First aid and nursing

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Theme 2. Sanitation of the patient (full and partial).

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Treatment of the patient with pediculosis.

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Transportation of patients.

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Alexey Alexandrovich Frolov
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PhD, physician
 Reception and registration of patients
• Routes of patients admission:

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– ambulance

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– in the direction of the district doctor

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– transfer from other medical institutions

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– self-admission of the patient

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• Types of patients hospitalization:
– planned hospitalization
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– emergency hospitalization
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– self-admission and hospitalization

 Reception and registration of patients
• Reception

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– Examination of the patient by a nurse.

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– First aid (especially if the patient is in serious condition).

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– Examination of the patient by a doctor.

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– The doctor makes a decision about patient hospitalization.

• Registration
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– Nurse register the patient
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 Reception and registration of patients
• If the patient is admission unconscious, without a passport, from the

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street, nurse informs the police.

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• If the patient died in the admission department, the nurse informs

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the relatives.

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• If the patient is admission from the street, the nurse informs the
relatives. ba Al
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The main medical documentation of the admission department
• "Journal of registration of admissions of patients and refusals of hospitalization“
• In case of hospitalization:
form No. 001 / y

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– last and first name,

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– year of birth,

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– passport and insurance policy details,

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– home address,

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– place of work and position,

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– telephones (home, office, relatives),
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date and time of admission,
where and by whom the patient was delivered,
– the type of hospitalization (planned, emergency, independent treatment),
– the diagnosis of the sending institution,
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– the diagnosis of the admission department,

– to which department the patient is transport.
The main medical documentation of the admission
department

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• "Journal of registration of admissions of patients and refusals of

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hospitalization“ (form No. 001 / y)

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• In case of refusal of hospitalization:

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– the reason for the refusal of hospitalization (transport to another institution, lack

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of indications for hospitalization, etc.)

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– what kind of medical care was provided
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The main medical documentation of the admission
department

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• “Case history” (medical history, medical record; form No. 003 / у)

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– Nurse fills the title page.

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– Nurse fills in the passport part of the case history.

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– Nurse fills in the first part of the "Statistical card of the departed from the

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hospital" (form No. 066 / y).
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 Title page of “case history” (form No. 003 / у)
• last and first name,
• year of birth,

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• passport and insurance policy details,

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• home address,

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• place of work and position,

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• telephones (home, office, relatives),

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• date and time of admission,
• where and by whom the patient was delivered,

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• the type of hospitalization (planned, emergency,
ba Al independent treatment),
• the diagnosis of the sending institution,
• the diagnosis of the admission department,
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• to which department the patient is transport.

The main medical documentation of the admission
department

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• "Journal of examination for pediculosis“.

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• Emergency notice to the sanitary-epidemiological station (fill in if

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the patient has an infectious disease, food poisoning, pediculosis).

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• "Journal of telephone messages" (to the police and other services).

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 Sanitary and hygienic treatment of patients
• Sanitary and hygienic treatment of patients is carried out by

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decision of the doctor on duty.

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• There is a sanitary inspection unit in admission department.

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• Sanitary inspection unit:

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– examination room

– room for undressing

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– bath-shower room
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– dressing room
 Sanitary and hygienic treatment of patients
• Air temperature should not be lower than 25 degrees centigrade.

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• Make a list of personal items in duplicate.

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• Valuables are handed over to the safe (a receipt is issued).

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• If the clothes are clean, they are put in a bag and taken to a storage

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room.
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• In case of infectious disease, the clothes are disinfecting with a
special solution and sent to a laundry.
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 Sanitary and hygienic treatment of patients
• Stages of sanitary and hygienic treatment of patients:

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– Inspection of the skin and hair of the patient.

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– Hair cutting, nail cutting, shaving (if necessary).

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– Shower or hygiene bath.

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 Examination of the skin and hair of the patient
• The purpose of the examination is to identify pediculosis.

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• Pediculosis (lat. Pediculum - louse) - damage to the skin and hair

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of a person as a result of parasite of lice.

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• In case of pediculosis case history marked with the letter “P”.

