Jump to content
MrsSurvival Discussion Forums
Sign in to follow this  
drumrunner

Safe Burial Practices

Recommended Posts

Medical & Flu Treatment

Edited by WormGuy

Share this post


Link to post
Share on other sites

Interim Public Health Guidance for the Use of Facemasks and Respirators in Non-Occupational Community Settings during an Influenza Pandemic

This document describes interim guidance for the use of facemasks1 and respirators2 in certain public settings during an influenza pandemic. Very little information is available about the effectiveness of facemasks and respirators in controlling the spread of pandemic influenza in community settings. In the absence of scientific data, this document offers interim recommendations that are based on public health judgment and on the historical use of facemasks and respirators in other settings. In brief, these interim recommendations advise the following:

Whenever possible, rather than relying on the use of facemasks or respirators, close contact3 and crowded conditions should be avoided during an influenza pandemic.

Facemasks should be considered for use by individuals who enter crowded settings, both to protect their nose and mouth from other people's coughs and to reduce the wearers' likelihood of coughing on others. The time spent in crowded settings should be as short as possible.

Respirators should be considered for use by individuals for whom close contact with an infectious person is unavoidable. This can include selected individuals who must take care of a sick person (e.g., family member with a respiratory infection) at home.

Facemasks and respirators should be used in combination with other preventive measures, such as hand hygiene and social distancing, to help reduce the risk for influenza infection during a pandemic. This interim guidance will be updated as new information becomes available.

Introduction

In November 2005, the U.S. Department of Health and Human Services (HHS) published the HHS Pandemic Influenza Plan (www.hhs.gov/pandemicflu/plan), which provides public health guidance to national, state, and local policymakers and

1Unless otherwise specified, the term "facemasks" in this document refers to disposable masks cleared by the U.S. Food and Drug Administration (FDA) for use as medical devices. This includes facemasks labeled as surgical, dental, medical procedure, isolation, or laser masks. Such facemasks have several designs. One type is affixed to the head with two ties, conforms to the face with the aid of a flexible adjustment for the nose bridge, and may be flat/pleated or duck-billed in shape. Another type of facemask is pre-molded, adheres to the head with a single elastic band, and has a flexible adjustment for the nose bridge. A third type is flat/pleated and affixes to the head with ear loops. Facemasks cleared by FDA for use as medical devices have been determined to have specific levels of protection from penetration of blood and body fluids.

2Unless otherwise specified, "respirator" in this document refers to an N95 or higher filtering facepiece respirator certified by the U.S. National Institute for Occupational Safety and Health (NIOSH).

3Three feet has often been used by infection control professionals to define close contact and is based on studies of respiratory infections; however, for practical purposes, this distance may range up to 6 feet. The World Health Organization defines close contact as "approximately 1 meter"; the U.S. Occupational Safety and Health Administration uses "within 6 feet." For consistency with these estimates, this document defines close contact as a distance of up to approximately 6 feet.

1

 

health departments for use during an influenza pandemic. Among the infection control measures described in the Plan is the use of facemasks and respirators in the healthcare and community settings (see Part 2, Infection Control [supplement 4] and Community Disease Control and Prevention [supplement 8]). Since publication of the Plan, HHS has received many comments and inquiries about the use of facemasks and respirators during a pandemic.

The U.S. Centers for Disease Control and Prevention (CDC) is unaware of any major new scientific information related to either the transmission of influenza viruses or the effectiveness of facemask or respirator use in preventing the transmission of these viruses since the drafting of the Plan. However, given the requests for additional public health guidance, CDC has prepared this document to assist in planning for decisions regarding the use of facemasks and respirators during a pandemic. As used in this guidance, "non-occupational community settings" refer to places and locations other than workplace and healthcare settings (e.g., mass transit, public gatherings, households); interim guidance for workplace and healthcare settings is provided in other documents (see below).

For advice on surgical mask and respirator use in healthcare settings, consult the document, Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Healthcare Settings during an Influenza Pandemic (www.pandemicflu.gov/plan/healthcare/maskguidancehc.html), which provides a framework to facilitate planning for those settings. Together, the interim guidance documents for the healthcare and community settings augment and supersede information contained in the HHS Pandemic Influenza Plan, and they will be updated and amended as new information becomes available. A separate document, Guidance on Preparing Workplaces for an Influenza Pandemic (www.osha.gov/Publications/influenza_pandemic.html), prepared by the U.S. Department of Labor, provides guidance for facemask and respirator use in occupational settings (healthcare and non-healthcare) during an influenza pandemic. For more information about pandemic influenza, visit www.pandemicflu.gov.

Background

An influenza pandemic will likely cause illness in large numbers of people in almost every community worldwide. Influenza is thought to be transmitted from person to person by close contact (within 6 feet) with individuals who are infected with influenza virus (e.g., via exposure to respiratory secretions). It is unclear to what extent inhalation of small particles or direct exposure to larger droplets contributes to this close-range transmission of influenza viruses. Experience with influenza viruses transmitted from person to person in institutional settings indicates that most transmission occurs over short distances; long-distance transmission through the air (e.g., via ventilation systems) has not been demonstrated. For a more detailed discussion of influenza virus transmission, see Appendix A of Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Healthcare Settings

2

 

during an Influenza Pandemic (www.pandemicflu.gov/plan/healthcare/maskguidancehc.html).

For many respiratory infections other than influenza, transmission occurs primarily during the later stages of illness when infected persons are likely to stay home or seek medical care. In contrast, influenza tends to be most infectious during the early stages of illness, especially just after the onset of coughing and sneezing. Therefore, much influenza transmission during a pandemic is likely to occur in non-healthcare settings, such as schools, public gatherings, and households. Although it is not possible to completely avoid all risk of becoming infected while continuing to interact with others in the community, individuals and households can use various strategies, including those described in this document and elsewhere (see below), to help limit the risk of exposure to themselves and their families.

Vaccination is generally considered the most effective way to prevent seasonal influenza. However, unlike the typical situation with seasonal influenza, an effective vaccine may not be available for all people early in a pandemic. Thus, current U.S. pandemic preparedness and planning efforts have included the coordinated use of nonpharmaceutical interventions to help reduce the spread of influenza. This approach is described in Interim Pre-Pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States — Early, Targeted, Layered Use of Nonpharmaceutical Interventions (www.pandemicflu.gov/plan/community/commitigation.html), which would be used in conjunction with this interim guidance for facemask and respirator use.

Community-based interventions include the following:

isolation and treatment with influenza antiviral medications of persons with confirmed or probable pandemic influenza;

voluntary home quarantine of members of households with confirmed or probable influenza cases;

dismissal of students from schools and school-based activities, and closure of childcare programs coupled with protecting children through social distancing in the community; and

social distancing of adults in the community and in the workplace.

One social distancing strategy is to avoid crowds, individuals with an influenza-like illness, and other situations that increase the risk of exposure to someone who may be infectious. If it is absolutely necessary to be in a crowded setting, the time spent in a crowd should be as short as possible. If used correctly (see below), facemasks and respirators may help to prevent some exposures while in a crowded setting; however, they should be used along with other prevention interventions, such as cough etiquette (see www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm) and hand hygiene (see www.cdc.gov/flu/protect/stopgerms.htm).

