Home Oral cavity On improving the system for recording certain infectious and parasitic diseases. Emergency situations in which it is necessary to use an Anti-AIDS emergency kit

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On improving the system for recording certain infectious and parasitic diseases. Emergency situations in which it is necessary to use an Anti-AIDS emergency kit

In the context of the continued unfavorable epidemiological situation regarding HIV infection (at the beginning of 2013, 8931 people living with HIV lived in the region with an affected population rate of 356.0 per 100 thousand) and an increase in the demand for medical care of these patients (more than 2000 HIV-infected), the risk of occupational infection with the human immunodeficiency virus among medical workers of various specialties remains real.
In 2012, a total of 69 emergency situations were registered in medical institutions in the region (in 2011 - 41 cases). Among the victims, 17 medical workers worked with HIV-infected patients. In 15 cases there was a needle prick, in 1 case there was a cut with a scalpel, in 1 case there was contact of infected material with the mucous membrane of the eye.
The main causes of “emergency situations” remain carelessness of medical workers when performing manipulations, violation of the technique of performing complex manipulations, as well as underutilization modern disposable and other safe technologies.
In these situations, it is necessary to correctly, clearly and timely organize emergency measures to prevent occupational infection, including preventive treatment using antiretroviral drugs. Thanks to the complex of measures taken, no cases of professional infection of medical workers with HIV infection have been registered in the region.
In order to prevent cases of professional infection of medical workers with HIV infection in medical institutions in the region, as well as in compliance with the sanitary and epidemiological rules SP 3.1.5.2826-10 “Prevention of HIV infection,” I order:
1. To the heads of government bodies and healthcare institutions in the region:
1.1.Ensure the immediate implementation of a set of measures to prevent HIV infection in the event of an “emergency situation” among health workers when providing medical care to an HIV-infected patient (or a patient with unknown HIV status) in accordance with the requirements of clause 8.3 of the sanitary and epidemiological rules of SP 3.1. 5.2826-10 “Prevention of HIV infection” and methodological recommendations for the prevention of occupational infections with HIV infection (appendix to this order). Duration: permanent.
1.2. Conduct training on safety precautions and actions in case of “emergency situations” when hiring employees and thereafter 2 times a year. Duration: permanent
1.3. Ensure strict accounting of “emergency situations” that arise during work medical personnel, with drawing up a Report on an industrial accident in form N-1 and providing a copy of the Report to the Saratov State Institution regional center for the Prevention and Control of AIDS and Infectious Diseases" (State Healthcare Institution "AIDS Center"). Duration: permanent.
1.4. Ensure the availability of first aid kits for the prevention of occupational HIV infection at the workplaces of medical workers who have contact with biomaterials. Duration: permanent.
1.5. Organize timely examination and treatment of injured medical workers within 2 hours after the “emergency situation” (no later than 72 hours), including nights, weekends and holidays. Duration: permanent.
1.6. Assign responsible persons for obtaining rapid tests for HIV, for maintaining records, for the correct formulation and evaluation of the results of rapid diagnosis of HIV infection. Provide lists of responsible persons by institution to the State Institution "AIDS Center" and ensure their further training on the basis of the laboratory of the State Institution "AIDS Center" (as agreed). Deadline: until July 15, 2013.
1.7. Ensure that the State Health Institution "AIDS Center" receives rapid tests for HIV and antiretroviral drugs for emergency prevention of HIV infection from medical workers in "emergency situations." Duration: permanent.
1.8. Send responsible persons (trusted HIV/AIDS doctors or infectious disease doctors) to the State Health Institution "AIDS Center" in order to train them in the tactics of chemoprophylaxis of HIV infection. Deadline: until July 15, 2013.
2. To the chief physician of the Saratov Regional Center for the Prevention and Control of AIDS and Infectious Diseases (State Healthcare Institution "AIDS Center") Potemina L.P.:
2.1.Provide training for specialists responsible for carrying out a set of measures to prevent HIV infection in the event of an “emergency situation” among medical workers. Deadline: until July 31, 2013.
2.2.Ensure an irreducible supply of diagnostic rapid tests for HIV and antiretroviral drugs for emergency prevention of HIV infection in “emergency situations” among medical workers. Duration: permanent.
2.3. Provide methodological assistance to specialists responsible for providing medical care in “emergency situations” in determining the degree of risk of HIV infection in victims, according to the choice of scheme preventive treatment, on tactics for monitoring victims. Duration: permanent.
3. Consider the order of the Ministry of Health of the region dated 02.06.2003 N 144 “On measures to prevent occupational HIV infection of medical personnel of health care institutions in the region” to be considered invalid.
4. Entrust control over the implementation of this order to First Deputy Minister Zh.A. Nikulin.
Minister
A.N.DANILOV

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MINISTRY OF HEALTH OF THE USSR

ORDER

In accordance with the “Fundamentals of the legislation of the USSR and union republics on healthcare”

2. I order:

2.2. The heads of institutions of union subordination that have clinics and hospitals, children's institutions, must ensure that information about identified infectious patients is sent to territorial sanitary and epidemiological stations in the manner established by the instructions approved by this order.

3. Consider the order of the USSR Ministry of Health dated December 29, 1978 N 1282 as no longer in force.

Control over the implementation of this order is entrusted to the Deputy Minister of Health of the USSR, Comrade A.I. Kondrusev.

Minister
health care of the USSR
E.I.Chazov

Application
to the order of the Ministry
health care of the USSR
dated December 13, 1989 N 654

Soyuzmedstatistika
N 105-14/11-89

This instruction is mandatory for doctors and paramedical workers of medical and preventive and sanitary institutions of all ministries and departments, the All-Russian Central Council of Trade Unions and others public organizations, as well as for doctors engaged in self-employment in their specialty and engaged in medical activities in cooperatives.

Validity period: from the moment of approval.

Accounting instructions infectious diseases and the compilation of statistical reporting about them, approved by order of the USSR Ministry of Health of December 29, 1978 N 1282, has become invalid.

“Doctors and other medical and pharmaceutical workers do not have the right to disclose information about illnesses, intimate and family life of citizens that has become known to them due to the performance of their professional duties” (from Article 16 “The obligation to preserve medical confidentiality""Fundamentals of the legislation of the USSR and Union republics on healthcare").

Notes:

The following infectious diseases are subject to special registration throughout the entire territory of the USSR, regardless of the place of infection and citizenship of the patient:

1.1. Quarantine diseases: plague, cholera, yellow fever. All cases of these diseases or suspicions of them are sent to higher health authorities in an emergency report in accordance with the established procedure.

