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MON TORUL OFIC TAL ROMANIE

PARTEA I PREVENIRI INFECTIILOR NOZOCOMIALE


Clpitolul1 CONTROLUL lNI'EC l llLOR
l.l Defini!ie. tnclofi si strr.. d. conrdnin!re, cri dc rdnsnit rc
Inrecti0nosocomialr (lN) ene infcclia mnhchla in 0nil.lis&irarc cL panrri (d.
et
!iprivatc)j
carc sc ftferi h oricc boali lnftciioast cc podrc U ftcuosturd ctric .\iriJu microbjotoeic
si
pentru c!rc *nlndolad. cp cnjoldgic, a conticririlin iDpul snildliziriiracNlui ncdi.d sal
oatrcvrc or mcdicdlc, crrc rttcrca2t lic bolnlvul d oriti in-qrijnilor mcdicrtc prinirc, fie
Nrsonrlul
Mnna. dar'.iri scririrSlii lalc
ti
csc legdli
Drir
jncubrhc
dc
ltrio
a asknrli
modicdlc in uniraiea respectiri, indifcrcr da.i slmproDrle bolii apdr srl nu
4d
pc pcrio .
Factori
$
su rsc dc mntrm i n,rc i ntrr ep itlli ccrti
gc ii resDonsabili dc co aminrrc sunt tbalc nuncbsi Eidetemini intectii urjmutl etr mrr
p tir
eE!c.
Adc$i dcvin rcziionh latrildncnc.
Ascriiillarogcnisntr rlcr.bn (nunc
!.ncric
dar dc Prncur .rganisoclor uniccluta invtTibjte
'
hr rer l. r.rob.
r
x rcn
-J'n
g, nrl ot l,r{.4. |J'
ciupcrcisan Levui carc dcrclnind ni.ozci
- pamz ili i rcsnor e bil i dc p.riztozc:
vm$n Ld (heFiortupej
ncurooopcj clc
)i
Slrsele dc conr.ninarejn spiral sunt rcprczcrlalc dc
pcnonxl d. ingrijncl
cch ipdme nic
si
surniclc conraminarc,.x.lojeriedep.t. srLrelc. ioatorc comune, erc
i
-
scclcii i, c xcr.tii prdbc dc lib.rardr, rintpligil
mxrcrialc utlli/are c.nbriixic:
l,rcienliisnirrleLorsuot
m!isuscctlibiti la intccrii ddiorir! rezisrcnleiratumtc
ditrinuare dc bo.li
s,ude nclc nrcdicamcnro(inmodcptosoare, ohnniotcmpi.e)
Toalctclc comunc sau pro\nnnaM xh.r pacic{iniftsc riscul irltqiilorincrucis.tc.
Pnndpalelccii dc r.nsmirerea infcciiilor sunr:
' hnsmitcrca irrcrunrM.ccxraiiic.vcniiesreprininrcmedjut
mainilor:
calcd $irni.
tnn
iu!e. rrrinui, expccronlie (picituitc
FlLrggc), e$c rcspdnsabiti dc
apanria unul pm. r dc l0% di.trc infectjilc nosocomirtc Aerosoln djn dispozjrivc c dc
cur4arc san din scnigi pdt tnnsport! porlictrl. nidoscopise.lc drganismcor
gd
$
6i!
i' .L
f
n F 1,.
.'.acrorl'.9.d
tu
!r
r'i
-
irocul.rc cu acc sau soluii conraninare:
.
pcncrarea organGmutLi cu oc.zia $ndajcior urirarc, inubariet oror,heate. imjziitor
dLPOViNF o!a
l.: lrnirLl i
nruL'r'n.
dr \upr.'tcch r\i,uq'roldinr'i'iilor
lcnm r nrdntrr. in{turiiLc lnmizoacd.nrlri;i
irrlccr i. if rtrnl L9r0 ccn.rh
ltfku
c.ntroLr'l
.ri.So i d.0ro..dtr'L d.lTolrr R...rnxMiriLc
i1.di.rc ii.nntL i. .rd.x rtr,c subcotr[o
h.lilo.ltr p,hlLr trtr ltrtril.rc Jcr]Lir I
rdu!e'.a prlccduilor i,,utiler
uhLi/rrcr p!,r.dtrr LnDrx/tretu unrrirledeingi ne ftirni:
!r'dr.xrro ,iirDitrLi' ii!r'rLlo'
]rrblctri
'c/islcrri
x ixlinLrl
i,r xntrl l9st.cnrc.
lr.ntL
onb.hrl boliLl)r \i pR!enlic rL lntrodus prc.rtrftrfile rfireAx.
fri',
caE sc rc!oD.odi pc$onalului nedical si
loinc
cchipdcnfuld.
rnncctic fonflL.
.r1tr..
posihllir.r...oDr.cn'lu, (ncd
cn sitrlclc:i rlrc tlLrid.
nro\cdn.
d. ll
0]ri.rii
in r9t6 c.rrcL. pcrru.oDf.h'llxrLiLr
'
|rr.ric
xu itutud's
f.cnuL
Lril. {rnda'd.x hx/i x
]\r lnn rdatrlar prf/ari
f,
vi'(la r.I cili dc conLrnrlnxr
si f'orocorL.tc
{xiddrl. (
s(oprl p(\cni'Litr,tr L.'iih.li"Jtrl pxcicllilor.