There is very limited information on the use of facemasks or respirators for the control of pandemic influenza in community settings. Thus, it is difficult to assess

3

 

their potential effectiveness in controlling influenza in these settings. In the absence of definitive data, this interim guidance document draws from the principles of traditional infection control and industrial hygiene approaches used for enhancing protection of healthcare personnel in the healthcare setting during an influenza pandemic. (For background, see Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Healthcare Settings during an Influenza Pandemic; www.pandemicflu.gov/plan/healthcare/maskguidancehc.html). However, there are fundamental differences between the healthcare and community settings, including the following:

in the healthcare setting, exposure to an infectious source is frequently intense and prolonged, which would be less likely in the community;

in the healthcare setting, the infectious source (e.g., an ill person or contaminated item) is more likely to be known to be infectious than it would be in community settings; and

in the healthcare setting, the ability to provide direct training in the proper use of facemasks and respirators is much more readily available than it is in the community setting.

Because of these and other differences, recommendations for the community setting differ from those for healthcare settings.

This document emphasizes that the use of facemasks or respirators is only one part of a combination of approaches that can be used to help reduce the spread of virus from infectious to non-infected persons. Guidance on community preventive measures is provided in Interim Pre-Pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States — Early, Targeted, Layered Use of Nonpharmaceutical Interventions (www.pandemicflu.gov/plan/community/commitigation.html).

Certain practices related to taking care of a person infected with influenza at home can create potentially infectious aerosols and require more stringent precautions (e.g., use of a respirator by a caregiver in the home). Examples include giving nebulizer treatments to children with asthma who have influenza and providing care (e.g., suctioning) for people with chronic respiratory conditions. Specific guidance for friends or family members who need to provide care for ill individuals at home is currently in preparation and will be available at www.pandemicflu.gov.

If new information becomes available about the effectiveness of current or future facemasks or respirators in controlling influenza in community settings, this interim guidance document will be revised accordingly.

Recommendations

The timing and severity of the next influenza pandemic cannot be predicted. Information about the prevalence and severity of influenza in a pandemic may affect how these and other public health recommendations are applied. Once a pandemic is

4

 

under way and more is known about the characteristics (e.g., virulence, transmissibility, clinical manifestation, drug susceptibility, and risk to different age groups and subpopulations) of a given pandemic strain, these recommendations may be modified. (Appendix 1 summarizes the interim guidance for facemask and respirator use during a pandemic, and Appendix 2 provides a sample public fact sheet that describes these recommendations in lay language).

1. Avoid the Source During an influenza pandemic, people should avoid contact with ill individuals and with groups of people that might include infectious individuals. While close contact (within 6 feet) with an individual ill with influenza carries an increased risk of infection, more crowded conditions increase the probability of being exposed to infectious material (e.g., from coughs and sneezes). Crowded settings should be avoided to the greatest extent possible during a pandemic.

Some individuals, such as pregnant women and persons with certain underlying medical conditions (e.g., cardiopulmonary disease or immunodeficiency), are at increased risk for severe illness or complications from seasonal influenza infection, and they may likewise be at high risk during a pandemic as well. In addition to the usual risk groups, others may be at high risk for severe illness and complications during a pandemic (e.g., normally healthy children or young adults). It is especially important that all persons who are at high risk avoid crowded settings and adhere to recommended infection prevention practices.

2. Contain the Source

When individuals are ill with respiratory symptoms (e.g., coughing, sneezing) during an influenza pandemic, they should stay at home except when it is critically necessary to leave (e.g., to obtain medical care). Individuals with a respiratory illness should wear a facemask to contain respiratory secretions (e.g., to cover coughs and sneezes) if they are in the presence of others. For specific information about the use of facemasks by ill persons ("source control"), see Interim Guidance for the Use of Masks to Control Influenza Transmission (www.cdc.gov/flu/professionals/infectioncontrol/maskguidance.htm). For information about masks cleared by the FDA and legally marketed as medical devices in the United States, see Masks and N-95 Respirators (www.fda.gov/cdrh/ppe/masksrespirators.html). For information on cough etiquette and hand hygiene, see Stopping the Spread of Germs at Home, Work & School (www.cdc.gov/flu/protect/stopgerms.htm).

Since a facemask worn by a coughing person may reduce the amount of potentially infectious material released into the surrounding area, one strategy for reducing the spread of influenza would be to encourage everyone to wear a facemask while they are together if a group gathering is unavoidable. This might reduce the overall risk to the group by increasing the likelihood that all unanticipated coughs and sneezes would be covered and that respiratory secretions would not be widely spread while people are speaking or breathing.

5

 

Another strategy that could reduce this risk would be to screen individuals as they enter a gathering and to exclude anyone with a cough or fever, or anyone who has been exposed to an ill household member. No approach is foolproof and instituting such measures may be problematic, but each strategy may have additive benefits when a gathering is unavoidable.

3. Prevent/Limit Exposures

If a gathering is unavoidable, crowding should be minimized and every effort should be made to encourage cough etiquette (see www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm) and hand hygiene (e.g., tissues, waste baskets, handwashing facilities, and alcohol-based hand sanitizers as an alternative to handwashing should be readily available; see www.cdc.gov/flu/protect/stopgerms.htm). In addition, individuals may consider wearing a facemask or respirator to help prevent exposure to respiratory secretions from symptomatic individuals. Different types of currently available facemasks and respirators are described in Appendix B of Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Healthcare Settings during an Influenza Pandemic (www.pandemicflu.gov/plan/healthcare/maskguidancehc.html).

Facemasks do not form a tight seal on the wearer’s face and are not designed to filter out small particles that can be inhaled and that may have a role in influenza transmission. However, facemasks are useful in blocking large infectious droplets (created when a person coughs or sneezes nearby) from landing on the susceptible mucous membranes of the wearer’s nose and mouth; this is thought to be an important mode of influenza transmission. Facemasks have the advantages of being relatively comfortable to wear and inexpensive to purchase. In addition, small facemasks are available that can be worn by children, but it may be problematic for children to wear them correctly and consistently. Moreover, no facemasks (or respirators) have been cleared by the FDA specifically for use by children. For these reasons, other prevention strategies (e.g., hand hygiene, social distancing) should be considered for this population (see Interim Pre-Pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States — Early, Targeted, Layered Use of Nonpharmaceutical Interventions; www.pandemicflu.gov/plan/community/commitigation.html). Washable fabric masks are used in many parts of Asia and elsewhere in the world when disposable facemasks are unavailable. However, no reusable fabric masks have been evaluated by the FDA for use in preventing transmission of infectious agents, and none are legally marketed in the United States for use in infection control.

NIOSH-certified N95 and higher filtering facepieces are made of dense material that is certified to filter out very small particles that can be inhaled. To be most effective, these types of respirators should form a tight seal against the wearer’s face. They also will block both small splashes and large droplets. These respirators are most effective and safest when the wearer has been properly fitted

6

 

(i.e., fit-tested) and provided with a health assessment and training to use the device. In the non-work setting, this fit-testing, health assessment, and training may be difficult to obtain, since these activities are usually performed for workers as part of an occupational health program. Respirators are not designed to form a tight fit on people with very small faces (e.g., children) or who have facial hair. N95 and higher respirators are less comfortable to wear than facemasks because the density of the material makes it more difficult to breathe through. Reusable (e.g., elastomeric) respirators are also available. These respirators can be cleaned, repaired, and re-used, but special precautions should be followed when using them. For more information about respirators, see NIOSH Safety and Health Topic: Respirators (www.cdc.gov/niosh/npptl/topics/respirators/).