1.2. Leprosy. Registration is carried out in the manner established by order of the USSR Ministry of Health on September 29, 1971 N 721 “On additional measures to strengthen the fight against leprosy in the USSR.” For a patient diagnosed with leprosy for the first time in his life and for a patient with relapse of leprosy, a special notice is drawn up in triplicate. One copy remains about the epidemiological department of the leper colony, the second is sent to the Institute for the Study of Leprosy (Astrakhan), the third is given to the doctor responsible for the fight against leprosy in the regional (territorial) or republican dermatovenerological dispensary.

1.3. Skin and venereal diseases: syphilis of all forms, gonorrhea, trichophytosis, microsporia, favus, scabies. Diseases are recorded in the manner established by the “Instructions for recording and reporting of venereal, fungal skin diseases and scabies”, approved by the USSR Ministry of Health on September 25, 1989 “Soyuzmedstatistika” N 105-14/2-89.

The doctor who made the final diagnosis listed diseases, fills out the “Notification of a patient diagnosed for the first time in his life” active tuberculosis, venereal disease, trichophytosis, microsporia, favus, scabies, trachoma, mental illness"(f. N 089/у). The notice is sent within three days to the district (city) dermatovenerological dispensary, department (office).

For a patient (suspected) with microsporia, trichophytosis, favus and scabies with a diagnosis established for the first time in his life, a second copy of the notice is filled out according to f. N 089/u, sent to the SES at the patient’s place of residence within 24 hours from the moment of diagnosis (suspicion).

Notes:

1. The regional, regional, republican, city (cities - capitals of the union republics) skin and venereal disease clinic every month on the 2nd after the reporting period reports by telephone to the regional, regional, republican, city (cities - capitals of the union republics) sanitary and epidemiological station summary information about the number of new identified patients with syphilis (all forms), gonorrhea (acute and chronic) based on notifications received.

2. In case of detection of syphilis and gonorrhea in persons served by medical institutions of the III Main Directorate in territorial treatment and preventive institutions, the latter transmit information about those sick with these diseases in addition to the territorial one to the sanitary and epidemiological station of the III Main Directorate.

1.4. Tuberculosis. Registration is carried out in the manner established by the “Instructions for recording patients with active tuberculosis and reporting on their diseases” (“Soyuzmedstatistika” N 105-14/3-89 dated 08/10/89).

For each patient diagnosed with active tuberculosis for the first time in his life, a notification is filled out according to f. N 089/у, which is sent within three days to the district (city) anti-tuberculosis dispensary, department (office), and in their absence - to the central district hospital.

When identifying patients with bacillary tuberculosis, in addition to notifications according to f. N 089/у, an emergency notice is drawn up according to f. N 058/у, which is sent within 24 hours to the district (city) sanitary and epidemiological station at the patient’s place of residence. Notification by f. N 058/у is filled out not only for newly diagnosed cases of bacillary tuberculosis, but also when bacilli appear in patients with a closed form of tuberculosis, as well as in the event of death from tuberculosis in patients who were not registered during their lifetime.

Notes:

1. The regional, regional, republican, city (cities - capitals of union republics) anti-tuberculosis dispensary monthly, on the 2nd day after the reporting period, reports by telephone to the regional, regional, republican, city (cities - capitals of union republics) sanitary and epidemiological station summary information on the number of newly identified patients active tuberculosis based on notifications received.

2. If active tuberculosis is detected in persons served by medical institutions of the III Main Directorate in territorial treatment and preventive institutions, the latter transmit information about those sick with active tuberculosis in addition to the territorial one to the sanitary and epidemiological station of the III Main Directorate.

1.5.1. Typhoid fever (002.0)

1.5.2. Paratyphoid A, B, C (002.1-3.9)

1.5.3. Other salmonella infections (003)

1.5.4. Bacillary dysentery (shigellosis) (004)

1.5.5. Yersiniosis (027.2)

1.5.6. Amebiasis and balantidiasis (006, 007.0)

1.5.7. Colitis, enteritis, gastroenteritis, rotavirus infections caused by established bacterial pathogens (Escherichia coli, aerobacter, aerogenes, proteus, etc.), adenoviruses, enteroviruses and other viruses, as well as food toxic infections of established etiology (008, 005.0 2-4, 8)

1.5.8. Acute intestinal infections caused by unknown infectious agents; food toxic infections of unknown etiology (009, 005.9)

1.5.9. Tularemia (021)

1.5.10. anthrax (022)

1.5.11. Brucellosis, all forms (023)

1.5.12. Listeriosis, erysipiloides, pasteurellosis and other bacterial zoonoses (027.0, 027.2, 027.8)

1.5.13. Diphtheria (032)

1.5.14. Whooping cough (including parapertussis, bacteriologically confirmed) (033)

1.5.15. Scarlet fever (034, 1)

1.5.16. Meningococcal infection all shapes (036)

1.5.17. Tetanus (037)

1.5.18. Acquired immunodeficiency syndrome (AIDS) (042-044)

1.5.19. Poliomyelitis acute (045)

1.5.20. Chicken pox (052)

1.5.21. Measles (055)

1.5.22. Rubella (056)

1.5.23. Japanese mosquito, tick-borne spring-summer and other transmissible encephalitis, acute lymphocytic choriomeningitis, lethargic encephalitis and others viral diseases CNS, non-arthropod-borne (063.0)

1.5.24. Crimean hemorrhagic fever, Omsk hemorrhagic fever and other hemorrhagic fevers transmitted by arthropods; hemorrhagic fever with renal syndrome and other viral fevers (065, 078.6)

1.5.25. Viral hepatitis (070)

1.5.26. Rabies (071)

1.5.27. Epidemic mumps (072)

1.5.28. Ornithosis (psittacosis) (073)

1.5.29. Infectious mononucleosis (075)

1.5.30. Foot and mouth disease (078.4)

1.5.31. Epidemic typhus, Brill's disease, KU fever, tick-borne typhus, murine typhus and other rickettsial diseases (080-083)

1.5.32. Malaria (084)

1.5.33. Leishmaniasis (085)

1.5.34. Leptospirosis (100)

1.5.36. Helminthiasis (trematodiasis, echinococcosis, taeniasis, teniarhynchosis, diphyllobothriasis, hymenolepiasis, trichinosis, hookworm disease, ascariasis, strongyloidiasis, trichuriasis, enterobiasis) (121, 122, 123.0, 123.2, 123.4, 123.6, 124, 126, 127.0, 127.2, 127.3, 127.4 )

1.5.37. Pediculosis (132)

1.5.38. Pneumocystis (136.3)

1.5.39. Legionellosis /482.9/

1.5.40. Nosocomial (purulent-septic) infections associated with the provision of medical care to patients (regardless of age) in medical institutions (008-009, 320, 595.0, 599.0, 659.3, 670, 674.3, 675, 682, 684, 686.0, 730.0 , 771.4, 771.5, 771.6, 771.8, 998.5, 999.3)

Nosocomial infection should be considered a disease of infectious etiology, infection of which occurred during the period of stay, treatment, examination of the patient in a medical institution; in newborns and postpartum women - within a month after discharge from obstetric hospital. The question of whether the disease that arose after discharge from the hospital belongs to nosocomial infection, is decided by commission in each specific case.

