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"Infection Control for
Viral Haemorrhagic Fevers
In the African Health Care Setting"
Annexes 6-9
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Annex 6 Requirements for Purchasing Protective Clothing
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Specifications
for Items of Protective Clothing:
This
list describes the generic requirements for ordering or purchasing protective
clothing from commercial vendors. Record the amounts needed on this list
of specifications. The list can be photocopied and provided to donors
to make sure that vendor specifications match the recommended specifications.
Determine the quantities needed from the recommendations on the chart
in Section 9.
Gowns
| Requirements |
Made from cotton
cloth, cotton blend, or disposable fabric. The requirements are
the same for both disposable and reusable gowns.
Gowns should
have the following requirements:
- Open at
the back with ties at the neck, waist and middle of the back.
- Ribbed or
elasticized cuffs.
- Be long
enough to reach the knees.
- If only
large size is available, larger size can be cut and altered to
fit smaller people.
If elasticized
or ribbed cuffs are not available, attach thumb hooks to the end
of the gown's sleeves. The thumb hooks can then be covered with
the long wrist-sleeve of the gloves.
|
| Quantity
needed |
Number
of disposable gowns _______ Number of reusable gowns _______ |
Apron
| Requirements |
Aprons are
worn if there is risk of direct exposure to body fluids. The aprons
are worn by physicians, nurses, corpse carriers, and cleaners. The
requirements for the apron are the same for disposable or reusable
models.
Aprons should
have the following requirements:
- Rubber or
plastic apron with hooks or ties around the neck and with ties
at the back.
- Made from
disposable plastic or heavy plastic which can be disinfected for
reuse.
- Able to
fit over gown.
|
| Quantity
needed |
Number
of disposable aprons _______ Number of reusable aprons _______ |
Caps
| Requirements |
To prevent
contamination of hair and head from patient's vomit or blood:
- Use disposable
caps.
- If disposable
caps are not available, use cotton caps that can be laundered
and reused
|
| Quantity
needed |
Number
of disposable caps _______ Number of cotton caps _______ |
Masks
| Requirements |
Worn to protect
mouth and nose from splashes or droplets of patient's body fluids.
Masks should
offer appropriate protection.
1. 3M HEPA
or N Series Mask:
- Has preferable
exhalation valve
- Lightweight
- Easy to
use
2. Biosafety
mask that limits 0.3-um particles
3. Dust-mist
masks
4. Surgical
masks only protect from droplets splashed in the face. They are
not HEPA rated.
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| Quantity
needed |
HEPA
mask _______ Biosafety mask _______ Dust-mist mask_____ |
Thin
gloves
| Requirements |
Thin gloves
to permit fine motor function. They can be surgical glove quality
but do not need to be sterile.
- Must reach
well above the wrist, preferably 10 to 15 cm (4" to 6")
long,
measuring from the wrist up along the arm.
- Should be
tested for pinholes.
- May be
powdered or non-powdered.
|
| Quantity
needed |
Number
of pairs _______ |
Thick gloves
| Requirements |
Thick gloves
for handling bodies, disinfection, and disposal of infectious
waste.
- Should be
made from neoprene or other thick rubber material.
- Must reach
well above the wrist, preferably about 30 cm (12î), measuring
from wrist up along the arm.
|
| Quantity
needed |
Number
of pairs _______ |
Boots or overboots
| Requirements |
The requirements
are the same for both latex overboots which can stretch over street
shoes, and regular rubber boots
- Should
be 30 cm (12") high and have textured soles.
- Provide
several sizes to meet size requirements of anyone who might use
them (for example, obtain pairs of boots in sizes medium, and
large).
Overboots are
preferable to regular boots. They take up less space, fewer
sizes are needed, and they are less expensive.
|
| Quantity
needed |
Total Number
of pairs of overboots_______ (medium __________ large _____________)
Total Number
of pairs of rubber boots_______ (medium __________ large _____________)
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Protective eyewear
| Requirements |
1. Use non-fogging
goggles that are vented at the sides.
2. If non-fogging
goggles are not available, purchase clear spectacles locally.
- Should have
ties extending from ear holders that can be tied around the back
of the head so glasses will not fall off when health care worker
leans over patient.
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| Quantity
needed |
Total Number
of pairs of non-fogging googles_______
Total Number
of pairs of clear spectacles__________
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| Other
recommended equipment |
Quantity
needed |
| Sprayers:
backpack style with hose to use for cleaning and disinfecting spills,
rinsing boots, and other decontamination procedures. |
|
| Plastic
sheets for mattresses and barriers: can be purchased locally. |
|
| Waterproof
mattresses |
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| Front
lamps: to fit over the physician's head to provide light when physician
is examining patients. |
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| Kerosene
lamps |
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| Body
bags |
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| Annex
7 Disinfecting Water for Drinking, Cooking and Cleaning
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The Standard Precautions
and VHF Isolation Precautions described in this manual recommend using
a source of clean water. In an emergency situation, health facility staff
may not have access to clean running water. For example, if the power
supply is cut off, water cannot be pumped to the health facility. Other
sources of water could be contaminated.