Persons with pre-existing heart or lung disease or other health conditions may have difficulty breathing through some respirators and should consult with their personal physicians before using a respirator. For more information about respirators, refer to Appendix B of Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Healthcare Settings during an Influenza Pandemic (www.pandemicflu.gov/plan/healthcare/maskguidancehc.html).

Both facemasks and respirators may be beneficial in discouraging wearers from inadvertently touching their nose or mouth with unwashed hands, which could help prevent virus transmission and infection.

Length of time and risk of exposure

Several activity-related and personal issues should be considered before deciding whether to wear a facemask or respirator for personal protection in non-occupational settings during a pandemic. The primary consideration in selecting between a facemask and respirator is whether close contact is expected with someone who has symptomatic pandemic influenza. Other considerations may include the duration of the event and whether it will or will not be crowded. One should also consider personal issues, such as the ability to wear a respirator correctly for the period of time anticipated. As noted above, compared with a respirator, a facemask is more comfortable to wear and could likely be worn for longer periods, but is not intended to provide protection against smaller inhalable particles. In contrast, if used correctly, a respirator can provide protection against most smaller inhalable particles, but is less comfortable than a facemask and is more difficult to wear for longer periods of time.

If the activity in which interaction with other members of the community is unavoidable, but is unlikely to involve close contact with an ill individual, a facemask could be comfortably worn during this interval to prevent unexpected splashes from a sneeze or cough reaching the wearer’s nose or mouth. (Examples include a brief trip to a grocery store to purchase food and supplies or attending essential religious services.)

7

 

If there is the expectation of close contact with a symptomatic individual, every effort should be made to limit the duration of exposure to the ill individual(s) to as short a period as possible. In such situations, proper use of a well-fitted N95 or higher respirator may be a reasonable choice. (Examples include treating an ill family member in the home or visiting an ill neighbor to deliver food or medications.)

Planning assumptions project that there will likely be shortages of respirators during a sustained pandemic. For example, quantities of N95 or higher respirators may have to be prioritized for use by certain healthcare workers whose occupational activities place them at increased risk for infection. If supplies of N95 or higher respirators are not available, facemasks can provide protection against large-droplet exposure and should be worn when close contact with ill persons is anticipated. If supplies of respirators and facemasks are unavailable, washable fabric masks might afford some protection against exposure to large droplets. However, no reusable fabric masks have been evaluated by the FDA for use in preventing transmission of infectious agents, and none are legally marketed in the United States for use in infection control.

Considerations for using facemasks and respirators

To offer optimal protection, both facemasks and respirators need to be worn correctly and consistently throughout the time they are used. Facemasks can be worn comfortably for longer periods, but they are not designed to prevent inhalation of small particles. Respirators, if worn and fitted correctly, will provide protection against most small particles, although they are not specifically designed to prevent transmission of infectious agents. There is limited evidence available to suggest that use of a respirator without fit-testing may still provide better protection than a facemask against inhalation of small particles.

Respirators should be inspected for damage (e.g., cracks) and structural integrity. For example, if the filter material is physically damaged or soiled, the respirator should be discarded. Users should familiarize themselves with the different types and limitations of facemasks and respirators and with the proper method for wearing them (see Appendix B of Interim Guidance on Planning for the Use of Surgical Masks and Respirators in Healthcare Settings during an Influenza Pandemic; www.pandemicflu.gov/plan/healthcare/maskguidancehc.html).

Wearing a facemask or respirator incorrectly or removing or disposing of it improperly can contaminate the wearer’s hands or mucous membranes with virus, possibly resulting in exposure of the wearer or others to the virus. Proper facemask or respirator use and removal include the following:

Prior to putting on a facemask or respirator, wash hands thoroughly with soap and water. Use an alcohol-based hand sanitizer if soap and water are not available.

8

 

Avoid touching the outside of the facepiece during and after use to help prevent contamination of hands with infectious material that may have collected there.

Once worn, the disposable facemask or respirator should be removed carefully using the elastic bands or ties at the back of the head (avoid touching the facepiece) and appropriately discarded in the regular trash. If disposable facemasks and respirators are unavailable and a reusable fabric mask is used, it should be removed in the same way and laundered with normal laundry detergent and tumble-dried in a hot dryer. As noted previously, no reusable fabric masks have been evaluated by the FDA for use in preventing transmission of infectious agents, and none are legally marketed in the United States for use in infection control.

After the facemask or respirator has been removed and discarded, wash hands thoroughly with soap and water. Use an alcohol-based hand sanitizer if soap and water are not available.

Additional Considerations

The lack of clear scientific evidence regarding the effectiveness of facemasks and respirators in protecting against influenza poses a challenge to proposing interim guidance on the use of these devices during a pandemic. Similarly, important operational and policy questions regarding the manufacturing, supply, and distribution of facemasks and respirators, and public education about their use, remain unresolved. Additional studies of influenza virus transmission coupled with research and development of improved facemask/respirator technologies may yield new practical and effective approaches for helping to prevent influenza during a pandemic.

This interim guidance document will be revised as new information about the use of facemasks and respirators in the setting of pandemic influenza becomes available. For up-to-date information about pandemic influenza, visit www.pandemicflu.gov.

9

 

1Unless otherwise specified, the term "facemasks" refers to disposable masks cleared by the U.S. Food and Drug Administration (FDA) for use as medical devices. This includes facemasks labeled as surgical, dental, medical procedure, isolation, or laser masks. Such facemasks have several designs. One type is affixed to the head with two ties, conforms to the face with the aid of a flexible adjustment for the nose bridge, and may be flat/pleated or duck-billed in shape. Another type of facemask is pre-molded, adheres to the head with a single elastic band, and has a flexible adjustment for the nose bridge. A third type is flat/pleated and affixes to the head with ear loops. Facemasks cleared by the FDA for use as medical devices have been determined to have specific levels of protection from penetration of blood and body fluids.

2Unless otherwise specified, "respirator" refers to an N95 or higher filtering facepiece respirator certified by the U.S. National Institute for Occupational Safety and Health (NIOSH).

3 Three feet has often been used by infection control professionals to define close contact and is based on studies of respiratory infections; however, for practical purposes, this distance may range up to 6 feet. The World Health Organization uses "approximately 1 meter"; the U.S. Occupational Safety and Health Administration uses "within 6 feet." For consistency with these estimates, this document defines close contact as a distance of up to 6 feet.

 

Appendix 1

Summary of Interim Recommendations for Facemask and Respirator Use

in Certain Community Settings during an Influenza Pandemic

Information on the use of facemasks1 and respirators2 for the control of pandemic influenza in community settings is extremely limited. Thus, it is difficult to assess their potential effectiveness in controlling influenza in these settings. In the absence of clear scientific data, the interim recommendations below have been developed on the basis of public health judgment and the historical use of facemasks and respirators in other settings.