How are hospital-acquired records subject to:

1. highly contagious infectious diseases;

2. cases of purulent-inflammatory (purulent-septic) infections associated with:

- childbirth and abortion;

- surgical interventions;

- injections of therapeutic and prophylactic drugs;

- blood transfusion and its substitutes, hemodialysis, hemosorption, vascular catheterization;

- use of devices artificial respiration, tracheotomy, intubation, catheterization Bladder, endoscopic examinations various organs and systems, etc.

1.6. Diseases subject to individual registration in medical institutions and summary registration in sanitary and epidemiological stations.

1.6.1. Flu (487)

1.6.2. Acute infections of the upper respiratory tract multiple or unspecified localization (acute laryngopharyngitis, other multiple localizations, unspecified localizations upper respiratory tract) (465)

1.7. Other conditions for which individual registration is carried out in medical institutions and sanitary and epidemiological stations.

1.7.1. Bacterial carriage:

1.7.1.1. typhoid fever(V 02.1)

1.7.1.2. paratyphoid (V 02.3)

1.7.1.3. other salmonellosis (V 02.3)

1.7.1.4. dysentery (V 02.3)

1.7.1.5. toxigenic strains of diphtheria (V 02.4)

1.7.1.7. carriers of human immunodeficiency virus (795.8)

1.7.2. Bites, drooling, scratching by animals.

1.7.3. Unusual reactions to preventive vaccinations.

2. The procedure for registering in medical institutions persons who are subject to personal registration at sanitary and epidemiological stations

2.1. All medical data about an infectious patient, including some epidemiological characteristics, are entered into the main medical documentation, corresponding to the specifics of the medical institution: " Medical card outpatient”, “History of child development”, “Medical record of an inpatient”, etc.

In the generally accepted manner, for each case of illness, a “Statistical coupon for registration of final (refined) diagnoses” (form N 025-2/u) or an “Outpatient coupon” (form NN 025-6/u-89 and 025-7) is filled out /у-89)

2.2. For each case of illness (suspicion), unusual reaction to vaccination, bite, scratch, salivation by animals, included in paragraph 1.5. and 1.7., fill out “Emergency notification of an infectious disease, food poisoning, acute occupational poisoning, unusual reaction to vaccination” - f. N 058/у (hereinafter referred to as “Emergency Notification”), which is sent within 12 hours to the territorial sanitary-epidemiological station at the place of registration of the disease (regardless of the patient’s place of residence). In addition, information is promptly reported to the same sanitary and epidemiological station by telephone.

2.3. Information about the sick person is also entered into the “Register of Infectious Diseases” (form N 060/u).

3. The procedure for filling out an emergency notification and transmitting information to the territorial sanitary and epidemiological station

3.1. Emergency notifications are filled out by a doctor or paramedical worker who has identified or suspected a disease in:

3.1.1. outpatient clinics of all departments, regardless of the conditions under which the disease was detected (when visiting a clinic, when visiting a patient at home, when preventive examination etc.);

3.1.2. hospitals of all departments in cases where the diagnosis of an infectious disease was made in a hospital (the patient was admitted without a referral from a polyclinic institution, the diagnosis of an infectious disease was made instead of the diagnosis of another disease, a case of nosocomial infection, a disease identified at the section);

3.1.3. medical cooperatives or doctors engaged in self-employment in their specialty;

3.1.4. forensic medical examination institutions;

3.1.5. kindergartens, schools;

3.1.6. health resort institutions and social security institutions;

3.1.7. institutions of paramedic service (medical and obstetric stations, collective farm maternity hospitals, paramedic health centers).

4. Additional instructions for completing and sending emergency notifications by personnel of certain types of healthcare institutions

4.1. Medical workers of paramedic service institutions of the USSR Ministry of Health (clause 3.1.7.) draw up an emergency notification in two copies: the first copy is sent to the territorial sanitary and epidemiological station, the second - to the medical treatment and preventive institution in charge of this point (precinct, district , city hospital, outpatient clinic, clinic, etc.).

4.2. Medical personnel serving children's institutions (nurseries, kindergartens, kindergartens, schools) send an emergency notification to the territorial SES only in cases where the disease (suspicion) is first identified by the personnel of these institutions during an examination of children or under other circumstances.

Information about infectious diseases identified by medical personnel of treatment and preventive institutions (hospitals, clinics) in children attending child care institutions is reported (by telephone and by sending an emergency notification) to the sanitary and epidemiological station by the personnel of these institutions.

4.3. Medical workers serving children's health institutions who have gone to the countryside for the summer (nurseries, kindergartens, kindergartens, pioneer camps, etc.) and student construction teams send an emergency notification to the sanitary and epidemiological station that carries out current sanitary supervision, as well as to the territorial sanitary and epidemiological station at the place of temporary location of the summer health institution.

4.4. Doctors engaged in self-employment in their specialty and engaged in medical activities in cooperatives send emergency notifications to the territorial sanitary and epidemiological station of the district at their location. The supply of emergency notification forms to doctors engaged in self-employment in their specialty and doctors engaged in medical activities in cooperatives is carried out by local health authorities.

4.5. Medical workers at an emergency medical service station who have identified or suspected an infectious disease, in cases requiring emergency hospitalization, report to the territorial SES by telephone about the identified patient and the need for his hospitalization, and in other cases report to the clinic (outpatient clinic) in whose service area they live patient, about the need to send a doctor to the patient’s home. Emergency notifications in these cases are drawn up by the hospital where the patient was hospitalized, or by the clinic whose doctor visited the patient at home.

4.6. Medical workers of treatment and preventive institutions of the USSR Ministry of Health serving water transport workers fill out emergency notifications in two copies, of which one copy is sent to the territorial sanitary and epidemiological station, the second to the basin sanitary and epidemiological station (hospital) according to their subordination.

4.7. Medical workers of treatment and preventive institutions of the III Main Directorate of the USSR Ministry of Health fill out emergency notifications in two copies, of which one copy is sent to the territorial sanitary and epidemiological station, the second to the sanitary and epidemiological station of the III Main Directorate according to subordination.

4.8. Treatment and preventive institutions of the Ministry of Railways, Ministry civil aviation, other ministries, departments and organizations, the notice is drawn up in two copies, one of which is sent to the territorial sanitary and epidemiological station, the second - to a higher departmental institution in the manner established respectively by the Ministry of Railways, MGA, other ministries, departments and organizations.

