1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
name etc.
2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also.
7. See notes for bibliography.
3. Covid19
For healthcare personnel
• In Waiting areas and queue patients should
maintain a distance of 2meters from each
other.
• The healthcare workers should cover their
nose and mouth with regular surgical face
mask.
5. Self Protection.
• May start Tab. Chloroquine Phosphate 500mg./
Hydroxychloroquine 400mg.every week.
• Dont’t apply foundation, sunscreen, liipstick with N95.
• Don’t wear any jewellery, Bangles Watch, money, Belt,
wallet, purse etc.
• Shave beard.
• Don’t carry mobile while on PPE.
• San itize mobile frequently.
• Don PPE before
1. Entering the room of a covid19 +ve .
2. Going within 3feet of a suspect.
3. Ask a suspect to don surgical mask himself.
4. Ask Covid19 +ve to put on N95 before you enter his
6. Self Protection.
• Avoid touching eyes, nose and mouth.
• Keep social distancing .
• Frequent hand hygiene.
7. Self Protection.
• Avoid/ be extremely careful aerosol
generating procedures-
1. CPR – consider DNR
2. Endotracheal intubation
3. Non invasive ventilation-
1. Bi Pap
2. C Pap
3. Bag mask ventilation
4. High flow Oxygen.
5. Suctioning.
8. Self Protection.
• Avoid/ be extremely careful aerosol
generating procedures-
1. CPR – consider DNR
2. Endotracheal intubation
3. Non invasive ventilation-
1. Bi Pap
2. C Pap
3. Bag mask ventilation
4. High flow Oxygen.
5. Suctioning.
9. Self Protection.
• Doff PPE very carefully
– Outer surface is contaminated don’t touch it
with bare hands.
– Roll gown and gloves inside out.
– Perform hand hygiene after doffing.
– Doff inside isolation ward.
– Don’t doff in corridor.
– Use checklist by buddy system
• Discard in proper bin/ disinfection bin.
12. Doffing Checklist.
1. Waterproof apron.
2. Shoe covers.
3. Gown and gloves peeled off as one unit., roll
inside out.
4. Gum boots
5. Hand hygeine.
6. Head cover from behind.
7. Face sheild/ goggles.
8. Mask from behind lower string first outside
doffng area.
9. Hand hygeine.
17. Ventilation and Air conditioning .
• 1.ACs should be run at 240C.
• 2. ACs should be run with windows open.
• 3.Heat Recovery Wheel should be set to Off
position
• 3.Suction of Central AC should not be
allowed to recirculate. It should be vented
through an upward plume 3meters height
above the tallest point of hospital.
18. Ventilation and Air conditioning .
• 4. In rooms with high viral load eg. Isolation
room,Operation Theatre, labour room, endoscopy
room,exhaust fans should be fitted and run when
occupied, even with AC running, and block off the
return air vents of these rooms.
• 5.There must be half an hour gap between cases in
OT
• 5.Scavenging port of Anethesia machine and
ventilators should be vented with a tubing into a
receptacle filled with 1% hypochloride solution, to
be changed daily.
25. Standard precautions
• hand hygiene
• Give up hand to face habit
• infectious waste management
• sharps safety devices
• PPE
• respiratory hygiene/cough etiquette
26. Standard precautions
• considers all person potentially infectious
• applies to all individuals, regardless of
presence/type of symptoms
• used against exposure to blood, all body
fluids, secretions, excretions (except sweat),
mucous membranes, non-intact skin
• Needle stick inury.
• Safe waste anageent
• Cleaning and disinfection of equipent.
• Cleaning of envvironment.
28. Hand hygiene
Wash hands:
– before and after client contact
– after removing gloves and other PPE
– after contact with contaminated surfaces and
items, specimens, even when gloves are worn
– before eating or drinking
– after using restroom
– after coughing, sneezing, blowing nose
31. Standard precautions
1) Work practices
• hand hygiene
• no eating, drinking in areas with risk of
transmission
• no re-capping of used needles
2) Engineering controls
• safety devices on sharp medical devices
• sharps containers
• hand washing facilities
33. Droplet Precautions
For patients of respiratory infections
1. Source control: put a mask on the patient.
2. appropriate patient placement in a single
room
3. PPE Don mask upon entry into the patient
room or patient space.
4. patient to wear a mask and follow
Respiratory Hygiene/Cough Etiquette.
35. Contact Precautions.
1. Appropriate patient placement in a single
patient space or room.
2. PPE gloves and gown.
3. Limit transport and movement of
patients outside of the room .
4. Use disposable or dedicated patient-care
equipment (e.g., blood pressure cuffs). If common use
of equipment for multiple patients is unavoidable, clean and
disinfect such equipment before use on another patient.
5. cleaning and disinfection of the rooms.
42. Sharps safety devices
Needle stick Safety
and Prevention Act
– Avoid the use
of needles
where safe
alternatives are
available
– Never shear,
break, bend, or
44. Sharps safety devices
Needle stick Safety
and Prevention Act
– Dispose needle
and sharps in
proper
container
– Never reach
into or overfill a
sharp container
46. Personal protective equipment
• Specialized clothing or equipment worn by
employees for protection against health and
safety hazards.
• Personal protective equipment is designed
to protect many parts of the body, i.e., eyes,
head, face, hands, feet, and ears
48. Standard precautions
Respiratory hygiene/cough etiquette
– cover mouth and nose with tissue when coughing,
sneezing / into own elbow.
– immediately toss tissue into yellow bin.
– wash hands with soap and water or use alcohol gel
– have client wear mask if possible
– barriers for front line staff
49. IN OT
• Handlesharp with instruments.
• -Pass sharps to each other via kidney
tray.
• -Pass needle to and for needle holder &
thumb forceps.
• -Use thumb forcepsin left hand
duringsurgery.
• -Use instrument for retraction.
• -Wear goggles during surgery.
• -Throw sharps into sharp collector.
• -Use skin stapler.
50. • -Wear gumboots in O.T.
• -Report needle pricks to ART center.
• -Soak used instruments in bleach
beforew ashing.
51. IN OT
• Do not Catch needle with hands.
• -Do not Pass sharps hand to hand.
• -Do not Recap used needle.
• -Do not Use of straight needle.
• -Do not Use hand for retraction.
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57. Waste management for COVID-19
• Keep colour coded bins .
• Double bags.
• Label Bins, Bags, containers, trolleys “COVID19
waste”.
• Transport “COVID19 waste” seperately from
other waste.
• BMW staff to wear PPEs Splash proof gowns,
Goggles, Masks, Nitrile gloves, Gum boots.
• Disinfect Bins, Bags, containers, trolleys 1%
hypochlorite solution.
• Make seperate Pit for burial.
58. Colour coding of Hospital Waste
Transfer out if COVID-19 negative
Discharge: afebrile for 48 hours; normal vital signs
(pulse, respiration and BP
59. Sanitization
• No brooms.
• No Vaccume Cleaners
• No Spraying No fumigation, No foggiing
• Only mopping with 1% hypochlorite 3 times a
day.
• Unidirectio nal Mopping away from you.
• The door knobs, handles, railings, lift switches,
nursing platforms etc. should be frequently
disinfected with 1% hypochlorite.
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