During an influenza pandemic, the risk for influenza can be reduced through a combination of simple actions. No single action will provide complete protection, but an approach combining the following steps may help decrease the likelihood of infection: handwashing, isolation and treatment with antiviral medications of persons with confirmed or probable influenza, voluntary home quarantine of members of households with confirmed or probable influenza cases, reduction of unnecessary social contacts, and avoidance whenever possible of crowded or congested social settings.

When it is absolutely necessary to enter a crowded setting or to have close contact3 with persons who might be infectious, the time spent in that setting should be as short as possible. If used correctly, facemasks and respirators may help prevent some exposures, but they should be used along with other preventive measures, such as social distancing and hand hygiene. When crowded settings or close contact with others cannot be avoided, the use of facemasks or respirators should be considered as follows:

Whenever possible, rather than relying on the use of masks or respirators, close contact and crowded conditions should be avoided during an influenza pandemic.

10

 

Facemasks should be considered for use by individuals who enter crowded settings, both to protect their nose and mouth from other people's coughs and to reduce the wearers' likelihood of coughing on others; the time spent in crowded settings should be as short as possible.

Respirators should be considered for use by individuals for whom close contact with an infectious person is unavoidable. This can include selected individuals who must care for a sick person (e.g., family member with a respiratory infection) at home.

These interim recommendations will be revised as new information about the use of facemasks and respirators in the setting of pandemic influenza becomes available. For up-to-date information about pandemic influenza, visit www.pandemicflu.gov.

11

 

Appendix 2

What You Should Know about Using

Facemasks and Respirators during a Flu Pandemic

This fact sheet provides information about the use of facemasks and respirators in public places during an influenza (flu) pandemic. It does not address the use of facemasks and respirators in the workplace or in healthcare settings.

Taking Protective Actions during a Flu Pandemic

A flu pandemic is an outbreak caused by a new flu virus that spreads around the world. The virus will spread easily from person to person, mostly through coughing and sneezing. Because the virus is new to people, everyone will be at risk of getting it.

During a flu pandemic, you can use simple actions to help protect yourself and others from becoming sick with the flu. No single action protects completely. If used together, the steps below can help reduce the chances of becoming infected.

• Wash your hands often with soap and water. Use an alcohol-based hand cleaner if soap and water are not available.

• Cover your mouth and nose with a tissue or your arm when you cough and sneeze.

• Stay away from other people if you are ill.

• Avoid crowded places and large gatherings as much as possible.

There may be times during a pandemic when you must be in a crowded setting or in close contact (within 6 feet) with people who might be ill. During such times, the use of a facemask or a respirator might help prevent the spread of pandemic flu.

Wearing a Facemask or a Respirator

Very little is known about the benefits of wearing facemasks and respirators to help control the spread of pandemic flu. In the absence of clear science, the steps below offer a "best estimate" to help guide decisions. They will be revised as new information becomes available.

Consider wearing a facemask if

• You are sick with the flu and think you might have close contact with other people.

• You live with someone who has the flu (you therefore might be in the early stages of infection) and need to be in a crowded place. Limit the amount of time you spend in these crowded places and wear a facemask while you are there.

• You are well and do not expect to be in close contact with a sick person but need to be in a crowded place. Limit the amount of time you spend in these crowded places and wear a facemask while you are there.

12

 

Consider wearing a respirator if

• You are well and you expect to be in close contact with people who are known or thought to be sick with pandemic flu. Limit the amount of time you are in close contact with these people and wear a respirator during this time. These recommendations apply if you must take care of a sick person at home.

What is a facemask?

Facemasks are loose-fitting, disposable masks that cover the nose and mouth. These include products labeled as surgical, dental, medical procedure, isolation, and laser masks.

Facemasks help stop droplets from being spread by the person wearing them. They also keep splashes or sprays from reaching the mouth and nose of the person wearing the facemask. They are not designed to protect you against breathing in very small particles. Facemasks should be used once and then thrown away in the trash.

What is a respirator?

A respirator (for example, an N95 or higher filtering facepiece respirator) is designed to protect you from breathing in very small particles, which might contain viruses. These types of respirators fit tightly to the face so that most air is inhaled through the filter material. To work the best way, N95 respirators must be specially fitted for each person who wears one (this is called "fit-testing" and is usually done in a workplace where respirators are used). Most of the time, N95 respirators are used in construction and other jobs that involve dust and small particles. Some healthcare workers, such as nurses and doctors, use these types of respirators when taking care of patients with diseases that can be spread through the air.

If you have a heart or lung disease or other health condition, you may have trouble breathing through respirators and you should talk with your doctor before using a respirator.

Like surgical masks, N95 respirators should be worn only once and then thrown away in the trash.

Additional Information

Neither a facemask nor a respirator will give complete protection from the flu. That is why it is important to wash your hands often, cover your coughs and sneezes with a handkerchief or your arm, and avoid crowds and gatherings during a pandemic. To learn more about these and other issues relating to pandemic influenza, visit

http://www.pandemicflu.gov.

13

 

 

 

:wormie2:

John

 

 

Share this post


Link to post
Share on other sites

ANNEX 3 Planning and Setting Up the Isolation

Area

Checklist: Supplies for a Changing Room

Storage Outside the Changing Room:

1. Shelf or cabinet with lock

2. Supply of clean scrub suits, gowns, aprons, gloves, masks,

headcovering, and eyewear

3. Covered shelf for storing disinfected boots

4. Bucket for collecting non-infectious waste

Inside the Changing Room:

1. Hooks, nails, or hangers for hanging reusable gowns, scrub

suits

2. Roll of plastic tape

3. Handwashing supplies: bucket or pan, clean water, soap,

one-use towels

4. Bucket or pan, 1:100 bleach solution for disinfecting

gloved hands

5. Container with soapy water for collecting discarded gloves

6. Container with soapy water for collecting used instruments

to be sterilized*

7. Container with soapy water for collecting reusable gowns,

masks, sheets to launder*

*Place outside the changing room if the changing room is too small

If large amounts of waste on floor:

Sprayer, bucket or shallow pan with 1:100 bleach solution for

disinfecting boots

141

Checklist: Supplies for Patient Area

1. 1 bed with clean mattress or sleeping mat and at least a

bottom sheet and blanket for each bed

2. Plastic sheeting to cover mattress or sleeping mat

3. 1 thermometer, 1 stethoscope, and 1 blood pressure cuff for

each patient or for each patient area

4. 1 puncture-resistant container for collecting non-reusable

needles, syringes, and discarded sharp instruments

5. 1 bedside table or shelf

6. 1 large wall clock with a second hand

7. Pan with 1:100 bleach solution or alcohol and one-use towels

for disinfecting the thermometer and stethoscope between

use with each patient

8. Bucket or pan, 1:100 bleach solution, one-use towels for

disinfecting gloved hands between patients

9. Supplies for disinfecting patient excreta (bedpan, urinal, 1:10

bleach solution)

10. Sprayer, 1:100 bleach solution, clear water, and mop for

disinfecting spills on floor and walls

11. Container with soapy water for collecting discarded gloves

12. Screens (or sheets hung from ropes or lines) placed between

VHF patients. beds

13. Extra supply of gowns and gloves

14. Container for collecting infectious waste to be burned

142

Annex 3

Use the grid on the next page to draw the layout of an isolation area in your own

health facility. Be sure to include:

. Area for patient isolation

. Changing room for health care workers to use for changing clothes

. Area for cleaning and laundering VHF-contaminated supplies

. Changing area for cleaning staff who handle VHF-contaminated waste but

who do not do direct patient-care activities.