4.9. Medical and preventive institutions of the Ministry of Defense of the USSR, the Ministry of Internal Affairs of the USSR and the State Security Committee under the Council of Ministers of the USSR submit emergency notifications to the territorial sanitary and epidemiological stations (clause 3.1.) only for civilian employees and family members of employees of these departments.

5. The procedure for information about the admission of patients with infectious diseases (suspected infectious diseases) for inpatient treatment, about clarification or change in the diagnosis of an infectious disease

5.1. An infectious diseases hospital (a hospital with an infectious diseases department) is obliged to inform the territorial sanitary and epidemiological station in the area of which the medical and preventive institution is located that refers the patient for hospitalization:

5.1.1. on the admission of patients with infectious diseases (suspected) listed in paragraphs 1.5., 1.7. of this instruction, within 12 hours from the date of receipt;

5.1.2. to clarify or change the diagnosis of an infectious disease.

5.2. A medical institution that has clarified or changed the diagnosis is obliged to draw up a new emergency notification and send it within 12 hours to the sanitary and epidemiological station at the place where the disease was detected, indicating the changed (clarified) diagnosis, the date of its establishment, the initial diagnosis and the results of laboratory tests.

5.3. The territorial sanitary and epidemiological station must promptly inform the medical institution in which the disease was detected about hospitalization and confirmation (change) of the diagnosis.

6. Maintaining a “Register of Infectious Diseases” (Form N 060/у) in medical institutions

6.1. For personal registration of patients with infectious diseases and subsequent control of the completeness and timing of the transfer of information to the sanitary and epidemiological station, information from the emergency notification is entered into a special “Register of Infectious Diseases” f. N 060/у (hereinafter referred to as "Journal f. N 060/у").

6.1.1. The journal is kept in all medical institutions, in medical offices of preschool children's institutions, schools, summer health institutions, etc.

6.1.2. Separate sheets of the journal are allocated for each infectious disease (bacteria carriage), recorded according to emergency notifications. In large institutions for mass diseases (measles, chicken pox, mumps, etc.) special journals may be established. Columns 13 and 14 are not filled in in medical institutions.

6.1.3. District and district hospitals (outpatient clinics) that have medical and obstetric centers and collective farm maternity hospitals in the service area are registered in the journal according to f. N 060/у also infectious diseases identified by nursing staff at paramedic service points based on emergency notifications received from them.

6.2. Based on operational reports received from territorial sanitary and epidemiological stations (clause 5.3.) in the journal f. N 060/у the necessary corrections, clarifications, and additions are made.

6.3. Data from log f. N 060/у should be used when assessing the epidemic situation in the service area of a medical institution.

Note.

In children's institutions (nurseries, kindergartens, kindergartens, schools) in the magazine f. N 060/u takes into account both diseases identified by the staff of children's institutions (clause 4.2.), and those identified by the staff of medical institutions (clinic, hospital), reports of which were received on the basis of special certificates “On temporary disability of a student, technical school student, vocational school about illness, quarantine and other reasons for the absence of a child attending school, preschool institution" f. N 095/у, as described in the journal f. N 060/у in column 16 - “note” a corresponding note is made.

7. Accounting for influenza and acute upper respiratory tract infections of multiple and unspecified localization

7.1. Patients with these diseases are registered in outpatient clinics using “Statistical coupons for registration of final (refined) diagnoses” (form N 025-2/u) or “Outpatient coupons” (form NN 025-6/u-89 and 025-7/у-89) (see clause 1.6.).

7.2. In hospitals in cases of nosocomial infection (clause 3.1.2.), nurseries, kindergartens, kindergartens, children's homes, orphanages, boarding schools and forest schools (clause 3.1.5.) influenza and acute respiratory diseases are registered in the journal f. N 060/у.

8. Officials responsible for organizing records and providing information in medical institutions

8.1. The chief physician of the medical institution is responsible for the completeness, accuracy and timeliness of recording infectious diseases, as well as for prompt and complete reporting of them to the sanitary and epidemiological station.

8.2. In each medical and preventive institution, the chief physician is assigned (documented by order) a person responsible for transmitting operational information to the SES about identified patients with infectious diseases, sending emergency notifications, and maintaining a log of infectious diseases.

8.3. In preschool institutions, schools, orphanages, summer health institutions, etc., the registration of infectious patients is entrusted to nurse institutions.

9. The procedure for keeping records of infectious diseases in sanitary and epidemiological stations

9.1. Patients with infectious diseases and persons with the conditions specified in paragraphs 1.5., 1.7 are subject to individual registration at sanitary and epidemiological stations.

9.2. Influenza and other acute diseases are subject to total registration at sanitary-epidemiological stations. respiratory infections, specified in clause 1.6., information about which sanitary and epidemiological stations receive on the basis of reports - f. N 85 - influenza from medical institutions, as well as skin and venereal diseases (see note to clause 1.3.), tuberculosis (see note to clause 1.4.) and special cases enterobiasis (see note to clause 1.5.36.).

9.3. The basis for recording an infectious disease at sanitary and epidemiological stations is a prompt telephone message about the detection of an infectious disease (suspicion), which is subsequently confirmed by an emergency notification sent by a medical institution.

9.4. The procedure for prompt reporting and submission of notice is specified in paragraphs 2-6.

10. Maintaining a Register of Infectious Diseases (form N 060/u) in sanitary and epidemiological stations

10.1. Magazine f. N 060/u provides for recording the following information: the date of receipt of the emergency notification, the name of the medical institution that identified it, information about the patient (last name, initials, age, date of birth for children under 3 years of age, name of the child care institution, place work, study), information about the disease (date of illness, diagnosis, modified (updated) diagnosis), date and place of hospitalization, information about epidemiological examination, laboratory examination.

10.2. Depending on the amount of information received, logging options are possible. N 060/у: in sanitary and epidemiological stations of large administrative and industrial centers It is rational to keep journals for each nosological unit; In the SES of small towns and regional centers, it is advisable to keep a single log, in which separate sheets should be allocated for each infection.

10.3. In order to organize entries in the journal f. N 060/у numbering is carried out from the beginning of the year for each infection. The first nine columns and column 11 of the journal f. N 060/у are filled out after receiving an emergency notification (telephone message), column 10 - upon receiving confirmation of hospitalization from the hospital.

10.4. Column 12 is filled out on the basis of emergency notifications about changes or clarification of the diagnosis received from medical institutions or based on the results laboratory research carried out at the sanitary and epidemiological station in all cases where the initial report was made on suspicion of an infectious disease, and in cases where the original diagnosis was changed.

Note:

For example, the initial notification was received for a patient with colitis. Information about this patient was recorded on the sheet “Acute intestinal infections caused by unidentified pathogens and ill-defined.” During a laboratory study in the bacteriological laboratory of the SES, Shigella Flexner was found. Information about this in f. N 060/у are entered in group 15 and in group 12 according to the line of the given patient, the diagnosis “Bacterial dysentery caused by Shigella Flexner, bacteriologically confirmed” is indicated. All information about the patient is transferred to the sheet “Bacterial dysentery”: the medical institution is informed about the change in diagnosis.