$rirrr
trlui
sj
\izrdrrLltr
ir prczcnr in r[rc lpnrleLe r\nLr Dqid]rnenrul dc Supnr.ghnc \i
(ort.l
I hrlacf to
brtuJr [lccsr ca$ colcd.aza d.r. p1n iM cthadcL. rnh.foa\e $ safiNr.n
r.'lonxlL'lur
rn
r'u rizciza rlonn.tii
/niid
rn.unlc por. rirlc l-unrr sxr r trrsrrxL rt.c r 5.rn. Lnon.x/r
l l :
|.1
iplr trLL'i\.rh nr Drisr idc rklir \idccoDrrftr.i i.!{.ri'r1cftr
PoirLr. \ prlccrlLilr dc corrol tt l.diiLr trcbule \, tie clxr.
ri
crr.s. r tc id'.-!ul
Nr{irl
tr'cdirxl P.nLn r rn,! {'b coDfll iDtcciiilc shr dlootribt!
N[r
Nnrcc
!ccontuninxr.x. rufuenir. de/ ilcc! I
!lanrisepsi..
Drr0nt,mirarca. ii
tm.hcr
nrldicrLi. \e rdrr.r7. !rrl'sn nr{cmLulu n d.r
!j
se rDLici
nar.n.lcLttr ert (supDrni.. Nn,.Nlc)
^rc
cx sdor dilnilNrrm ru inrt r d.
nrinoor-lxnnnre ir utc d. crrih.c.
t,'orcj.,{
pcAoftlulLi d. o c.ntaDifuto
iin{xDcd. d. t.
irlx dc
F'srnctrl!
itr' lLli dc op.rxhi) \i ri[rca niJcmi'iri micrtffsri nn!]or h ncdn,t
(1'riitenia.s.
r.riuer !a'e !0,,$a in ind.Fnrtor nrurdiirici ls|iL ca
podclcli'.
$LDrltirclor
'-l
'
itr'. 1.,i,pi'r
r
..1r, r
'
\'
'L'
,ct.,,t.,
rc
rtrn
in sotutic dcziitaclmri iiarnr. dr r n rpihr.,dr;ihr.drsiingc \ccr!lii. d.
)
l)ezinfccti..k rpeatir *'r \c r|Li.i
nr
nr ir nrnr. D./ff..!ia cnc hrprr srtcf..,ti I
dcconh.rfirir \i sc .0lici fuiui pc nd.rialc sn sunnlir. curore Nu \s n!7i icrli/i dcctr
I LtrrL.ril \i J.rii,li.li)
rul
ti rer i/rle itr a.c..tr on.nlic p. . np.1lra. Jrbnd uttizitLii
p,od \rlorJNludleni!/dczinlcclic Curo c...r. drdi tle/i'ni.ri. ifto ii{. nerilizxn Mri
obled. .r rcbri.. in n$d mp..arn :li se il.i i'i r li'nf $pa tr
(cuirtrc
rpor dc/inridic)
anris{ri, cnr. ficlLnlii dc Ninx[c,. i n icLici.aft se xplica l. nivenL r urior vLi.
. i'n lr]k sxL dNn.rinJ m,cnrlnnnnrclc pre/eirc
nr Nom.rtulde.u]ilil|i.ccdtr.ir.
MONTORULOFICIALALROMAN E
Decontaminarca, .u cnia. dczintulia concuri aseDsia ca.c rcprczin{i un a.sanbtu dc misui
trc.i
rn n-Fli.".nroou.oercn.n'o
t
ngf trJ'5r'i.r
lgicna .sc un msamblu dc pnncipii
!t
praclici
carc vizcazi xhd|orarca s:lnftilij
si
pru$phc:
.
lu!rca La co.osinrt (infomir.a);
- m cohpo a'nenthdividu.l
Jicolecri!:
o lilo/ofie sio momla:
.
un ansrnrblu dorcguli dc munci
1,3 Chiddc pr.rulii univ.rsalc
Ordinul Di.isrului siniriiii Dr 916/2006 p vind aprohrea Nofreto! dc suptuv.gh.r.
pEvcnirc
,si
contnl al inlicliilor nosoconialc in uniriilc santurc (Anck
nr.J) denD.n.
con..nruldc..prccluriluiivcrelcisiyabil.+cmodatirarcadcapLi.!rcaaccjon
Scopol4li.nrii precauiiitor
univds r
(pU)
Scopul aplicirli precaulilor uilveEale csic
trcvciina
ldcul dc
'nunca
.l p.*onalului.
Corccp(ul dc prdatrrii universale se rclera lai
- ma$dlc carc se aplioi nr vcdcrcr
flevennii
hnsnritcii HIV. ViIB. vH(.n
al| tr!.mi
.r'.
1o('
i .,
'e
Llc ri|
n.
.tr1h-' r'd
rdt
!inge, altc iudc bnt.gice i
lcsubrilc
tuluror prci.n!ilor
se consideri a li por$rirl inridrr
cu Hlv,vIIB.VHCl
!i
Jlfi
4cnii
inicmbicni c! calc deransnitcrcDrrcrtcmti
Ganquini):
to! pacienliisc considcrr porcntial intcchri cu HlV, \rIlB. VHC sau ctr ahi rsen! mi.obre,i
.rc,I Jc LI
-N.b sd
: dco.a.. rci .
quh'J'
-._1r,.,,1elr\'rlB\Ij..
.'1"
p
nr i.c-ootra' dnr$'ntr,', i.