143

Planning and Setting Up the Isolation Area

Planning Grid: Layout for Isolation Area in Your Health Facility

144

Annex 3

 

 

 

:wormie2:

John

 

Share this post


Link to post
Share on other sites

http://drum-runners.survivaltimes.info/Medical%20-%20Medical%20Kit.pdf

 

 

 

Do you carry a first aid kit in your airplane or car? According to AVweb's Brent Blue M.D., first aid kits of the drugstore variety are mostly packed with stuff that is totally useless and occasionally harmful. Over the years, Dr. Blue has assembled his own traveling medical kit for dealing with on-the-road emergencies, based on his long experience as an emergency room doc, frequent traveler, pilot, outdoorsman, and dad. He offers details of exactly what's in his kit, why each item is there, and how to

 

assemble a really good kit of your own.

 

 

 

by Brent Blue M.D. (bblue@aeromedix.com), Senior Aviation Medical Examiner

 

This article originally appeared in AVweb, the Internet's aviation magazine and news service, and is reprinted here by permission.

 

 

 

One of the things that has always driven me crazy about the commercial first aid kits that you find in drugstores and pilot supply catalogs is that they're filled with crap that is totally useless ... and sometimes even harmful.

 

 

 

Never one to be soft-spoken or unopinionated, I have tried to make my feelings known (vigorously) to various manufacturers of first aid kits, only to be ignored.

 

Even high-priced aviation-oriented medical kits aren't well thought out, in my judgment. Let me give you an example. MedAire, Inc. is a company that specializes in providing medical services to airlines and corporate flight departments, training their in-flight personnel and providing emergency "telemedicine" consultation by radio or flight phone in the event of medical emergencies aloft.

 

 

 

MedAire offers a series of very elaborate and expensive medical kits to their

 

airline and bizjet customers. Each of these kits includes a blood pressure cuff and stethoscope. Now that might sound like a good thing to have along, but in my opinion they don't belong in a first aid kit, especially one intended for use by non-medical personnel. Not only are these items bulky and expensive, but they really don't serve a good purpose.

 

 

 

Remember that first aid kits are strictly for first aid in medical emergencies, not for ongoing evaluation of medical conditions. In an emergency, it's not important to know a person's precise blood pressure -- all that's important is whether it's high, normal or low. If you can feel a pulse in the wrist or groin, the systolic pressure (top

 

number) is at least 90, which is adequate.

 

 

 

If the pulse can only be felt in the neck and not in the wrist or groin, the pressure is low -- probably in the 60 to 80 range (systolic). On the other hand, if a pulse is visible in the temple area or are very strong in the wrist -- and especially if accompanied by headache -- blood pressure is

 

probably high.

 

 

 

For first aid purposes, a general determination of B.P. as being high, normal or low is all that is needed. You don't need a sphygmomanometer and stethoscope for that.

 

Another problem I have with most first aid kits is that they contain too much special-purpose stuff and not enough multi-purpose stuff.

 

 

 

The folks who design them apparently assume that the user cannot be creative. When I help mountain climbers create medical kits for climbs in the third world, I know that weight and space are at a premium, so I try to give them medications and other items which can be used to deal with multiple problems. For instance, acetaminophen (Tylenol) with codeine is great to treat pain, but is also good remedy for diarrhea, cough, headache and insomnia.

 

 

 

Another example: antibiotic eye drops can be used in the ear, but eardrops cannot be used in the eye. Yet another complaint I have about most first aid kits is the way

 

they're packaged -- typically in a plastic or metal hinged-lid box that requires the user to dump most or all of the contents out to find a needed item. This makes the kits difficult to use, which in turn causes people to avoid using them in anything but the most dire emergency. If you carry a first aid kit in your car or airplane or boat or backpack, think about when the last time was that you actually opened the kit and made use of the contents.

 

 

 

For most people, the answer is "a long time ago" or "never." To my way of thinking, a medical kit should be designed to be useful and user-friendly, not a "break glass in case of emergency" affair. With these concepts in mind, I have developed a first aid kit for my own use which cuts out all the B.S. and contains a host of useful items, most of which can be used for a multitude of purposes. It's not the cheapest kit (we'll talk about cost later), but it includes stuff one is most likely to actually need, and I've tried to include the best and most useful items available, packaged in a fashion that makes the kit truly useful.

 

 

 

What I Carry, and Why

 

Let me go over the key stuff I carry in my kit, and explain why I selected each item:

 

Band-Aid-type adhesive bandages

 

First, let me admit that I am not a big fan of Band-Aid-type strips. They occlude the wound and make it gooey. You know that white, wrinkly skin you find under a Band-Aid? The medical term for that is "maceration," and it not only impedes healing but

 

also promotes infections. But it's hard to fight all that Johnson & Johnson advertising money. Seriously, adhesive bandage strips are great for bleeding wounds in order to stop the bleeding, but I recommend that the strips be removed after a few hours ... or immediately if they get wet. I prefer the fabric stretchy adhesive strip, particularly for fingertips and knuckles, but the straight ones are great too. Most kits just don't

 

include enough. Mine has a lot.

 

 

 

Band-Aid decorated spots and strips

 

Okay, these are pretty useless, too, but I have a fouryear-old son. Regardless of the situation, a decorated strip or spot can cure a crying attack faster that an ice cream cone, and you can't store ice cream in a firstaid kit (except for the freeze-dried stuff the astronauts have never taken into space).

 

 

 

Rubber gloves

 

Conventional rubber gloves have their place, but I would not necessarily use them on my family. Paramedics around the country use the blue ones because they do not tear as easily. These blue gloves are so good that I know paramedics who buy their

 

own when their employers are too cheap to provide them. They also can be used to carry water in a survival situation, and as a tourniquet.

 

SAM splint

 

Splints do several things. They provide a firm material that can be used on broken arms or legs. The purpose of splinting an injured extremity is threefold: to reduce bleeding, to decrease pain, and to reduce further injury. The splint material I use can be bent easily, can be reused, and does not age quickly. The SAM has detailed usage instructions rolled up with it, but in general the splint should be unrolled, doubled

 

and curved around the extremity. Curving the splint material provides a great deal of rigidity and strength. The splint can be applied to the injured extremity with tape or gauze, or tied on with triangular bandages secured with knots. Upper extremities

 

should also be put in a sling with a triangular bandage after splinting ... the more elevation, the better.

 

 

 

Provoiodine liquid

 

God, I love provoiodine solution. Basically, Provoiodine sterilizes everything on contact. It is great for cleaning abrasions (it does not sting like regular iodine) and sterilizing wounds. Any situation where a wound has occurred deserved to be wiped off with provoiodine. I first saw it used (later proven counterproductive) by the Chief of Surgery at my medical school (I am not telling which one). The surgeon mixed the brown solution with peroxide and poured it into the belly of patients who had infections in their abdomen. He called it "brown and bubbly." You should have seen

 

this combo start to bubble out of a belly wound. Looked like Old Faithful or Mount Saint Helens erupting!