If the diagnosis is changed by the medical institution that sent the initial notification, or by another (for example, a hospital), then the same records are made on the basis of the second notification received under f. N 058/у, in which the medical institution reports a changed diagnosis.

10.5. In column 13, the date of the start of the epidemiological survey of the outbreak is noted, and the name of the person who conducted the survey is entered in N of the outbreak survey card (form N 357/u).

10.6. Column 14 indicates the date of reporting the detected disease to a preschool institution, at the place of study, work or to the SES at the place of permanent residence (for non-resident patients), in the case of detection of nosocomial (purulent-septic) infections - at the location of the health care facility where the infection occurred.

Note.

SES of cities, capitals of union and autonomous republics, regional (territorial) centers, cities of republican, regional subordination must inform district SES of rural areas at the place of permanent residence of patients whose infectious diseases have been registered by the medical institutions of these cities, in order to carry out appropriate anti-epidemic measures in the foci of diseases (contact examinations, disinfection, etc.). In the same way, district SES of rural areas must inform the city SES at the place of permanent residence of sick urban residents whose infectious diseases were identified by medical institutions in the rural area (for example, when traveling to a dacha, to a pioneer camp, for agricultural work, etc.).

10.7. Column 15 indicates the data of the laboratory test, regardless of the laboratory of which institution it was carried out (SES or medical institution).

10.8. On the first day of the month following the reporting month in the journal according to f. N 060/у for each infection, the results for the month are calculated: the total number of registered diseases according to the final diagnosis (column 9, taking into account entries in columns 12 and 15), the number of diseases registered in rural residents (column 6), the number of diseases detected in children under the age of 14 years inclusive (column 5) and including rural residents (column 6).

10.9. For a number of infections, in connection with the requirements annual report on the movement of infectious diseases (form N 85-infection), the number of diseases identified in children aged 0 to 2 years inclusive and from 3 to 6 years inclusive should be counted. And with regard to diseases of other salmonella infections and bacterial dysentery identified in children aged 0 to 2 years and from 3 to 6 years, information on children attending child care institutions is provided separately for each age group. At the same time, all children on the lists of preschool institutions are included in the number of those attending children's institutions, regardless of the time and reasons for their absence from these institutions before illness.

10.10. The current report also separately highlights information on the most common hospital-acquired infections.

Chief of the Main
epidemiological
management
Ministry of Health of the USSR
M.I. Narkevich

Chief of the Main
security department
motherhood and childhood
Ministry of Health of the USSR
V.A. Alekseev

Chief of the Main
sanitary and preventive
management
Ministry of Health of the USSR
V.I. Chiburaev

Chief of the Main
organization management
medical care
Ministry of Health of the USSR
V.I.Kalinin

Head of Department
specialized
medical care
Ministry of Health of the USSR
A.N.Demenkov

Electronic document text
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official website of the Department of Health
Tomsk region
www.zdrav.tomsk.ru
as of 08/27/2013

Order of the Ministry of Health of the Saratov Region dated July 2, 2013 N 654
"On measures to prevent occupational HIV infections among medical personnel of regional healthcare institutions"

In 2012, a total of 69 emergency situations were registered in medical institutions in the region (in 2011 - 41 cases). Among the victims, 17 medical workers worked with HIV-infected patients. In 15 cases there was a needle prick, in 1 case there was a cut with a scalpel, in 1 case there was contact of infected material with the mucous membrane of the eye.

The main causes of “emergency situations” remain carelessness of medical workers when performing manipulations, violation of the technique of performing complex manipulations, as well as insufficient use of modern disposable and other safe technologies.

In these situations, it is necessary to correctly, clearly and timely organize emergency measures to prevent occupational infection, including preventive treatment using antiretroviral drugs. Thanks to the complex of measures taken, no cases of professional infection of medical workers with HIV infection have been registered in the region.

In order to prevent cases of professional infection of medical workers with HIV infection in medical institutions in the region, as well as in compliance with the sanitary and epidemiological rules SP 3.1.5.2826-10 “Prevention of HIV infection,” I order:

1. To the heads of government bodies and healthcare institutions in the region:

1.1. Ensure the immediate implementation of a set of measures to prevent HIV infection in the event of an “emergency situation” among health workers when providing medical care to an HIV-infected patient (or a patient with unknown HIV status) in accordance with the requirements of clause 8.3 of the sanitary and epidemiological rules SP 3.1.5.2826- 10 “Prevention of HIV infection” and methodological recommendations for the prevention of occupational infections with HIV infection (appendix to this order). Duration: permanent.

1.2. Conduct training on safety precautions and actions in case of “emergency situations” when hiring employees and thereafter 2 times a year. Duration: permanent.

1.3. Ensure strict accounting of “emergency situations” that arose during the work of medical personnel, with the drawing up of an Industrial Accident Report in form N-1 and providing a copy of the Report to the Saratov Regional Center for the Prevention and Control of AIDS and Infectious Diseases (GUZ " AIDS Center"). Duration: permanent.

1.4. Ensure the availability of first aid kits for the prevention of occupational HIV infection at the workplaces of medical workers who have contact with biomaterials. Duration: permanent.

1.5. Organize timely examination and treatment of injured medical workers within 2 hours after the “emergency” (no later than 72 hours), including at night, weekends and holidays. Duration: permanent.

1.6. Appoint responsible persons for obtaining rapid tests for HIV, for maintaining records, for correctly setting up and evaluating the results of rapid diagnostics of HIV infection. Provide lists of responsible persons by institution to the State Institution "AIDS Center" and ensure their further training on the basis of the laboratory of the State Institution "AIDS Center" (as agreed). Deadline: until July 15, 2013

1.7. Ensure that the State Health Institution "AIDS Center" receives rapid tests for HIV and antiretroviral drugs for emergency prevention of HIV infection from medical workers in "emergency situations." Duration: permanent.

2. To the chief physician of the State Healthcare Institution "Saratov Regional Center for the Prevention and Control of AIDS and Infectious Diseases" (State Healthcare Institution "AIDS Center") Potemina L.P.:

2.1. Provide training for specialists responsible for carrying out a set of measures to prevent HIV infection in the event of an “emergency situation” among medical workers. Deadline: until July 31, 2013

2.2. Ensure an irreducible supply of diagnostic rapid tests for HIV and antiretroviral drugs for emergency prevention of HIV infection in “emergency situations” among medical workers. Duration: permanent.