.i
'r.
r'1u..To|x.r..o..to
rmnsm rcr
' 'nr<hilff
p! !J. ;ne ni h
Regull dc brzi in rplicrrdN prrcruliitor
unircbrlo
I C .ns ideri toii
pa
cicnl n
pdrcnri
al in lccrari:
2.
(lonsidqa
ca singcl.. alre flui{Gbioloei.e.\i!csuturitc
sunr.onramiDrc cu HtV.HC\'. HC\ l
l. Clonsidcta cr acclc si dlrc oblectefolosirc in p.acric. N.dicdli suDr conraminatc dtrpr uriti/are:
Conlaclul rcgunenrelorqi rucoasetorcu unnarorrulc prodlsc
rrcburc considcftro h nscl
' ichid amnioli0. lichid pcricardic, lichid pernorc0t.
tichjJ plcuEl
lichid sirovtxt. lichid
spcnnd j secEtii vasinalel
oiicc rlre fluidco icc vizibil conrami'rotc cu sdnge.
I mpl.n.rtlrc!
Dre.,
uliild r un ivcrsr re
L Uritiarcdechipomenlului dc pr.recfic!d.cvdl,
cdbpldr, corccri
2 Spehrc.niinllor!l arLtorpi4i olcrcsmc clorl
3. Prclcnndi accidenlclo!sia alior lipui dc expunere piofesion
ii
4. Penomlintict .uHrV:
5 FraluaNr risculri pc caregorli dc locui de Dunca
si
.clivirad pEsare &
I.mon.tul
ncdi.o sanibrn, fuDclie dc conta.rulcu sangc
iirlto
lichidc biologi.e.
MON TORULOF C ALAL ROMAN E
Rr$msndiii
nrivind
uliliare{ echin!meDtelor dc
Droicctic
- ii
(intul
rutrcr rdivn ilor d tr onililo
mcdicrLe
fortrri,
bluc nnpcnncabi lc. oc hclar d c
sc.vi. i dc tr'8ci1r. l$ontr rre
comnlctrli
Don0l
lal.rclf.runci cdnd sc
,nticjpc!za produ.o.a de *ropi.
liiciluri.
jcturi
cu pr.dFc hnnogicc
Dorcnti.l
contrnrnlte. ir scctli c!
ptulil
clirursicrl.
i'nervcnrii carc nnpli.i cdnrrtol cu r.EnDi
ale lorpului in tu)d n.rnral sic'ilc
.b.rd \2{u rr p.i,r
Dun.lic
contr.rul cu rcsnNcitr'l pacr$rulLi dre
r.zi
i soll(ii d. oonrintrilde (nlis0
- Mnipulxrcr m.r D reLialc porcnrirl
conrrnimn ne{eilc.nrrr.
,lez!hnr!;fl
dr n11!nr nc.i ro' r,
mrnipularcr d. Dnnrnal. coDrxrnimrc
- ctrriitcf ic. ndcpinrrca de produse bxnoqi.c
- colcdxrc mate.irh.oikmrnrd.
cu.ili.clidcco nrcirrnun.nrft.
Miru\ilc fu sunr nn strb$itu
ncnrtr
diin,lor. prin Lm,oLc niiille rchuic
dlpa ir depanmc. xce$m
rcrlvitili .rrc
ni!n'pm
conruimrc sau
nmDir! cu dilc c nuideorlaii.e
silr dc op.riric. in rlnrpul tuxilruli ii
r nJ'.nr ui lc\rlnlrl
cortrclul cu
Dlc
ctr! cr mcni'isira vimli \au
bad.rixra. or TBC ptrhnonara cxre sunr BK
conhcfu I cu
|Ecicnli
cxre tuscsc
aspnarca secrqnlor rn hco hrcniccpc
- ingrilnca pligiloi
suptrrdrc
prcgiiiEaNrli'ziitorcLchn
odanrcc
Drclalircx
lrccinuriLor pcnh rdnri'risnalc
di2oL\'rcr
Dulberilor
h.n izarc
Miri c tcbuic sa iic de rit ulrru si si lic binc
vo\rTocur orr rA' Ar RovAlE
Spil0rca h6injlor dsigrd igidr, prdiccrir
$i
sccurir.ica pcrsornci
ti
. modillli siu, prcvcnind
ltutrrnircrca gcnnenil purtai pc nl1ni, resDonsabili dc o mdc pane dinrc intecriite
nosocdniale. E$c o sarcini anr.nonr. asnrcntul mcdic0l cac rsponsabit ditoct peniru
-tipuri
dc sDilare, neinilor
Lrlajul rinplu clinin Uord tmnzitoic lomuri din orcrobacdii. lirusuri, lcyui. ciqrcrct Dul
nnr sdr nni purin
FrogeDe ti
care nu se nultitli.i. l. se .Limirt h roulna[ dupa o spil.rc
mcliduloasi$ coDtactul cu m a$iscpric
Lrvrjul igie c sau .miscpri. elimini in totoliralc fioh rdibie
si
difrinudr/i flom
roncn .L, sau ETidenii. adici gcnncnii opontrdii .m sd gisesc i. nod natlral
nc
pictc
Ghnbc.culaudu dc cxqnplu) corc sc mutripli*i anonnat in rbseni. nr$LnLordc
jgictri
!idrc
ln scidcu rczistcnlci organismtrlui.