 

 

 

Waterless soap

 

Antibacterial waterless soap is the best for prepping the hands for working with wounds or any other situation for sterilizing the skin.

 

 

 

Hand cleaner/prep pads

 

These are saturated with benzyl ammonia and packaged in individual tear-open packets. They're non-sticky and do not require rinsing to clean up hands. I find them good for everything from cleaning the relief tube to getting ready for dinner, but they're really great for washing off solid or liquid contaminants on the hands or skin.

 

 

 

Small towels

 

Several pilot friends recommended towels. They do come in very handy for all sorts of situations, and take minimal space. I use disposable ones.

 

 

 

Earplugs

 

Earplugs are important. Hearing loss from loud sound is cumulative, and those of us from the rock-crazed 60s already have problems. Headphones are okay for flying, but there are lots of times on the tarmac that earplugs come in handy. They are also good for passengers (especially infants and small kids) who do not have headsets or do not want to wear them. They also work great if you get stuck in a hotel room with a snoring copilot.

 

 

 

Antacid chewable tablets

 

These tablets can be lifesavers when dietary indiscretions get the best of you. Although the liquid is more effective, the tablets store better and do not spill. Two at a time is the minimum dose, and can be used as frequently as necessary.

 

 

 

Throat lozenges (eucalyptus or menthol)

 

These help with minor sore throats and coughs. Although they provide symptomatic help only, this medication can really improve a sick person's disposition.

 

 

 

Hydrocortisone cream

 

Now available over-the-counter without prescription, hydrocortisone cream is the best remedy available for dry skin, irritation, and most scaly rashes. It's particularly good for contact dermatitis such as poison ivy or poison oak. A small amount applied

 

frequently works best -- you do not need to goop it on.

 

 

 

Suntan lotion

 

The water-based children's type is our favorite, since it doesn't tend to blind you when you start to sweat and it drips into your eyes.

 

 

 

Mosquito Repellent

 

Citronella-based repellent is the best. It is non-toxic to children, smells okay, and won't melt plastic like DEET (which is also toxic to children). Citronella has one huge advantage in addition: It repels flies and other biting insects besides mosquitoes that DEET does not.

 

 

 

Ibuprofen (Advil, Motrin)

 

Ibuprofen is one of the truly great drugs developed since aspirin, and is part of a drug family known as NSAIDs -- non-steroidal anti-inflammatory drugs. Non-prescription dose is 400 mg (two tablets) every six hours, while the prescription strength is 800 mg (four tablets) every six hours. It is useful for headaches, sunburn, pain, muscle aches, and general soreness. The only downside is that it can cause stomach upset, so it should be taken with food.

 

 

 

Acetaminophen (Tylenol)

 

The acetaminophen dose for adults is 1000 mg every four hours for fever and pain. Acetaminophen differs from aspirin and ibuprofen in that it has no anti-inflammatory effect, but is much easier on the stomach.

 

 

 

Aspirin

 

Aspirin is similar in effect to ibuprofen, and has similar stomach side effects. Dose is two to three 325 mg tablets every four hours for fever, arthritis, headache, or other pain.

 

 

 

Tee Tree Oil

 

Doug Ritter of Equipped To Survive® turned me on to this stuff. It is the best thing I have found for insect bites (stinging ants, bees, mosquitoes, etc.). The thick

 

stuff should be dabbed (not rubbed) on the site on an "as necessary" basis. It also works well for minor burns almost eliminating the pain immediately. Friends have reported to me that it also works well as an anti-fungal to relieve athlete's foot and ringworm.

 

 

 

Non-adhering dressing

 

If you have to cover a wound, this is probably the stuff you want to use. The Telfa pad supposedly keeps it from sticking, but sometimes you have to soak it off a crusted wound.

 

 

 

Unstarched roll gauze

 

This unstarched gauze is great for wrapping large wounds. It is not elastic so it will not go on too tight (unintentionally). It conforms to the area it is placed and tends to stay there.

 

 

 

Cohesive compression bandage

 

Although this stuff looks like an Ace bandage, it is not. The material sticks to itself, is waterproof, and can be reused to some extent. It's great for wrapping wounds, especially over unstarched gauze, and eliminates the need for securing clips or tape. It's important to note that it is elastic, so take care not to wrap it so tight that it impedes circulation. Although it's intended for dressings, it's also perfect for splint

 

applications, creating a makeshift sling, and all sorts other uses. Think of it as the duct tape of first aid kits.

 

 

 

Ace elastic bandages

 

Ace bandages are for general support of joints and for compression dressings. Support of ankles, knees, wrists, and elbows are the most frequent use, but Ace bandages can also be used with gauze pads and or unstarched gauze rolls for keeping a wound from bleeding. Ace elastic wraps can be dangerous if wrapped too tight, causing a tourniquet effect and cutting off circulation. If used to stop bleeding, an Ace bandage must be loosened periodically (every 30 minutes is fine) until bleeding is controlled, and then reapplied less tightly for gentle pressure. They can be washed, re-rolled, and reused.

 

 

 

Gauze pads

 

Gauze pads are good for cleaning and dressing wounds, and are better than plain cotton dressings since they do not leave fibers in the wound. They're also great for applying provoiodine, etc.

 

 

 

Tape (zinc and plastic)

 

Zinc tape is more conforming, but plastic tape does not absorb water. Only experience with use will help you decide which tape is the best for each job. I carry a roll of each in my medical kit.

 

 

 

Mastisol tape-skin adhesive

 

This stuff is the Crazy Glue of first aid kits. Put this on the skin and tape will stick forever, even in water! Great for steri-strips (see below).

 

 

 

Steri-strips

 

Steri-strips are modern day butterfly bandages. They will aid closing and/or keeping a wound closed (especially when used with Mastisol). However, I have concerns about putting steri-stips into a first aid kit, because wounds are very difficult to keep sterile when closed in the field. It is essential to remember this caveat: Open wounds rarely get infected, and when they do it is usually minor.

 

 

 

Closing a wound, however, creates the potential for an abscess and blood poisoning that can create a disaster. The scarring from a wound that is not closed might be greater than one that is closed, but that can be dealt with later by a plastic surgeon. Blood poisoning or abscess formation while camping can be lethal, especially if it occurs in a survival situation or a third-world country. In most cases, it's better to leave the wound open.

 

 

 

General wound care should start with cleaning with soap and lots of water. Painting with provoiodine completes the cleaning. If soap and water are not readily available, irrigating with the provoiodine is best alternative. For a dressing, I am personally fond of using gauze lightly wetted with provoiodine directly on the wound, with a layer of dry gauze on top -- a so-called provoiodine wet-to-dry dressing. A few

 

studies have shown provoiodine to be irritating and destructive to live cells, but my personal experience is that the wet-to-dry dressing works extremely well for sterilizing wounds and preventing infections.

 

 

 

Triangular Bandages

 

There are good for making slings and tying extremities to splint material for stabilization. They can also be used as a tourniquet as a last resort for uncontrollable bleeding.