This Annex describes how to use household bleach to disinfect water when
clean running water is not available in the health facility.
Adding a small
amount of full strength household bleach to water will disinfect it
enough so that it can be safely used for drinking, cooking, and cleaning.15
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| An
example of a water container |
1. Locate several
containers for storing the disinfected water. They should have:
- A narrow mouth
(to prevent hands being put into the water)
- A screw top or
attached lid
- A spigot, if possible.
Examples include jerry cans, large plastic jugs, or buckets with spigots
and lids that can be firmly closed.
2. Make available:
- At least 1 litre
of full strength household bleach. Use the instructions on the package
to prepare a full-strength concentration.
- Pieces of bar
soap or powdered soap.
3. Clean and disinfect
the containers. To disinfect the containers, wash them with soap and water,
or rinse them with 1:100 bleach solution.
4. Collect water from the available source (for example, a river, stream,
or well used by the village).
5. Place the water
into the disinfected containers, and add 3 drops of full strength household
bleach per litre of water.
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| Prepare drinking
water |
6. Mix the water and bleach drops together.
Let the water stand
for 30 minutes. This water is now safe to drink and to use for preparing
meals. Clearly label the containers so that the health facility staff
will know that the water is for drinking and is available for use. Use
a marking pen to write DRINKING WATER on the container, or put
a sign on it that says DRINKING WATER.
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| Using
stored clean water for handwashing |
7. Provide clean
water for the:
- Handwashing stations
in areas where health workers are likely to have contact with patients
who have fever or with infectious body fluids.
- Disinfection station
where reusable needles and syringes are cleaned and disinfected.
8. Assign the job of collecting and disinfecting water to a specific health
facility staff person. Give the health staff person information about
how to do the task and why it is important. Make a schedule for collecting
and disinfecting water routinely.
To disinfect a
large quantity of water:
1. Determine how many litres the container holds.
Example: 25 litres
2. Calculate the amount of bleach that is needed to disinfect the specified
quantity of water.
Example:
Use 3 drops of
bleach per litre of clear water.
3 drops x 25 litres = 75 drops.
3. Find a spoon,
cup or bleach bottle cap that can be used to measure the required amount
of bleach. Count the number of drops that the measuring spoon, cup or
bottle cap will hold.
Example: 75 drops of bleach = 1 teaspoon
4. Use the measuring spoon or cup to measure the amount of bleach each
time the large quantity of water is disinfected.
15 World Health
Organisation: Cholera and other diarrhoeal diseases control -- technical
cards on environmental sanitation. Document WHO/EMC/DIS/97.6. Geneva:
1997.
| Annex
8 Preparing Disinfectant Solutions by Using Other Chlorine Products |
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The disinfectants
recommended in this manual are made with household bleach. This table
describes how to make 1:10 and 1:100 chlorine solutions from other chlorine
products.
Preparation
and Use of Chlorine Disinfectants
| Use
a chlorine product to make : |
1:9
solution
For
disinfecting:
|
1:100
solution
For disinfecting:
- Gloved hands
- Bare hands
and skin
- Floors
- Clothing
- Equipment
- Bedding
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| Household
bleach 5% active chlorine |
1
litre bleach per 9 litres of water |
100
ml per 10 litres of water or 1 litre 1:10 bleach solution per 9 litres
of water |
Calcium
hypochlorite powder or granules 70%
(HTH) |
7
grams or ½ tablespoon per 1 litre of water |
7
grams or ½ tablespoon per 10 litres of water |
| Household
bleach 30% active chlorine |
16
grams or 1 tablespoon per 1 litre of water |
16
grams or 1 tablespoon per 10 litres of water |
| Annex
9 Making Supplies: Sharps Container, Incinerator, and Boot Remover |
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Making a Sharps Container:
If a puncture-resistant
container is not available for collecting used disposable needles, syringes
and other sharp instruments that have penetrated the patient's skin, make
a container using these instructions.
Materials:
- Plastic bottle
or container made from burnable material (empty plastic water bottles,
for example)
- Cardboard box
to serve as a stand for holding the plastic bottle
- Plastic tape.
- Gather several
plastic bottles and boxes made from cardboard or other
sturdy, burnable material.
- Tape the sides
and lid of the cardboard box together so the top side is closed.
- Draw a circle
on the top of the box that is the same diameter as the plastic bottle.
- Cut out the circle
and leave a hole in the top of the box.
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| An
adapted sharps container |
Place the bottle
inside the hole. Fill the bottle 1/3 full with 1:10 bleach solution.
- Place the bottle
with its stand in the patient's room or where disposable skin-piercing
equipment is used.
- At the end of
the day, when disposable waste is collected, carry the bottle and its
stand to the site for burning infectious waste. Place the bottle and
box in the pit for burning.
Making an incinerator:
See Annex 10.
Making a boot remover:
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| Please bring
this picture to the local carpenter |
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| Infection
Control For VHFs Manual |
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