Frictiunea igidnici cu un
Fddtri
hidm,lcoolic clinina fl.rr haDzi!.ric si dhinu.azi flora
Lnvnjul rhi rgicrl se pnoticd in sililc dc operalii, siliLc dc ndsorc sittte dc pxisxrnente
lDdicaliilc spnlirii niinilor
-
hi rarcdsila lcsim din scRiciu:
i.dimc sidupituhtunrc. manuiilorsau a oricnrultip dc cchiphrentdc prorecric:
dupa oricc gest contrnrinantj
- duDi a.or!arca nrgrijirildr 1!i0ni.c dc conlon san hotclie' s.
cu oorzid insijinbr nei'rv!,ive (injcctii.
recottarc ljc sansc. pu.re!
uno so e
sasticc.
ulpao
En.lnreDrului
sondaiului linar. etc.):
- imi c dcnrcnrmrea
!idistribuirca
0timcnrctor si a ncdicamcmctortcr
osi
- duDi lolosirca loalclci.
dtrp, ingnj;M Lnul paoie imunodcpresivsru punator al mciinfeodii
-
cuocazi.mLizirii unei proccduri iNrzivcl
- uu.Jzi snrJrrr..""1"' r'
-ora'. .rpr.!J.
, d.-n"
'.
dupi dolt sccvcnle de
jngrijnc
cu nsc de conrairiraN ta acctari pacihr
sau n rc doi
SoLuia hldturlclolici- sa!
eclul.
Int ulilizdc pdnrru a subshui Laujul andscpric i,r oaat
oiinilorcurrtc dir
Nnc.
dc vcdcrc nrros.opic
ficliurca cu $l!ti0 hldr.alcoolici sau ctr
eet
sc aptic, pc hiinilc !arc nu prcr'ne umc virhitc
'lc
murdiiric sa!pulben. in cuoontuarsc rccurge h spaLorc!ctr ap, si srpun.
cu o.arr unor prcccduri cu rhc inoLr dc inltcrii (caiereiynut
cennat,
Nnorix
loibari.
&enajul plcuml. clc
)l
MONIIORUL OFICIAL AL ROMANIE
'
ncntu
inrercntiilc .hirueicalc la blocul opcr.lor sau in seflicnrt de adiotosic
- in alrc scnloii de lnve$igaEr
pcntfl anearcx nNbnlf.
- slipnn lichidcu dhnibuitor:
Drcsoapc
ic unjcil lolorinli indisdbdori
sanun lichid rtrriscpric sdu soh4ic spudorst .nriscntici du disrributrorl
- pbs.dpc Jc unici folosi|li in disiribuilol
solulic sau g.l nr dislribdorsd r_n anbalajul dc ptozdni!rc
- dhiuveri cL n,hi'ric cr sci7.n:
api conhtd ri brc(erio log ic:
.
solulic spumarli.ntiscprici cLr spcch larg (clorlExidind
dc cxcnrplul:
polnLr:i s(nli dc uici loloin!i lmprcgndi cu solulicnniiscttica sprtranri:
- nnliie sau
Ccl
hjdroalcoolic in disdbuito.l
p0bclc cu scnrri (neartionatcmnual)
R.Nlizarer proccdurii Lrvajul sinplu
' sedescopcEmdinilcsis cb
lclcl
"-dip.n.,7;brr
'
i"
'
i
",
sc .. c - r" .'
/h l.
- rc udimAinilc$.niculxliilemiinilorl
sc arlici o lioza dc sipun:
-
sc snoli fi.cam ftint
pnn
ffcri.narer
.$inrisl5inspatiilcinrcrdigihte,injurulunghiitor,hcrtumnatcadceeretor.Lapoticcril,
n$iietclc Dain ilori penh n ecare dir lccslc ngiuni sc cxecuta ciro J nriscirti
sD sprLi din abundcnli rir. si hsrm si clryi srpun pe o zoni deja chrnr:
sc r$rci prin ramponare cu
$eNelclc
dc liici folorjlF hr. { rcvhi $npn trnei zorc dcja
selnchide robinetul (daci
nu csic !ulondic).u ulrinu
leNclcl
de mijni0!itizdri
.
r' tr
r.. si(.J.,
Lptrbrli l; i rr ."e ur'Dcl.,. r n in"
Ntr sc acrgc chiuvera dupA spalarc. m,rilor! manev.a va murd*i din nou niitut..
sc spalimainilc inainrc dc a inbricr n1lnusilc dcunic. tuLosinlr.
MONIORUL OFICIAL AL ROMAN E
Rexl iz*or proced u.ii Lav.j u I igi enic sau $opric
sculi bine rdinilc
ii
tialatiilc:
-
slplici o dozi d. sipun antjscpti.l
' $ sprlt ficcaE mdni nDsand:
s insnti in snatiiLe inrerdi-sihle.
jnjurul
unghiilor, l. cxtdhihrea dcgdckr de ta licc!rc
nini carc sc ficlcd.