 

 

 

Mosquito hemostat with fine nose

 

These are the surgical equivalent of needle-nose pliers, but made of springy steel alloy and with a selflocking feature. They are great for removing splinters, fishhooks, and a variety of other missions.

 

 

 

Bandage scissors

 

These are small scissors with one blunt blade, allowing bandages to be cut off without injuring the bandage. (I also carry a Robin Safety Boy Rescue Cutter for heavy-duty jobs like cutting seatbelts and breaking out windows, but it's too big and heavy to include inside the medical kit, and should be stored within easy reach in the event of a crash.)

 

 

 

Diphenhydramine 25 mg chewable (Benadryl)

 

Benadryl is good for allergic reactions, itching, and insomnia. Adult dose is one or two tablets every six hours, or half that for children.

 

 

 

Sterile needles

 

I carry several hollow bevel-point hypodermic-type needles in my kit. They're the best thing I've found for digging out small splinters and making small incisions. They're not recommended for draining abscesses, since a needle-punctured abscess will reseal and form again. (An abscess should be lanced with a scalpel blade.)

 

 

 

Scalpel blade

 

This is incredibly sharp, good for large splinters and incising (making a large cut in) an abscess for drainage. Also good for cutting thread. The blade can be clamped in the hemostat.

 

 

 

Dimenhydrinate (Dramamine)

 

Dramamine works as well as any other over-the-counter drug for motion sickness (which is not particularly well). The tablets are chewable and the dose is on the packet. (The ReliefBand provides far more predictable and effective relief for most people.)

 

 

 

Zip-Lock bags

 

These are good for everything from transporting water to ice packs to disposing of used dressing material. They have zillions of uses, and are invaluable.

 

 

 

Safety pins

 

Used to secure triangular bandages, replacing lost buttons, and a variety of other useful applications.

 

 

 

Folding paper cups

 

I find them handy.

 

 

 

Cotton-tip applicators (Q-Tips)

 

These applicators can be used to apply medications, clean the external part of the ear, cleanse wounds, and remove foreign bodies from the eye.

 

 

 

Moleskin

 

This stuff is used to protect the feet and take pressure off of blisters. Self-adhesive, but best used with Mastisol. To take pressure off a sore area of the foot, cut Moleskin in the shape of a donut with the central hole slightly bigger than the blister or other lesion.

 

 

 

Instant ice

 

These chemical cold-packs can be used on a contusion, sprain, strain, or other traumatic injury. The cold reduces bleeding and swelling. They will not last long, but will help immediately and are better than nothing while you find some ice. Heat should not be applied for 72 hours.

 

.

 

Eye wash

 

Use this for washing out contaminants (battery acid, chemicals, dirt, etc.) from the eye. The eye must be held open for this to work.

 

 

 

Electrolyte powder

 

This is particularly good for fluid replacement for diarrhea, and for treating dehydration due to heat exhaustion or heatstroke. Plain water is next best choice. Remember that hot dry climates may precipitate dehydration more suddenly than you might expect. My physiologic rule is that if you are drinking enough to have to urinate every three hours, your tank is full.

 

 

 

Liquid tears

 

Good lubrication for irritated eyes of any cause. Not for washing out a foreign body or chemical unless nothing else is available. Eye wash or even plain water is better for irrigation of contamination.

 

 

 

Lip balm

 

Always handy for routine use.

 

 

 

Trash bags

 

Good for everything from trash to holding ice for ice packs.

 

 

 

Sanitary napkins

 

Also can be used for holding pressure on bleeding wounds.

 

 

 

Tongue depressors

 

Can be used as finger splints, looking down the throat, or toys for kids. Can supplement large splints.

 

 

 

Urine/puke bag

 

The #1 TravelJohn is the best of the products we have tested. The internal polymer absorbent material gels any liquid, making it spill-proof, and neutralizes odor. These cannot be used for water storage or transport because it cannot be recovered from the gel. Can be used for ice or cool packs when placed in a freezer or filled with cold water.

 

 

 

How I Package My Medical Kit

 

To my way of thinking, packaging of a medical kit is almost as important as what it contains. The contents do you no good if you can't find what you need when you need it. Furthermore, a kit that is a pain to unpack and repack is unlikely to be used very often. My kit is designed for frequent use and rough handling. I take it wherever I go -- flying, hiking, skiing, camping at Oshkosh -- and use it often.

 

 

 

After surveying a wide range of boxes and bags, I finally settled on a professional-quality urethane-coated Dupont Cordura bag manufactured by Nocora, Inc., of Pinedale, Wyoming. Nocora builds these bags specifically for Emergency Medical Technicians. They're extremely rugged, bristling with carefully-organized zipper pockets, and with more than a dozen rugged clear-plastic zip-locktype pouches specifically designed to secure and organize medical items in a logical and easy-to-find fashion.

 

 

 

It can be carried or strapped on and worn as a fanny-pack. As you might imagine, packaging like this is not cheap (the Nocora bag costs close to $100), but it makes all the difference between a truly usable medical kit and one that sits unused year after year. If you carry a first aid kit in your car or airplane, it's also important to make sure it's mounted in a location that's easy to access in the event of an accident. You should also check your kit periodically for replacement of used or depleted supplies. Most of the medications I carry are long-lived, but a few expire

 

and should be replaced periodically.

 

 

 

Assembling Your Own Medical Kit

 

To assist you in putting together your own medical kit, here's a detailed listing of exactly what I carry in mine:

 

Item Qty Where It Goes

 

1"x3" Woven (Swift Brand) 30 Bag Set #7

 

3" Cotton Tip Applicators Sterile 2's 30 Bag Set #5

 

3"x4" Non-Ad Pad 5 Bag Set #6

 

4x4 Gauze 40 Bag Set #6

 

7/8" Plastic Spot (Swift Brand) 30 Bag Set #7

 

Arizona Sun SPF 30 1oz 1 Elastic Loops

 

Aypanal Extra Strength (Acetaminophen) 2's 32 Bag Set #5

 

Benadryl Caps 25mg 24 Bag Set #2

 

Betadine Pads 20 Bag Set #1

 

Betadine Solution 1/2oz 2 Elastic Loops

 

Blistex 1 Elastic Loops

 

Buffered Aspirin 2'S 32 Bag Set #4

 

Cedaprin (Ibuprofen) 200mg 2's 32 Bag Set #4

 

Character Strips 3/4"x3" 30 Bag Set #7

 

Co-Flex 3" 1 Interior Zipper Pocket #1

 

Cold Pack 2 Interior Zipper Pocket #2

 

Cough Drops Menthol Eucalyptus 24 Bag Set #3

 

Dermicel Tape 1" 2 Exterior Zipper Pocket #1

 

Dermicel Tape 2" 1 Exterior Zipper Pocket #1

 

Dramamine 1 Bag Set #3

 

Ear Plugs Max (NRR 33) Pr's 4 Bag Set #3

 

Elastic Bandage 2" 1 Interior Zipper Pocket #1

 

Elastic Bandage 4" 1 Interior Zipper Pocket #1

 

Elastic Bandage 6" 1 Exterior Zipper Pocket #1

 

Electrolyte Tablets 32 Bag Set #2

 

Eye Wash 4oz 1 Exterior Zipper Pocket #3

 

Fingertip "8" Woven (Swift Brand) 30 Bag Set #7

 