Order of the Ministry of Health of the Saratov Region
dated June 2, 2003 N 144
“On measures to prevent occupational infections
HIV infection of medical personnel of healthcare institutions in the region"

By order of the Ministry of Health of the Saratov Region dated July 2, 2013 N 654, this order was declared invalid

On the implementation of preventive and anti-epidemic measures against HIV/AIDS in the Saratov region, see the order of the Ministry of Health and social support Saratov region dated March 1, 2007 N 246

For additional measures to counter the spread of HIV infection in the Saratov region, see Resolution of the Chief State Sanitary Doctor for the Saratov Region dated July 13, 2005 No. 11

On intensifying measures aimed at countering the spread of HIV infection in the Saratov region, see Resolution of the Chief State Sanitary Doctor for the Saratov Region dated March 25, 2004 No. 7

Considering the unfavorable epidemiological situation regarding HIV infection in the region (the total number of HIV-infected people since the beginning of registration is 5667), the risk of occupational infection of medical workers of various profiles increases. Behind Lately There has been an increase in the registration of emergency (extraordinary) situations among medical workers with HIV-infected patients in treatment and preventive institutions in the region. In 2001, 6 emergency situations were registered, in 2002 - 16, in 3 months of the current year - 8.

In order to prevent occupational transmission of HIV infection and timely provision of adequate preventive treatment, I order medical workers exposed to the risk of occupational infection:

2. To the heads of regional health authorities and institutions:

2.1. Conduct, by June 10, 2003, seminars with medical workers on the prevention of occupational infection of medical workers with HIV, at which methodological recommendations in accordance with the appendix will be communicated.

2.2. Provide conferences twice a year with subsequent tests on the prevention of occupational HIV infection among medical workers.

2.3. Ensure the availability of first aid kits at the workplaces of medical workers who have contact with biomaterials to prevent occupational transmission of HIV infection.

2.4. Conduct instructions on safety precautions and the rules for using an emergency first aid kit with medical workers upon hiring and subsequently 2 times a year.

2.5. Ensure strict accounting of emergency situations that arise when a medical worker works with instruments contaminated with blood and other biological fluids of the patient.

2.6. Provide in the event of an emergency:

— providing medical assistance to the injured medical worker;

— registration of an emergency in the logbook, drawing up an accident report N-1;

— determining the degree of risk of infection and prescribing emergency chemoprophylaxis for HIV infection;

— examination of the injured medical worker for HIV infection.

3. To the chief physician of the State Health Institution “AIDS Center” L.P. Potemina:

3.1. Provide counseling and follow-up for health workers exposed to HIV infection.

3.2. Provide a minimum supply of antiviral drugs for chemoprophylaxis for medical workers in the event of a threat of occupational HIV infection.

3.3. Provide the municipal medical institution “City Hospital No. 2” and the Saratov ambulance station with antiviral drugs for emergency preventive treatment of medical workers in the region exposed to the threat of professional HIV infection on weekends and holidays.

3.4. Carry out timely replacement of antiviral drugs intended for preventive treatment, 2 months before the expiration date.

3.5. Conduct, until June 30, 2003, seminars on the use of antiviral drugs in emergency situations with medical workers from the municipal municipal hospital No. 2 and the Saratov ambulance station and trusted doctors from medical institutions in the region.

4. To the Chairman of the Saratov Health Committee A.V. Mikhailov:

4.1. Ensure that the AIDS Center receives sets of antiviral drugs (per 10 people) to provide emergency prevention of occupational infection to medical workers on weekends and holidays.

4.2. Ensure the targeted use of antiviral drugs and timely replacement of these drugs when their expiration dates expire at the AIDS Center.

4.3. Ensure the immediate issuance of antiviral drugs on weekends and holidays at the request of medical institutions in the region in emergency room MMU "City Hospital N 2" (at the address: Saratov, Chernyshevsky St., 141), at the request of medical institutions in Saratov at the city ambulance station (at the address: Saratov, Kholzunova St., 36 ) to provide emergency prevention of HIV infection to medical workers.

5. Entrust control over the implementation of this order to the deputy head of the department for organizing medical care for the adult population, D.A. Kedrov.

CJSC "Vitalpharm"
Production and distribution

Composition of an ANTI - AIDS first aid kit in the regions

There is no uniform composition of the ANTI-AIDS first aid kit in Russia, but there are orders that regulate the composition of the first aid kit in individual regions. We present to your attention some of them for your reference.

Order for an Anti-AIDS first aid kit in the Altai Republic

Order dated April 25, 2011 No. 52

“On approval of the Anti-AIDS first aid kit”

Alcohol 70% - 100.0 ml.

5% alcohol solution of iodine - 10 ml.

Sterile gauze wipes - 10 pcs.

Adhesive plaster - 1 pack.

Finger pads - 3 pcs.

Rubber gloves - 2 pairs.

Cotton swabs 10 pcs.

Order of the Ministry of Health of the Samara Region dated January 27, 2006 N 16/9

“On improving work on identifying HIV-infected people, dispensary observation, organizing treatment of patients, preventing HIV infection in the Samara region”

The Anti-AIDS emergency first aid kit includes: 70% alcohol, 5% alcohol solution of iodine, dressing material, a sample of dry potassium permanganate 50 mg, which in case of an emergency, dissolve in 100 ml of distilled water (diluted 1:10000) or 0 .05% solution of potassium permanganate, bactericidal patch, eye pipettes 2 pcs., sterile cotton balls and gauze swabs.

Ministry of Health of the Republic of Sakha (Yakutia)

Ministry of Health of the Republic of Sakha (Yakutia) No. 01-8/4-1177 dated July 20, 2012.

On measures to prevent occupational infection with HIV and parenteral drugs viral hepatitis medical workers of treatment and preventive organizations of the Republic of Sakha (Yakutia)

70% ethyl alcohol 100 ml.

5% alcohol solution of iodine 1 bottle

Sterile cotton balls 20 pcs.

Sterile bandage 1 pc.

Scissors 1 pc.

Bactericidal adhesive plaster 1 pc.

Finger pads 3 pcs.

Glass 1 pc.

Compound ANTI-AIDS first aid kits (from SanPiN 2.1.2. 2631-10) - to each office separately!

Alcohol 70%

5% alcohol solution of iodine

Adhesive plaster, dressing material

Weighed portions of potassium permanganate, 50 mg each

Latex gloves

Container for diluting water

If blood gets on your face, your hands should be thoroughly washed with soap and water, and your eyes with water or a solution of potassium permanganate in a ratio of 1:10,000. If the skin is damaged (cut, injection), squeeze out the blood on the damaged surface, treat the skin with 70-degree alcohol, then with iodine.

To stop bleeding from cuts or abrasions, solutions of hydrogen peroxide or iodine are used. For antiseptic treatment of cut sites, use a 5% alcohol solution of iodine.