Dc
raDd in po'lu p{lmci oprs. cxccurtrd 5 Di$crril
sc spali pc rinJ, rsp..rtnd
..ftgula 5-(cinci D(.fui cicularcl pdli.cl. si rpoi
,niculaliile nlinilori
se slatDic din ahmdsnlidinspft virtuI d*crclorsprc rrlicutnriilc'nri'riloli
su dcnridpalmclc dncnhrc in ruslenr'! a clna oncc.onhmirarci
!e uluci or
snjt.
pnn hnpon.rc o
5crvelele
dcurici fnlosifli]
.
sejnchidcFbinctul(docinucNrom.LiclctrulrimulscncreLdemiiniurlliTat:
sc.runcli
$dvcrclclc
in pubch cu pcddr Eri se adreeD
tuboLi
cu Drana
TinpulJc spilrre: 2,1
'ninute,lir;
pcrierc
Lavriul anliscptic rrcbuic cfcctuat .orcd iminte dc rcolizarco inrrililii, uritiTtnd rrsx d. aDi c.a
rr cprop..' ru.eh' l! r
r.
J ,i' i
tcocgca.Jn'(!..c'r'e)
Se cxcor:l snJlrfta $risepricia nrainilo'in!intc dc { inbric. ninqiledcnnicti fotosinri
llediarq proc.durii Spnlrq igienicn r nAinilor priD lric{iunc
sc pun rphinaiiv 2
'n
de solulie in scobirura miinii uscarc si $ cteci@aza iii.trmea
rinl de 30 secuDdc licciind p.lnclc
lini
la dcgclc !!oi insisdnd in spatiil.
jnre.djeitatc
' sc lreri nccarc policcin irlcriorul mtinn inchtse, inoi cxftm irfti tc dcsclclor itoprc unde
de h licc c mara in
nod(l
pdlm.i dpusc.
Rcalnjren procodurii Ldv,jul chirurgical
Nuccsn, punarcr uneinretd.calotc
tiutilizaredde 5crcfclc
slcdlc pcnrru
uscarc, nainilor
Sc ph inp allhil na$a
ti
caloi..
Sd pEparn/prcgatcJrc
nond
impregnali cu solufn sptrma.fi h&epti.a.
sc ud:r minlilc, inicu aliile. stebFlclc
nlini
h coatci
' sc rplici o dozl dc sapun anriscntic
tisc
irc spuma di. abundenF
nnn
,nasaiut cicctrrr
J"ld.\rttr'J. lgaeu p, ,l,.ao.r.'hp k I n' L'i
.
se mcriir nrtinilc doa$rpra.oarclorin rimpul acc*ci oneritii;
sc clircsc din dhunder!i manib, antcul4iile. antcblatclci
sc psic unghiile tiide scun cu
Dcria
sldili inprcgnatn cu soturie sDumanli amis+rici
."rl:'c..dinJL',Je J naioile. r.hc'ctu
'
r J eo' dcl
' sc ia inci odozi dc sapun ontiscptic
tlsc
tuscrzi dnp & I ninur mainjLc, inchcictunh.
antcbr4cLc, anoi sc cliilcscr
se u$Ei. prir r.mpon.rc scrlclclc s.nlc ficcxr. rnenrbnL- irccpind dc r dcsclc spru
..ate s menrnind mtinilcr icate
l)"l)ii ? orc cIc ncccsur r.litcc(r isictrci rii'nlor.
L:rajLLl chinryical poalc fi conulchr ctr lrlcrilri chnuBiclle cu soh'hi hidoalcoolicc sru
Dcnndnc dcrcnrnkrc dc trrlLi^rcd pLodusclor riscprrc sipun liohid bhnd (doux).
saipld liclid anhi$hc, soluric rpunrrli anriscprici: in r.$ 0rz. cstc rccohxtuLnl si 1.
rcduci sru si se interuDr udli/Nr podusului rcspcdiv
si
si, \e r|rlicc..rcnri
hidrd.nra dupa liccarc spiloLc a rniinilor.
lonnr.cr uDci pcliculc ulennse, Liticiorsc priri utilizdco
'cpclrri
a soturiilitrr.scluilor
hid..rlcooLi..: sc rcconrndi spiLa.cr ru rpi di| .hul.ila a iiinilor
Usratoxri n aicrpirliip nicpinrc, grisi'minrml. r reguncntuhir sc r.c.mrnlti
clirn ctr rpi din rhmdcnlll \irpLicarer, dupi u\cxE. a uncicrcnre em.lictricd. triiirri
cxrt si nudete'ioE/c D,inu!ile de cauciuc nrc.dl in crr. ac.nea khui.
Du'1
c
l.: Pt.crurn dr p'!r,n"r r inlrrn'l
'
r'rn\mi\cpi !slcacrirnd
Aii.tiuric crr! ilccsilr n!lcl dc
oruer1n
s11:
zona zoo$$dN.minxl:
-
/otu 7.o{c' Locrlizit lx
F.
cnr i irnuodcprllivr:
plcicrti hhco$onrl/nti
lcc*c
f'c.au1i
. ilitrr dc prccrtrriilc mnJrrd. prcrnr risn ndir.r agcriior palog$i cc sc
trnnnir
D.
cdlcd &nrlul pin iinul. rusc v.rbn. respmlic.
A.cic pnrurii ncceriri. efecN. o camcri.u
trdsnnc
ncgrtiv,,. cu Lsi inctiisi_ pcnhr.
n ntinc o
t,rsiurc
adc$"n . .lJulLi intc.an.ra dc iz.lrr \ihol
P(\iLrerrcg
jvi.rdultriJircxrnende
Tolarc. trla'ic
'noriroriari
ixr aerutrrcbrie d;ijri i'l
ertcriofl I cLidini sru tihot imintc dc rcciclarc
trotccrir respnaro c irchuic uriliz r dc ci[! roarc pdAo]ncle carc nrr in raDrch
GuDr
idcdc
\r|]aratcl.c c tuLo$sc l,lrn dcacr).
