoting the normalization of the secret and motor function of the stomach and intestines, moderate mechanical sparing of the gastrointestinal tract.

General characteristics: a physiologically complete diet with the preservation of extractive and other substances that stimulate the separation of gastric juice, do not irritate the gastric mucosa. Meat with coarse connective tissue and products containing vegetable fiber are given mainly in crushed form. Excluded leguminous plants.

Calorie content and composition: proteins 80-100g, fats 80-100g, carbohydrates 400, calories 3000. Vitamin C - 100 mg, other vitamins - in an increased amount.

Diet number 3.

Indications for use: constipation, caused by malnutrition, as well as arising on the basis of a decrease in the excitability of the neuromuscular apparatus of the intestines.

The purpose of the appointment: the effort of intestinal motility by including mechanical, chemical and thermal irritants in food.

General characteristics: a variety of foods are prescribed, including those rich in coarse vegetable fiber and promoting intestinal motility (dairy products, vegetables, raw vegetable salads, fresh berries and fruits, sauerkraut, buckwheat and pearl barley, fried meat, fatty fish, eggs hard boiled, honey, figs, cold fruit and vegetable soups, carbonated drinks). Foods that inhibit intestinal motility are limited: puree and finely ground food, hot dishes and drinks, pureed cereals, kissels, cocoa, strong tea. Table salt is added in an increased amount.

Calorie content and composition: proteins 100-120g, fats 100-120g, carbohydrates 400-450g, calories 3000-3500.

The diet is normal.

Diet number 4.

Indications for use: gastroenteroscolitis, acute enterocolitis and exacerbation of chronic, dysentery in the acute period, condition after surgery on the intestines.

The purpose of the appointment: a significant sparing of the intestines, the exclusion of products that enhance intestinal peristalsis and fermentation in the intestines.

General characteristics: a diet with calorie restriction at the expense of carbohydrates and fats. Proteins within the lower limit of the physiological norm. Exclude milk, natural coffee, juices, spices, processed cheese, products containing vegetable fiber (beets, cabbage, turnips, spinach, sorrel), pickles, smoked meats. The diet is prescribed for a period of no more than 5-7 days.

Calorie content and composition: proteins 80g, fats 70g, carbohydrates 50g, calories 2000. Vitamin C - 100 mg. Missing in food products the amount of vitamins of group B and others is replenished with vitamin preparations.

Diet: eating 5-6 times a day in limited quantities. Free liquid 1.5 liters in the form of hot tea, broth, rosehip broth.

Diet number 4b.

Indications for use: chronic enterocolitis in the period of moderate exacerbation with a combination of bowel disease with damage to the stomach, dysentery during the period of remission of acute phenomena.

The purpose of the appointment: to provide adequate nutrition during a period of moderate exacerbation of chronic enterocolitis, to help reduce the inflammatory state and normalize the dysfunction of the gastrointestinal tract.

General characteristics: in a physiologically complete diet, the content of carbohydrates and salt is moderately limited. Exclude products that mechanically and chemically irritate the intestinal mucosa and enhance fermentation processes and rotting in it. Foods containing non-coarse vegetable fiber are introduced into the diet (vegetables in pure form, prunes, apples, stale white bread).

Calorie content and composition: proteins 100-120g, fats 100g, carbohydrates 300-350g, calories 2600-2900.

Diet: eating 5-6 times a day.

Diet number 5a.

Indications for use: acute cholecystitis or exacerbation of chronic, acute pancreatitis or exacerbation of chronic, chronic cholecystitis in the presence of peptic ulcer, 5-6th day after operations on the biliary tract.

Purpose of appointment: to promote the restoration of impaired liver function, accumulation of glycogen in the liver, stimulation of liver function, bile secretion, limitation of mechanical irritation of the stomach and intestines.

General characteristics: diet with limited fat, proteins and carbohydrates - within the normal range; the content of lipotropic factors is increased. Excluded extractives and fat breakdown products resulting from frying. All dishes are prepared from pureed products in boiled or steam form.

Diet number 5.

Indications for use: chronic diseases of the liver and biliary tract- cholecystitis, hepatitis, cirrhosis of the liver without exacerbation of the process and in the absence of diseases of the stomach and intestines, Botkin's disease in the recovery stage.