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Examination of the skin and hair of the patient

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a b c
Types of lice: a - clothes; b - head; с - pubic.
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Lice are carriers of typhus and relapsing fever.

Examination of the skin and hair of the patient

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• Signs of pediculosis:

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– the presence of nits (lice

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eggs that are attached to the

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hair or tissue);

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– the presence of lice;

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– traces of scratching and

pustules on the skin.
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nit pediculosis
 Sanitary treatment of a patient with pediculosis
1. disinfestation (destruction of insects carrying infectious disease);

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2. hygienic bath (shower);

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3. cutting hair and nails;

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4. dressing the patient in clean clothes.

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 Sanitary treatment of a patient with pediculosis
• Necessary equipment for disinfestation:

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– Protective clothing.

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– Disinfestation solution.

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– Shampoo, acetic acid (6% solution, heated to 30 °C), ethanol (70%).

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– Polyethylene headscarf, polyethylene membrane, oilcloth, towels, paper, comb,
scissors. ba Al
– Basin for burning hair and matches.
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– Oilcloth bag.
 Sanitary treatment of a patient with pediculosis
1. Prepare the necessary equipment and wear protective clothing.
2. Lay an oilcloth on a chair (couch), seat the patient on it and cover his shoulders with a polyethylene

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membrane.

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3. If necessary, cut hair over the prepared basin.

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4. To treat the hair with a disinfestation solution, tie the head with a polyethylene headscarf and a towel
on top, leaving for a some time.

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5. Untie the headscarf and wash with warm water and shampoo.

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6. Dry patients hair with a towel and treat they hair with a heated 6% solution of acetic acid.

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7. Tie the head with a polyethylene headscarf and towel again, leaving for 20 minutes.
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Untie the headscarf and wash with warm water and shampoo.
9. Tilt the patient's head over white paper and carefully comb, then inspect the patient's hair again.
10. Burn cropped hair and paper in a basin.
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11. Fold the patient’s clothes and the nurse’s protective clothing in an oilcloth bag and place in a
disinfection chamber. To process the comb and scissors with 70% alcohol, the room with a
disinfestation solution.
 Transportation of patients

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• Transportation – moving the patient to the place of care.

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• Method of transportation is chosen by the doctor.

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 Transportation of patients

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• Transportable / non-transportable patient.

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• If the patient is non-transportable medical care is provided in the

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emergency room. Then the patient is transported to the intensive

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care unit.

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 Transportation of patients

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• Type of transportation

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– patient walk independently accompanied by medical staff (satisfactory condition)

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– sitting or half-sitting in the wheelchair (moderate condition)

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– on a stretcher (severe condition)

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– on a wheel stretcher / medical gurney / medical bed (severe condition)

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 Transportation of patients
• In the department, bedridden patients are transported head first.

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• When descending the stairs, bedridden patients are transported with

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their feet forward.

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• When shifting the patient wheel stretcher is placed on the stopper.

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• The wheelchair and wheel stretcher should be covered with a bedsheet
and blanket. ba Al
• Bedsheet and blanket need to change after each use.
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• The wheelchair and wheel stretcher should be disinfected.

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Transportation of patients

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Transportation of patients
Shifting the patient

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 Transportation of patients
• Stroke – lying on back.

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• Unconsciousness – head turned aside.

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• Acute cardiovascular failure – half sitting.

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• Burns – on the intact side.

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• Spinal fracture – on a rigid stretcher.

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Rib fracture – half sitting.

• Pelvic fracture – lying pillow under the knees.

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• Skull fracture – fix the head, without pillow.

 Sanitary and epidemiological regime of the
admission department
• Mandatory sanitary and hygienic treatment of incoming patients.

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• Emergency notification of the sanitary-epidemiological service (by

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phone and with filling out a special form) and providing all

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necessary measures in case of an infectious disease, food poisoning,

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pediculosis.

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• Regular wet cleaning of rooms and surfaces of objects.

• The use of various methods of disinfection (boiling, the use of

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disinfectant solutions and ultraviolet radiation).

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Thanks for attention!