Hygiene of the patient
The skin is constantly getting germs, including pathogens, but with healthy, undamaged skin, the diseases rarely occur, since microbes are removed from the skin surface along with the keratinized cells peeling off under normal conditions. In addition, the special glands secrete a bactericidal( fatal microbial) secret. Intensive activity of the sebaceous and sweat glands, excessive detachment of horny skin scales, dust and dirt are very favorable conditions for increasing the number of microbes on the skin. In axillary regions, in folds of the skin without access to oxygen, the multiplication of microbes occurs especially intensively. On the skin of the perineum, this contributes to the allocation of urogenital organs and intestines. In severe and untidy patients, conditions for significant skin contamination are created.
Combs, micro-traumas of the skin, arising from itching of the skin, intertrigo and crack in the fold area, are peculiar "gates", a condition for microbes to enter the damaged skin, into the blood and spread the infection in the body. In patients with a weakened function of antimicrobial protection( immune deficiency), the spread of microorganisms in organs and tissues occurs particularly quickly and is accompanied by the appearance of severe pathological processes. Therefore, to ensure that the skin actively performs the role of protection and barrier from infection, it must be kept clean, protected from increased humidity, as well as from excessive dryness.
Caring for patients, it should be borne in mind that some diseases( hypertension, cerebral diseases, certain diseases of the stomach, pancreas, etc.) are often accompanied by vomiting. Therefore, with the urge and the emergence of vomiting, patients should be assisted immediately to avoid vomiting into the respiratory tracts of
and the flooding of patients, bruises in vomiting, contamination of clothes and bed.
For this, the caregiver must hold the patient's head when vomiting, substituting a basin or bucket for vomit. After vomiting, the mouth cavity should be rinsed with boiled water, and in severe patients - repeatedly treated with moist tampons;dry your face dry.
Face, neck and upper body should be washed daily in the morning and evening. Hands, in addition, must be washed with soap before each meal and after each visit to the restroom. Water for washing should be at room temperature, and for febrile patients not less than 25-30 C. First, use a sponge or cotton swab to wash the patient's face, ears and neck, and then hands with the heavy patient. Walking patients do this themselves, but first they wash their handswith soap
The legs should be washed daily with warm water and soap every day, and the patient who is on bed should wash his feet 2-3 times a week, putting a basin on the bed, and with daily sweating, the procedure should be carried out daily
Genital skinorgans and backWalking under normal conditions requires daily washing. Walking patients for this purpose use a hand shower or bidet( a special kind of toilet bowl with warm water supplied by a vertical jet), and bedridden patients wash away after each bowel movement, women in addition - after each urination. For this, an oilskin is put under the patient, under the buttocks, the ship is brought in, her legs are bent at her knees and they are bred in different directions. It is sent from a jug or Esmarch mug provided with a rubber tube, clamp and vaginal tipt on the crotch jet of water or a weak solution of potassium permanganate. At the same time, a sterile cotton swab on the long tweezers produces several movements in the direction from the genitals to the anus. Another cotton swab drains the perineal skin, leading the tampon in the same direction, so as not to infect the infection from the anus to the vagina and urinary tract. The male is washed in the same way5 with the only difference that a sterile cotton swab and disinfectant solution( potassium permanganate) are needed mainly in those cases where pressure ulcers or cracks in the rectum have developed, as well as inflamed external hemorrhoids.
The nails on the arms and legs should be cut short, without burrs. In the presence of cracks skin okolonogtevogo roller damage area is treated with 3% iodine solution.
Walking patients take a hygienic bath or shower at least once a week. If the patient has a bath and a shower that are contraindicated, then he needs to do daily wiping. Especially this applies to febrile patients
and suffering from excessive sweating. Sweating is accompanied by the release through the skin of a large number of salts, metabolic products, which, accumulating, irritate the skin, cause itching, cause other anxiety to patients.
To clean the skin, a special disinfectant solution containing camphor alcohol, vinegar or cologne should be used: 1-2 tablespoons of camphor alcohol, vinegar, medical alcohol or cologne should be added to 0.5 liters of warm water( 43-45 * C).The technique of rubbing the skin is as follows. One end of the towel is moistened with a disinfectant solution, lightly squeezed and starts rubbing the neck, behind the ears, back, the front surface of the chest and axillary hollows. Particular attention should be paid to folds under the mammary glands, where obese women and very sweating patients may develop diaper rash. Then wipe the skin dry in the same manner.
For general washing of patients should be well prepared bathroom. The bath should be washed with any detergent solution and thoroughly treated with 0.5% clarified chlorine solution or 2% chloramine solution. In order to disinfect the bath, you can use the detergent "Sanita", containing special chemical ingredients. The tiled floor in the bathroom should always be dry and the air temperature at least 25 ° C.Ventilate the room only after finishing the hygienic bath;in no case should drafts be allowed during the washing of the patient;The door to the bathroom should be closed. At the bath, on the floor there should be a wooden flooring, covered with a napkin.
The patient should be allocated an individual washcloth. Immediately before washing the patient in the bath, the loofah should be thoroughly washed with soap, rinsed and boiled for 10-15 minutes.
While washing the patient in the bath, you need to make sure that the water reaches a third of the chest, and the heart area is above the water. Do not allow the water temperature in the bath to drop below 36-37 ° C.To do this, using a special water thermometer, you must constantly monitor the temperature prescribed by your doctor. The patient is washed with a washcloth and soap, the head is thoroughly washed, then the body and, in particular, the places that are affected by intertrigo( mammary glands in women, groin, perineum, interdigital spaces, axillary hollows).The duration of the hygiene bath at a water temperature of 36-37 "C and an air temperature of 25" C should not exceed 20-25 minutes. Then the patient is dryly wiped with a towel preheated on a steam heating battery, put on clean linen, pre-cooked, and escorted to bed.
If during the washing in the bath the patient felt ill, dizziness, weakness, shortness of breath, pain or other unpleasant sensations,
should not continue washing in the bath. It is necessary to quickly wipe the patient with a towel, put him to bed, measure blood pressure and count the pulse. With pain in the region of the heart and with dyspnea, it is recommended to give a patient 1 tablet of Validol or nitroglycerin, 15-20 drops of Corvalol or Valocardinum under the tongue, to ensure the influx of fresh air, previously covering the patient with a blanket. At the next visit of the patient to the doctor it is necessary to describe in detail the episode of deterioration of state of health, that the correct analysis of the situation was made and rational recommendations are given.
If the patient is not allowed to conduct a hygiene bath, then he is washed in the shower. In the bath put a bench, and wash the patient in the same manner, starting with the head. In this case, there should be two carers, one of whom supports the patient, insuring him from falling, keeps track of his well-being, and another washes.