Purpose of appointment: to promote the restoration of impaired liver function.

General characteristics: a diet with a physiological norm of proteins, some increase in carbohydrates, moderate restriction of fats and the exclusion of foods rich in cholesterol. Culinary processing with the exclusion of nitrogenous extractives, purines and fat breakdown products resulting from frying. Mushrooms, spinach, sorrel, spices, cocoa, chocolate, cranberries, currants are also excluded. A diet with an increased amount of lipotropic factors and vitamins. Table salt up to 10-12g.

Calorie content and composition: proteins 80-100g, fats 60-70g, carbohydrates 450-500g, calories 2800-2900. Patients with impaired fat metabolism limit carbohydrates.

Diet: frequent meals (after 2-2.5 hours) and drink plenty of fluids up to 2 liters of warm liquid.

Diet number 6.

Indications for use: gout and uric acid diathesis, erythremia, etc., when the exclusion of meat and fish products is indicated.

The purpose of the appointment: to promote the normalization of purine metabolism and reduce the endogenous formation of uric acid.

General characteristics: the exclusion of fats and foods rich in purine compounds (lard, lamb and beef fat, liver, kidneys, brains, sprats, fried meat and fish and their strong broths, sauces, sorrel, spinach, green pea, chocolate, cocoa, coffee, alcoholic drinks). Introduce products containing alkaline radicals (vegetables, fruits, berries, milk), moderately limit table salt.

Calorie content and composition: proteins 80-100g, fats 80g, carbohydrates 400g, calories 2700. Carbohydrates are limited for patients with impaired fat metabolism.

Diet: 5 meals a day, drink plenty of water up to 2-2.5 liters of liquid in the form of tea, fruit and berry fruit drinks, alkaline waters.

Diet number 7a.

Indications for use: acute glomerulonephritis, after rice-apple, potato or sugar days, chronic nephritis in the stage of renal failure.

The purpose of the appointment: to create conditions that are as gentle as possible to the kidneys, the effect of limiting salt on hypertension and edema.

General characteristics: diet with severe protein restriction. Fats and carbohydrates within the physiological norm, salt, hyposodium diet (food without salt, salt-free bread is specially baked). The sodium content of the diet is 400 mg, which corresponds to 1000 mg ( 1d) table salt. For patients with insufficiency of kidney function in the presence of azothermia, table salt is added as prescribed by the attending physician. Patients are allowed to give as much liquid as urine was excreted in the previous day. Culinary processing of products - without mechanical sparing. Vegetables, fruits, berries are administered in sufficient quantities, some in raw form.

Calorie content and composition: proteins 5-30g, fats 80-100g, carbohydrates 400-450g, calories 2500-2600. In an increased amount, vitamin C and B vitamins are administered.

Diet: Meals 5 times a day.

Diet number 7b.

Indications for use: acute nephritis after diet No. 7a, exacerbation of chronic nephritis with edema, high blood pressure, but with preserved kidney function.

Purpose of appointment: the same as with diet No. 7a.

General characteristics: the content of fats and carbohydrates within the physiological norm. The amount of proteins in comparison with diet No. 7a is increased to 45-50 adding boiled meat or boiled fish and 200g of milk or kefir. Otherwise, in terms of the set of products and the nature of the culinary processing, the diet is the same as No. 7a. The content of table salt in products increases to 1.5 g.

Calorie content and composition: proteins 45-50g, fats 100g, carbohydrates 450-500g, calories 3000.

Diet number 7.

Indications for use: acute nephritis during convalescence, chronic nephritis with little pronounced changes in urine sediment, nephropathy of pregnant women, hypertension and other cases where a salt-free diet is needed.

Purpose of appointment: moderate sparing of kidney function. Effects on high blood pressure and edema.

General characteristics: salt-free, in terms of the set of products and the nature of culinary processing, it is the same as diet No. 7a and 7b, but the amount of proteins increases to 80 g adding boiled meat or fish, as well as cottage cheese. Legumes, strong meat broth, cakes and creams, carbonated and alcoholic drinks, fried meat, beer are excluded.