Ministry of Health of the Republic of Bashkortostan

Order No. 174-D dated January 30, 2012

On emergency prevention of HIV infection

Composition of a first aid kit for emergency prevention of HIV infection

Ethyl alcohol 70% - 50 ml;
5% alcohol solution of iodine - 20 ml;
Adhesive plaster – 1 pack;
Sterile cotton balls No. 20 – 1 pack;
Sterile gauze wipes No. 10 – 1 pack;
Sterile bandage – 1 pc.
Express tests for HIV – 2 pcs.

Department of Health of the Vologda Region.

Order No. 1181 dated October 4, 2011.

70% ethyl alcohol – 2 bottles of 100 ml.

5% alcohol solution of iodine

Bandage – 2 pcs.

Bactericidal patch – 1 pack.

Finger cap – 2 pcs.

Scissors with rounded jaws.

Department of Health of the Kostroma Region

Order of SDC No. 696 dated 07-11-2012

On approval of the composition of the "ANTI HIV" first aid kit and the algorithm of action

in the event of an emergency involving a threat

to provide first aid to prevent occupational HIV infection among medical workers

70% ethyl alcohol, 100 ml

Eye pipettes in a case

Sterile distilled water 500 ml

Dressings (sterile wipes, bandage, plaster)

Scissors

Antiretroviral drugs lopinavir/ritonavir + zidovudine/lamivudine or any other antiretroviral drugs

RULES FOR USING THE FIRST KIT

If infected material gets on your skin, you must thoroughly wash the area with soap and water and treat it with 70% alcohol.

If there is a cut in gloves and skin, you need to remove the gloves, immerse your hand in a disinfectant solution, squeeze out the blood from the wound, then treat the wound with iodine, seal it with an adhesive plaster and put on new gloves.

If blood gets into your eyes, you need to rinse them with water, then with a weak solution of potassium permanganate.

If blood gets into your mouth, rinse it with a weak solution of potassium permanganate, then 70° alcohol.

We rinse the nasal cavity with potassium permanganate, then instill protorgol.

Dez. solutions are used within 24 hours.

Disinfection is carried out within an hour in the following solutions:

3% chloramine or bleach

0.6% calcium hypochloride

6% hydrogen peroxide

4% formaldehyde

0.5% sulfochlorontin

2% soda solution

All instruments must be washed with water before disinfection. The wash water is covered with dry bleach in a ratio of 1:5 (200 grams of lime per 1 liter of water) for 1 hour, then drained into the sewer.

GOVERNMENT OF THE SARATOV REGION

On measures to prevent occupational HIV infections among medical personnel of healthcare institutions in the region

Revoked based on
Order of the Ministry of Health of the Saratov Region dated 08.08.2017 N 117-p.
________________________________________________

In order to prevent cases of professional infection of medical workers with HIV infection in medical institutions of the region, as well as in compliance with sanitary and epidemiological rules SP 3.1.5.2826-10 “Prevention of HIV infection,” I ORDER:

1. To the heads of government bodies and healthcare institutions in the region:

1.1. Ensure the immediate implementation of a set of measures to prevent HIV infection in the event of an “emergency situation” among health workers when providing medical care to an HIV-infected patient (or a patient with an unknown HIV status) in accordance with the requirements of clause 8.3 of the sanitary and epidemiological rules SP 3.1.5.2826- 10 “Prevention of HIV infection” and methodological recommendations for the prevention of occupational infections with HIV infection (appendix to this order). Duration: permanent

1.2. Conduct training on safety precautions and actions in case of “emergency situations” when hiring employees and thereafter 2 times a year. Duration: permanent

1.3. Ensure strict accounting of “emergency situations” that arose during the work of medical personnel, with the preparation of an Industrial Accident Report in form N-1 and provision of a copy of the Report to the Saratov Regional Center for the Prevention and Control of AIDS and Infectious Diseases (GUZ “ AIDS Center"). Duration: permanent

1.4. Ensure the availability of first aid kits for the prevention of occupational HIV infection at the workplaces of medical workers who have contact with biomaterials. Duration: permanent

1.7. Ensure that the State Health Institution “AIDS Center” receives rapid tests for HIV and antiretroviral drugs for emergency prevention of HIV infection from medical workers in “emergency situations.” Duration: permanent

1.8. Send responsible persons (trusted HIV/AIDS doctors or infectious disease doctors) to the State Health Institution “AIDS Center” in order to train them in the tactics of chemoprophylaxis for HIV infection. Deadline: until July 15, 2013

2. To the chief physician of the State Healthcare Institution “Saratov Regional Center for the Prevention and Control of AIDS and Infectious Diseases” (State Healthcare Institution “AIDS Center”) Potemina L.P.:

2.2. Ensure an irreducible supply of rapid diagnostic tests for HIV and antiretroviral drugs for emergency prevention of HIV infection in “emergency situations” among medical workers. Duration: permanent

3. Consider the order of the Ministry of Health of the region dated 06/02/2003 N 144 “On measures to prevent occupational HIV infection of medical personnel of health care institutions in the region” to be considered invalid.

4. Entrust control over the implementation of this order to First Deputy Minister Zh. A. Nikulina.

Minister
A. N. Danilov

In conditions high level the prevalence of HIV infection, the increase in the number of patients with HIV infection in the stage of secondary diseases, the terminal stage of HIV, more and more patients infected with the human immunodeficiency virus are seeking medical help.

The number of HIV patients receiving specific antiretroviral therapy is increasing, which increases the risk of professional contact with the biological fluids of a patient infected with resistant strains of HIV.

Preventive measures in medical institutions are carried out on the basis that each patient is regarded as a potential source of blood-borne infections (HIV infection, hepatitis B and C). Therefore, general precautions must be observed when working with blood, body fluids (sperm, vaginal secretions, any fluids mixed with blood, containing HIV cultures and culture media, synovial fluid, cerebrospinal fluid, pleural fluid, pericardial fluid, amniotic fluid).

IN medical organization a set of measures should be carried out to prevent the occurrence of emergency situations when performing various types of work.

Emergency situation- exposure to blood or other biological fluids the patient on the mucous membranes, injured skin of the medical worker, trauma to the skin, mucous membranes when performing medical manipulations(prick, cut). In addition, anti-epidemic measures are necessary in case of an emergency situation when a pathogenic agent is released into the air of the production area, environment, on equipment in the event of an accident at a laboratory centrifuge.

In preventing the infection of medical personnel with HIV infection, the main directions of an integrated approach to this problem can be identified:

— preventing direct contact with the patient’s blood and biological fluids;

— developing skills for safe manipulation and operation of equipment;

— compliance with the work and rest regime of medical workers;

— compliance with the requirements for the disposal of epidemiologically hazardous waste;

— timely and full implementation of measures to reduce the risk of infection in the event of an emergency.