P&icrlll va prnr in alara cameRi (riuncicirt r. rtobur s.
ti.iscarcii
pcnrn cfccuarea uDor
pro.rdd.i) mr\ca chiruryicala a$zara pc$c glri s n
s. u
t.c!
i to c mdd rl.lc fc.csrtu rcspccriii prccruliilor
dc
[ey.Di.c
I irl.clijLor
tan nlsc pccrlc n ipcunciruc,or. in anric$reF.
cancli
ncntu
usrcrnrercide irc rt:
hr la tc, nr 6nuti dc unici lolosin ril
naleriale
Dc
ru isicna melnilor.
- sc
nlasev-n
pacicrtoup.cidtii (n.xlm
2 pa.icnri) inlr-o csncri cu prcstunc negativi. cu
llta inchisiljrevizuri cu anticlnrcri sau hol:
-
5e vorcxplica prccaulillcdo izolfo pdcidrLluit
a familici a.enuia:
sc vdr nc.tinc inchirc ror timDul atal nt. canereicir
tiut!lrlccdmc
iFnruancilinc
prcsiuns negltivd a acnlniii pcnrru rnurispardi alcniip.ldgcni di'r aer
sc vor afi$i pe nla camcrci prccauliilc spccifi.c provcnini iEnsnircrti infecliitor
lc
.atc
reriani pcnrru a fi cnitc dc oricD pcNodni cxrt inrri in comcra dc izoLarc:
sc insrui$lc pacicntulsi si acop.ft nasul
ti
gun cu
$rveletdc
hdnicdruncicind rulesrc
-
\e plascaza uniccipimr
Gac)
pe unadin lotcmlclc polrl pcmru
capacjcmutsi coL.ctcz.
matcrialclc rolosire (lerelele. coDprcsc):
-
5e thilcazd mobilizarca pdcicntul0iin afara ra'neEi:
d.g, tcbuic rt ptriscrsci cameB pcntfl divene pruccduli, pdcicnrlt v0 pun. o n.s.i
lhiru rgica li iar $efrlo iul de iNsrigatii/rrahme nl va fi anun
td
I d.sprc
nrcaulii
lc de i70 Larc
nabilire pentn cr rcnca s:l fic nentnrutc
ri
ncoto
St
pcntu cr pacicntut
si tic adus nr
c nera dc izolxrc cir mi repede posibil.
1.6 Prcc tii dcpr.venire a nfstiilor Irrnsnise prin picnorilc
Flugge
llolilu !a6 ncccsni a{lel de precaulii su :
- fncunionia hcmothiLusinflenTrdctiDb:
- Falif gila slrupto.o.ici;
Pncononiilc hrcrerienci
- Scarlatinalacopiiifrici:
Paroridi ri ep idem ici:
-
lnlcclia N adchovitusun bcopii.
prcc.miile. in accslc cauri, ru nacsirt in
'nod
obligarriu clDrcrc dc izotre cu prcsjund
nesativi
!i
cu sislcm d. inchiddc auro'nati anjiii
rcspocrma acc{or p'eoautii prcvirc rispindnco ilicc(i]lorcc sc ransnn pri,r picntuiitc hi
Pulgge (slopi
dc salivr rhptndiii in acr prjn tLNc. srinut. rorbit): accn pic un,
inoircaic cn gcfteni patogeli. cad
!c
podca si sc 6ucn, rftnsformind0-s. in
Draful
bactcnrn crre cstc lDoi irlDiatl
-
ratcriolclc ncocsdm aplicini accsior prccautii vdr fi pestmlc pc un cincjor in llaE
- prciclrtul\o fi p asar ifu-ocdmcd pmvrzuri
ou toale.i completutila!.i
vo\ oP rorrr{ a FoviNr
- prcicoillDoatc i'npi4icanrcm cn Ln all bolna\.clrc arc acccasi.iccrnbci
sc lor crpll.a pa.icntuhn$diliciptuccduril. dc izoldsi
sc lor ati$ prcoutiilc dc izolar pe usa ca.sci pcotfl a intumra, in prcalaul,
Dc
orici[c
sc vor sD6b Nairih nroirtc
ri
dupa icsnca dif caNn dc izoldrc.ir si
lrc
prrcu$u
inr$vontilor d$prx pacicnl0luii
se ra ixa nasca pe fa!d.
Drin/ind
o ntrmride
irefun
in dnpul maninulrni:
.
se ftsiaicfc
lacieDtulsi
utlll/e/.
s.rvelele
dehinie.comprcsc
Dcnr
.{iacopfi gun i
Msul atunci ciird tuicstc, srrinuii
;i
si lc colcclczc in rccificrtul dc ld pdri
.
riznaMii lor li inntoirisi podnc brlar. si diej p. cdr lc ror
nrocum
din auron.tutcu
cchiDarnenb de proretric
$
sa pistczc disranrd dc ccllUrln un melru liti dc prcienr:
.
dri
ldcientul
rRb ie si prrisc.sca cnm.ra
ncnro
invcnigrlii. va puna o msci ficiali
bire firari pe guri
)i
nrs irr scrvrciul respectiv lr fi inlrii'rlrt dcsprc procauliunilc d.