Calorie content and composition: proteins 80g, fats 100g, carbohydrates 400-500g, calories 2800-3200. The content of table salt in products is about 6-7g. Vitamins C, P, group B are prescribed in an increased amount. For patients with amyloidosis of the kidneys with preserved kidney function and patients with nephrosis, diet No. 7 is prescribed with a high content of proteins up to 140 g, polyunsaturated fatty acids and vitamins.

Diet number 8.

Indications for use: obesity in the absence of diseases of the digestive system, liver and of cardio-vascular system requiring special diets.

Purpose of appointment: influence on a metabolism for the prevention and elimination of excess adjournment of fat.

General characteristics: restriction of calorie content of food, mainly due to carbohydrates and partly due to fats, the protein content is above the physiological norm. Vegetables and fruits in sufficient quantities. They limit table salt, exclude flavoring seasonings and nitrogenous extractive substances that stimulate appetite, fatty meats, flour and pasta, pickles, smoked meats, chocolate, cocoa, instead of sugar - xylitol, sorbitol. Moderately restrict the introduction of free fluid(1000 ml), potatoes, white bread.

Calorie content and composition: proteins 100-120g, fats 60-70g, carbohydrates 180-200g, calories 1800-1850. Vitamin C in an increased amount, other vitamins within the physiological norm.

Diet: frequent meals of low-calorie food with sufficient volume, eliminating the feeling of hunger.

Diet number 9.

Indications for appointment: diabetes in the absence of acidosis and concomitant diseases of the internal organs.

Purpose of appointment: creation of conditions that support a positive carbohydrate balance, prevention of lipid metabolism disorders.

process	justification
1. Take gloves in sterile packaging, unfold; 2. Take the glove for the right hand by the lapel so that the fingers do not touch inner surface gloves;	Ensuring sterility
3. Close the fingers of the right hand and insert them into the glove;	Ensuring sterility
4. Put on a glove without breaking its lapel, opening the fingers of the right hand;	Ensuring sterility
Take the glove for the left hand with the second, third and fourth fingers of the right hand (gloved) by the lapel so that the fingers do not touch the inner surface of the glove;	Ensuring sterility
Close the fingers of the left hand and insert them into the glove; Straighten the cuffs on the left, then right gloves, pulling them over the sleeve.	Ensuring sterility

Rules for removing sterile gloves

IF ONE GLOVE IS DAMAGED, BOTH SHOULD BE CHANGED IMMEDIATELY, BECAUSE ONE GLOVE CANNOT BE REMOVED,

WITHOUT POLLUTING ANOTHER

process	justification
1. Take the fingers of the right hand in the glove by the lapel on the left glove, touching it from the outside, make a lapel;	Gown sleeve infection prevention
2. Take the fingers of the left hand in the glove by the lapel on the right glove, touching it from the outside, make a lapel;	Compliance with sterility. Ensuring infectious safety.
3. Remove the glove from the left hand, turning it inside out and holding the lapel in the right hand;	Compliance with sterility. Ensuring infectious safety
With your left hand, take the glove on your right hand by the lapel on the inside and remove it, turning it inside out (the left glove was inside the right one) .	When removing gloves, touching the outer surface of used gloves causes infection of the skin of personnel

Dressing preparation technique

Dressings are called tissues and other products that are used in surgical practice to drain the wound, stop bleeding, remove wound contents and apply bandages.

dressing material requirements

1. It is good to suck up the wound discharge, i.e. have a high degree of hygroscopicity
2. Dries quickly by evaporating moisture
3. Soft and elastic fit to the body, not have a large mass
4. Do not lose these qualities when sterilizing with steam under pressure
5. Do not irritate body tissues;

The main type of dressing material is gauze and cotton wool

Remember: When preparing any kind of dressing, be sure to tuck the edges of the gauze inward.

Equipment: industrial packaging of sterile gloves, manipulation table.

Manipulation algorithm:

Rice. 4. Putting on sterile gloves.

Removing used gloves.

Indications for removing gloves:

damage to gloves

termination of contact with blood and other body fluids or damaged skin or mucous membranes;

completion of work with disinfectants, PSO, sterilants, cytostatics, hormonal creams, etc.;

completion of work with medical waste;

if hand hygiene is required.