First Aid Book 1 Bag Set #6

 

Flexicon 2" 2 Interior Zipper Pocket #3

 

Flexicon 4" 2 Interior Zipper Pocket #3

 

Flexicon 6" 2 Interior Zipper Pocket #3

 

Folding Paper Cups

 

Gloves Nitrile (Blue) Large PR's 2 Belt Wings

 

Golf Towels ultra Compressed

 

Hydrocortisone 1% Foil Pack 5 Bag Set #8

 

Imodium AD 1 Bag Set #5

 

Kleenex 2 Bag Set #5

 

Knuckle Woven (Swift Brand) 30 Bag Set #7

 

Kotex Maxi Pads (Individually Wrapped) 2 Bag Set #6

 

Liquid Children's Tylenol 2oz 1 Exterior Zipper Pocket #3

 

Mastisol 4 Bag Set #8

 

Moleskin 4"x12" 1 Bag Set #6

 

Mosquito Hemostat 4" 1 Velcro Keeper

 

Natrapel (deet free repellent) 2oz 1 Elastic Loops

 

Nu-Tears 1/2oz 1 Elastic Loops

 

Pepto Bismol Tablets 48 Bag Set #2

 

Porous Cloth Tape 1" 2 Exterior Zipper Pocket #1

 

Porous Cloth Tape 2" 1 Exterior Zipper Pocket #1

 

Safety Pins Assorted 1 Bag Set #3

 

Sam Splint 1 Exterior Zipper Pocket #2

 

Scalpel Blade #10 3 Bag Set #1

 

Small EMT Shears 1 Velcro Keeper

 

Steri-strips 1/4x1-1/2 (Envelope of 6) 1 Bag Set #8

 

Steri-strips 1/4x3 (Envelope of 3) 1 Bag Set #8

 

Steri-strips 1/8x3 (Envelope of 5) 1 Bag Set #8

 

Sterile Needles 18guage 3 Elastic Loops

 

Tampons 2 Bag Set #6

 

Tee Tree Oil (Burn Away) 1 Elastic Loops

 

Tongue Blade (non-sterile) 3/4" x 6" 15 Bag Set #5

 

Trash Bags 20qt 4 Top Slip Pocket

 

Triangle Bandage 3 Interior Zipper Pocket #1

 

Urine/puke bag (#1 Travel John) 1 Exterior Zipper Pocket #2

 

Vacuum Packed Wash Cloths

 

Vionex No Rinse Jell 4oz 1 Exterior Zipper Pocket #3

 

Wash Up Towelettes 30 Bag Set #1

 

Zip Lock Bags 12" x 15" 2 Bottom Slip Pocket

 

 

 

In preparing this article, I tried to price out what all this stuff would cost if you bought it at retail (including the fancy bag, but excluding a few hard-to-find or physician-only items), and came up with a total of a bit over $500. You could obviously shave a little off that figure by reducing the quantities, and shave a fair amount off by using less sophisticated packaging than the $100 Cordura EMT bag that I chose. Basically, you get what you pay for.

 

 

 

NOTE: For those who may be interested, I've made up some medical kits substantially identical to the one I use (including the fancy Cordura bag), and made them available on the Aeromedix.com Web site for $350. (As an emergency room

 

doc, I can buy most of the stuff in the kit in bulk and/or at discount.) If you're interested in one of these kits, you can order it online or phone Aeromedix.com at 888-362-7123.

 

 

 

About the author...

 

Brent Blue M.D. is a Senior Aviation Medical Examiner and was the physician for

 

the U.S. Acrobatic Team at the World Competition in 1994. He serves as AVweb's

 

aviation medicine editor, and is also on the EAA's Aeromedical Council

 

 

 

:wormie2:

John

 

 

Share this post


Link to post
Share on other sites

Wormie, I just put this link in my favorites after pulling all the info off Drumrunner's site that I felt I needed...if I had $350, I'd buy one of these from this guy! This is such a great first aid kit! :)

 

Have a Merry Christmas, WormGuy!

Share this post


Link to post
Share on other sites

This section describes how to:

. Prepare bodies of deceased VHF patients.

. Transport the body safely to the burial site.

. Disinfect the vehicle after transporting bodies.

Section 7

Use Safe Burial Practices

Section 7

There is risk of transmission in the health facility when a VHF patient dies because the bodies and body fluids of deceased VHF patients remain contagious for several days after death. Family and community members are also at risk if burial practices involve touching and washing the body.

7.1 Prepare the Body Safely

Burial should take place as soon as possible after the body is prepared in the health facility. Health facility staff should:

Prepare the body safely.

Be aware of the family.s cultural practices and religious beliefs. Help the family understand why some practices cannot be done because they place the family or others at risk for exposure.

Counsel the family about why special steps need to be taken to protect the family and community from illness. If the body is prepared without giving information and support to the family and the community, they may not want to bring other family members to the health facility in the future. They may think that if the patient dies, the body will not be returned to them.

Identify a family member who has influence with the rest of the family and who can make sure family members avoid dangerous practices such as washing or touching the body.

To prepare the body in the health facility:

1. Wear protective clothing as recommended for staff in the patient isolation area. Use thick rubber gloves as the second pair (or outer layer) of gloves.

2. Spray the body and the area around it with 1:10 bleach solution.

3. Place the body in a .body bag. (mortuary sack) and close it securely. Spray the body bag with 1:10 bleach solution.

Section 7 Use Safe Burial Practices

4. If body bags are not available, wrap the body in two thickness of cotton cloth and soak with 1:10 bleach solution. Then wrap the body in plastic sheeting. Seal the wrapping with plastic tape. Spray the body bag as in Step 3. Place the body in a coffin if one is available.

5. Transport the body to the burial site as soon as possible. Assign a health officer or health facility staff person to accompany the body to ensure that the safety precautions remain secure during the journey.

7.2 Transport the Body Safely

VHF Isolation Precautions should remain in force when the body is being transported to the burial site.

1. Plan to take the shortest route possible for security purposes and to limit any possibility of disease transmission through accidental contact.

2. Any health facility staff who must touch or carry the body during transport should wear the same protective clothing as is worn in the isolation area. Note: The driver does not need to wear protective clothing if there is no contact with the body.

3. Take a closed container or sprayer with 1:10 bleach solution in the event of any accidental contact with the body or infectious body fluids. Also use it to clean up spills in the transport vehicle.

7.3 Prepare Burial Site

1. The grave should be at least 2 meters deep.

2. Explain to the family that viewing the body is not possible. Help them to understand the reason for limiting the burial ceremony to family only.

Section 7

7.4 Disinfect the Vehicle after Transporting the Body

1. The staff person who disinfects the vehicle must wear protective clothing.

2. Rinse the interior of the vehicle where the body was carried with 1:10 bleach solution.

3. Let it soak for 10 minutes.

4. Rinse well with clean water and let the vehicle air-dry. Be sure to rinse well because the solution is corrosive to the vehicle.

Use Safe Burial Practices

 

:wormie2:

John

Edited by WormGuy

Share this post


Link to post
Share on other sites
Guest
You are commenting as a guest. If you have an account, please sign in.
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...
Sign in to follow this  

×

Important Information

By using this site, you agree to our Terms of Use.