1,? lr.cnuiii de prlrdire n infediilor trrnsnile prin coni|rt direct cu sc$chilc siu
Sc \or
tftgili
mrlerlalele necesxre rplicirii
[ecrnliikn
de.orhd p. n cin'cnn if llin
hrldrc. ni$ chidrsi.rl.i
n,inu$l de unici lilosinF:
ars.j pontucamera de i,llxEi
ec1 rru pungi dc plaiic
sc vor explicr pacicnt'lui/liDrillciFo.cduil.dc i,o atu:
sc vordfie pc trs, aucvc pto.adiiponhr inlbnrardi
sc vor spila mii'rilcinrinre
i
dlpi ie!re! dh c.mDia.
si
duni nrdcpdnarca nfmsitr:
probclc biologicc iccokatc lor li pl.rde in curii iDpcrnclbic. cri.hcrare oorer
sj
s. v.r
tinile lmedirt la hborito.
sc vo' ak\r pc pdn* cxrcrn, a.rniilorin(n'ctilnide mancu.rc prudcntdl
- vzna(orii vor n ln$ruirl si poarre Darusi
i1
hntdc
nc
rot
tlrarsrt
vizrci
!i
ri
ti
spclc
mainilc drpa indcFtrarc. cchip.ncn tr' lui de
Folcclic:
- l.r1e obiccrclc carc au rcnn ir .otrrad cu picicntul \or fi
tlasatc
inr. sinSud purga
iotcmcabild
ri
sc vor m nlirdlc trc.csdc pcnr indLTinaEa sau penru
dczinlickrcd
- sr vor uriliza matciale scparilc pedn tlc.arc
Fcicnr
in panc (lcnnon.rcj
rensiomctuc.
s.'. c..i,cr 'c
'u ".J1
.
'
i
'l"n.r '
i h,.
r
n.'_r'.dc
-
$ limirca?'i mobili^r.api!icnulul hrfa.rcxncrci:
.
in cazul dcplasirii pacieniului la diL re seFic n dc invc$igrlii
i
i toranc n!. sc vdr dcopcri
lreil dnile dacb cxisa. iar scriciilc rcsncdive r.r fi informalc dcsp ptucaulitle de
MoNToRULoFrc]ALALRoMANIE
- !c lor schinba ninnsilc dupi lic.rE prcccduri cticruar; prcienrnluj g
se vor spito
n$i.ilc dupi indepi rrea fic.irui dnd dc mintrsi.
l.S lrrautii dopreveniru, infecliilor Ir p&inti cu trutroponic
Acc{c preclulii suntindi. c pmrtu prorectirpacicntilorcu:
.
SindtunrullrunodcficicrbiDohindilci
boll inLcriorse cu eDplie
ycziculrlil
- rni!'nentcimunosuprcso.rc.
Anlicrrer accslor
Drccaulii
variaza dc td m spirdt ta atruL, tiind influeniat
ri
dc
lradtrl
dc
ETisicnr6 a olgani$nuluj pacicnrulli;
Accstc prcc.trlii paniculaizarc in lundiic de paroloei. pacidtrLLuisunt:
.
rlz
ed p(rc'tu|,n ..ng
inh- r, ne' d. r/. d!
(. pcrLF.pJ
rq\J
Il.nr
i tnr
na
iculcbana[ii suspensie s, se dcpure sau si liD sodds. afira din cancr.ij
' limitEailaicului ircnnrmdcizolfci
-
tunotur
haldrclor dcpmlccric. ntririlorsi rninutitor de citrc
ticadnalltde
hArijnc
si
de
.
urili/G! dc lcilcnc iriti
ii
de cchip0mcnr .omplcr de pmtc.rie in clat ingrijnii
pxcieDtnhi cato. n'leriiun trnslla dcoltmi
.
\$larcr nriinilor in mrimtrhc ctdpcpdrn decodani.aRi
triarcd lpidctuiologici prin coDroatc rigurorse
{cxudar
nno&ringir., examcn
coprupardznologic. ridiogr"ii. pulfomri) a pcsoanclorcarc ingrrjesc
tactentut,
pcfrru a
li idcn ri fi crli punatorii sinftoiii
- elirara pio.cdurile inuziac la plcicntii cu nculbpcDic ntrtucir accsrco prczimi un i$
crcscur p.ntupacicnlll
{ imunilalc sot^tri;
- peBonllul dc cur:ircnic va fi in(ruirsn,t puni hrLare. misri
Sinrnusinraific
si innc ir
Mlrerialclc necesarc vor li
DislmtD
r_n .nticdncri
lre
un cSrucior specilt.
- ntnltide unica tblosimii
acopunorj pcntu incil!!mi'nei
-
se
Dlascun nacicnlulsinxurint-o
crh.di
MONITORLLOF CALAL ROUAN]E
.
s. r\rlici
nrrl.nruhLirfxmiLi.i
prccruliunlLe
de izorre pcnrto x i drnnnfa afxLcucn si f-i
$iDnla cootcnr.i cu.clita dc iilriir:
r \o. rfin Nnn.tnD lc0c u\rcrnrc.c:
sr\o'spaLirilhilcctrtrtrxlcrdfriscp(irn(i'ncsidtr0,ir.|turaLcrlninonlfnrecr si
rr rrcu'nLl
rudtu il inqritinlor
s.vorpun.h.lxrclcdcprorc!licsirl.nr\iL...nfti.nnrtcxuriL'ni.r{r dxnli
v.rtiirtcrzis.!i7rlc1r. \orrcl{r curorc i..xllii,dbon\csrtrnrticIrc:
' drortc
rrci.ntr'i
m r. o bot'Li conhun*i nur.rirleLe sau obi.d.le crre
Fisr\!