Equipment: container with disinfectant solution, class B medical waste bag, class B medical waste container.

Manipulation algorithm:

Rice. 5. Removing used gloves.

Medical gloves - required consumable any medical institution, whether it be a feldsher-obstetric station or a large clinic. In this article, we will tell you how to properly use medical gloves.

One of the most important rules– compliance necessary conditions asepsis. Before putting on medical gloves (whether examination gloves or surgical gloves), wash your hands thoroughly and then treat them with an antiseptic solution. Put on gloves after your hands are completely dry. This rule does not apply to doctors working in ambulance teams. In an emergency situation, work at the scene of an accident, disaster, metro station, and so on, gloves are taken out of the pack and put on hands.

Disposable medical gloves must not be used to perform several manipulations on one patient. This is due to the fact that millions of bacteria live on the human body, and the composition of the flora in different areas is very different. Accordingly, a complication may arise even with a simple procedure for taking blood from a finger. After use, disposable gloves must be removed, hands should be treated again with an antiseptic solution. Used gloves are disposed of as class B medical waste (potentially hazardous).

They are worn in cases where there is a risk of contact with biological fluids, damaged skin and mucous membranes, as well as in contact with medical instruments contaminated with biological fluids, for example, processing probes, washing tracheostomy, caring for patients in anesthesiology and intensive care units.

Also, non-sterile gloves are used in infectious diseases departments when working with patients infected with resistant (that is, resistant to antibiotics) microorganisms and patients with HIV. Non-sterile gloves should not be pulled tight while donning, otherwise they may tear. The use of gloves is not necessary for contact with intact skin or environmental objects (for example, in the case of an examination by a general practitioner in an outpatient treatment facility).

How to use sterile gloves correctly?

(including obstetric, surgical) are used where full asepsis is required. These are operating units, maternity hospitals, treatment rooms, dressing rooms, burn departments, and so on. It should be remembered that putting on sterile gloves is not a substitute for disinfecting hands with skin antiseptics. Before putting on sterile gloves, hands must be thoroughly washed and treated with a skin antiseptic.

If we are talking about the surgical intervention, then the hands are processed according to the technology of processing the hands of the surgeon. The scheme is approved by the World Health Organization. First, wash the fingers, starting from the inside, then the back, then the spaces between the fingers, the legs and under the nails. Wash the left hand first, then the right. After that, the hands and forearms are treated. Begin by washing the palms, then the backs of the hands, then the wrists, then the forearms. In conclusion, once again wash the nails and under the nails. Hands are dried with sterile wipes, following the same sequence as when washing hands. Before and after wiping, the hands are kept raised up so that water does not get on the hands.

After washing, hands are treated with various antiseptic solutions, for example, chlorhexidine wipes. After the hands are washed, sterile gloves are put on according to the following algorithm (with the help of an operating sister):

1. Away from the sterile table, an individual package of sterile gloves is opened. Then the inner envelope with gloves is shaken out onto a sterile surface.

2. Using sterile tweezers, open the inner packaging.

3. First, the glove is put on the right hand, then the left.

4. The cuff of the glove should cover the cuff of the gown by 5-10 cm.

When should gloves be changed immediately?

In the event of a puncture, tear or defect;
If there was an accidental contact with an electrosurgical instrument (for example, an electrocoagulator);
When liquid gets under the glove;
With the appearance of "glove juice" (the secret of sweat and sebaceous glands, which may contain microorganisms. If the glove is torn or punctured, they can infect the wound);
When stickiness appears;
During the transition from the "dirty" stage of the operation to the "clean" one (for example, when excising festering tissues).

Important! When replacing gloves, it is necessary to treat the hands with an antiseptic.

How to properly remove gloves?

After completion of the operation, sterile gloves are removed as follows. Right hand take the cuff of the left glove and remove it from the hand, turning it on inside. The right glove is removed in the same way. After that, gloves are placed in a container with a disinfectant solution for class B waste for subsequent decontamination.

After removing gloves, hands are washed again and treated with antiseptic solutions. To prevent drying of the skin of the hands, it is recommended to use a nourishing cream.