unda dc to re Du nrr!\iLll
FccxuliunlspeciaLe
ni rlaftr.l.riiidNnr
l-9 ltilizrrcx.chipimtntului dc iTolarc
- prcrcnncr rnniniLrrii inl..rnlor dc h p.Aornx ira..L!i hr(ip.ciunri sxrdc Lr n.nh
N{,nrlu
uine irg,irire lr
Drcirnri:
rcdNdcarn.uhLiiifc.rinini.crlilttr.tri rfrtrre\.i7uri
{ | lclc cch ipalrntrLl izohror n, lnNr. dc \!,r:
rorte coNpo0cDr.lc..hlp.lncnn,lui Llc
nrorc.i.lhrxl
rf-! cn Dti!f kn'!i $ \n.rl\rtr
tcuorr.nirnn.Drini.ochcl.ridc|li(t.roc.hond.)srs.r.i/rid.D.lirtrrorlt
ni
DdcrixLr irr tufcLie de
rr)cedun
cxre unn.xTii
\ctrgt.n.^m(.1!.r' ! cf.r,cLr. bctrziizolxlorr \r.in. tLL.n' rNrir rnrn..tr.
d.
nixni. Nfl
! cN/irxu Dncrnrlclor tblosirc
r:lerlunru pmc.durii dr inb$$&
\e
+,ila
Niinilc.u m rgrnr de ctr.itrrc rrF.fri( pcdn I prc\cni
d.^okrrer
mLcroorg.rlmc or i'r e.tunLL inu\i1..
sc inihm.. h. rtul
iri
sr irjliisoxn dcrtrtrl imllreiutrlclrprlrr pere uojtamr !bijrurii,.
.ai.rcbr c rn o N!P.r. .onlplrl:
- sc lcrui bi'r
)
rcntrilc rtr sc r.!c htuorru s rp.i s. tcxll b.idcL! halrtutur irr
jLn
se .r.azri mr\cr conn)nlbil
l]cft
nrs si
!u.i
ri rc l.xg:i
)lrentritc
nrini ir r.! trica
or.ifnrLi. {ir.i!dr dcsrs( sa I ilLftc.:
(lr(ll
snr rc$srri ocl,.lxri d!
tror.cric. $'b n]rrgifex dc
los
a
inantr!ilc se x,r
nurc
r{tiLi'rit si r.oNrc nrrsnrilc rnindcilorhrtatLt idc|nrcclrc
indrpirh(i.chipinre tuluideprolerrir
schrc$rmrJcIintLLd:iFrrllee\rem..lcrdripafl.nr'lu dc
]rt{..!!
\unr rotrkrjimr.i
cuniinr donrn.nLi inrninuvrii \eind.F rxTa nriid0si dc pc mria n.dornrnlnti mti' irl
sc iftlcprncui sj miitrtr\r d. p. matir ioniin. a inroducird nnt.r' dou, JNgtre prr
i 1 ,, i i
I
'
J
'p.
i .
ni !m lindqrinirii iifusilr nu \c \i ir!
nicr..
o prn.r c\reM a x.ci..a:
\crntr'c.ut nLrn,v.rl\NcirlNr[ cchirrn]cDro.ofilDn.arc.
MONITORLJL OF C AL AL ROMANIE
.
se dczlcaen masca
lnand-o
numi dc
lireruri
i
sc dqjorteudj de $cn6e4 h sa l
pcnlru cchipanmrc conhmin el
- daca pacientul arc o bo.h.c sc rispind.itc
tc
crlca.cnLlui. $a$ scv. indepinalhimr:
sc dczlede'i hahtul din
j!ru|
situluii
- sc prindc halalul do pancd cxrcdi dinre une
Si
sc tr.g. de pe mdncc i idorendu- t pe dos
pc nrsura cc csc scos de pe coaj perm a cvirdconraminorcal
se
jnrc
h.latul
nrorccror
ci1 n.i deplrtc dc utritormr. sc impiturcilc pe
dos ri rc
dcno/nerl.iin recipicntuL pcniru ccbitamcnlc conrhninatcj
-
5c stala mliinilc
si
.mcbratclc cu sipun
$i
agenl lnliscl)lic inainrc dc a icsi din camera
(da.5
chnNcb sc alliin.mcD pacienrului)i
- !c inchide rcbinctul (dac. nu c$c aubmrtic) inlosind un pro$p de irAric cc sc rtunci in
- se acfioncazi clonF
'\sii,
pcnlru a o dcschld.. rol$ind un alr pr.sop
dc hdnic djnr:
sc va
jnohjdc
lsa c.ncd, pc dimfari. cu ne.a ncprotcjdtl
- daci dhiuvera esic in anccarn$a. sc vor srita miinitc
St
dnrcbialete cu satnn \i rgenl
mliscpric d.p:l pirisned camerei de izolorci
.
dupi ficcorc
trocc'l(i.
cinrcioruld.luctu vr fi oldrar. dczintecrat
:i
dokr .0 oacnrtcte
ncccsorc unci {lrc
procoduri:
.dmcn dc izolatu M fi complet curitaia
si
dcTinfedrlt ljupi c\rcmdrca p,cientuhi