Measures to prevent HIV infection among medical workers

Medical personnel with skin lesions are removed from work and sent for examination and treatment. If it is necessary to perform work, all damage must be covered with adhesive tape and finger pads.

All manipulations during which hands may become contaminated with blood, serum or other biological fluids should be carried out with gloves. Gloves are put on immediately after the skin antiseptic has completely dried. The same pair of gloves should not be used between patients. For operations with a high risk of glove failure, two pairs of gloves or heavy-duty gloves should be worn.

You cannot draw blood with a needle without a syringe; you cannot store infected material with blood and its components in open containers without disinfectants.

During work it is necessary to use technical means that ensure safety. These are containers for sharps (contact-free disposal of medical waste), hand washing devices (dispensers), needle destructors, needle capping devices, vacutainers, self-closing syringes, non-dismountable self-locking syringes, disposable safety scarifiers, etc.

Piercing and cutting instruments (needles, scalpels, scissors) should not be passed from hand to hand. They must be placed on the table/tray and then picked up or warned by a colleague about the transfer of sharp objects. When opening bottles, vials, test tubes with blood or serum, you should avoid pricks, cuts on gloves and hands.

After use, syringes are considered epidemiologically hazardous waste (class B) or extremely epidemiologically hazardous (class B) medical waste. Collection, disinfection, temporary storage, transportation, destruction and disposal of used single-use injection syringes are carried out in accordance with San-PiN 2.1.7.2790-10 “Sanitary and epidemiological requirements for the management of medical waste.”

Do not put caps on used needles!

Safe containers for sharps are located at arm's length. Do not overfill containers with used sharps! Collect needles that fall on the floor with a magnet.

Referral forms to a clinical diagnostic laboratory are strictly prohibited from being placed in blood tubes or wrapped around blood tubes.

Transportation cannot be carried out biological material for laboratory research in open containers with cotton-gauze stoppers. The blood tubes are closed with ground-in rubber stoppers or Parafilm “M” laboratory film. When centrifuging, the tubes must also be closed with ground-in rubber stoppers or laboratory film. Transportation of biomaterial is carried out in closed containers subject to disinfection treatment. Test tubes with broken edges should not be used. It is prohibited to pour liquid infectious material over the edge of a vessel (test tubes, flasks, bottles), or remove undisinfected blood clots from test tubes or bottles by shaking them out.

During the manipulation, you must not take notes, touch the telephone receiver, etc. Eating food or using cosmetics is prohibited in the workplace. Work clothes and shoes must be individual, match the size of the workers and be stored separately from personal clothing.

Before you leave workplace, you should remove everything individual means protection and place them in special containers.

When performing manipulations, a patient with HIV infection must:

1. Make sure the emergency first aid kit is intact.

2. Perform manipulations in the presence of a second specialist, who can continue to perform it in the event of a rupture of gloves or a cut of the skin and mucous membranes.

3. Treat the skin nail phalanges iodine before putting on gloves.

4. Work with two pairs of gloves or heavy-duty gloves.

5. Make maximum use of tools and others medical products single use.

1. Iodine 5% alcohol solution - 1 bottle.

2. Ethyl alcohol 70% - 100.0 ml.

3. Bactericidal patch - 1-2 pcs. per one security office employee.

4. Antiseptic napkin for injections - 2 pcs. per employee of the security office for treatment of the injection site.

5. Finger pads - 1-2 pcs. per one security office employee.

The first aid kit and instructions and methodological documentation should be stored in an easily accessible place. Monitoring the correct storage and replenishment of the first aid kit is the responsibility of the heads of departments or persons appointed by them.

Actions of a medical worker in emergency situations

If an emergency occurs, it is necessary to immediately provide first aid to the victim. In case of cuts or punctures on the skin:

- remove gloves (if gloves are heavily contaminated with biological material, treat gloves before removing disinfectant), treat hands with 70% alcohol, then wash with soap and water, lubricate the wound with 5% alcohol solution Yoda.

If blood or other biological fluids come into contact with the skin:

- treat the skin with 70% alcohol, wash with soap and water and re-treat with 70% alcohol.

If blood or other biological fluids of the patient come into contact with the mucous membranes of the eyes, nose and mouth:

- rinse the oral cavity with plenty of water and rinse with a 70% solution ethyl alcohol;

— the mucous membrane of the nose and eyes is washed generously with water (do not rub).

If the patient's blood or other biological fluids come into contact with a gown or clothing:

- remove work clothes and immerse in a disinfectant solution;

- wipe the skin of the hands and other areas of the body under contaminated clothing with 70% alcohol;

- remove and disinfect gloves.

Shoes treated by wiping twice with a rag soaked in a solution of one of the disinfectants.

In case of an accident while operating a centrifuge The lid is slowly opened only after 30-40 minutes. (after the aerosol settles). Centrifuge beakers and broken glass are placed in a disinfectant solution, the surface of the lid, the internal parts of the centrifuge, its outer surface disinfected. The centrifuge is disinfected after disconnecting it from the power supply. Events are held in facilities personal protection(mask, goggles, gloves, robe, cap). Final disinfection is carried out in the room where the accident occurred.

The injured medical worker must immediately report the accident (cut, puncture, contact of biomaterial on mucous membranes, accident at a centrifuge) to the person responsible for implementing measures to prevent HIV infection and the occupational safety engineer of the institution. Make an entry in the emergency log.

In case of injury When providing medical care to an HIV-infected patient, the injured medical worker must begin taking antiretroviral drugs as quickly as possible, which he can obtain at the AIDS Center (on weekdays) or at his place of work from the person responsible for implementing HIV prevention measures. -infections.

Measures in the institution in the event of an emergency

To do this, it is necessary to conduct an HIV examination of the patient with whom the accident occurred, using a rapid test with the obligatory sending of a sample from the same portion of blood to the AIDS laboratory for standard HIV testing in ELISA.

Conduct an HIV test of the injured medical worker to determine the HIV infection status at the time of the emergency.

Inform the State Health Institution "AIDS Center" about the emergency situation by phone: 55-34-45 by a representative of the administration of the health care facility with the subsequent provision of an Accident Report.

HIV testing is carried out with mandatory pre-test counseling on HIV infection.

Carrying out chemoprophylaxis in case of a positive result of a patient’s blood test for antibodies to HIV

If a patient receives a positive rapid test result, the affected health care worker is immediately given antiretroviral drugs.

Antiretroviral medications should be started within the first two hours after the accident, but no later than 72 hours.

If HIV status the potential source of infection is unknown and cannot be identified, chemoprophylaxis can be prescribed for epidemic indications.

Stock of antiretroviral drugs must be stored in medical institution at the choice of the heads of health authorities of the territories, with the expectation that examination and treatment of the victim can be organized within 2 hours after an emergency.

In an authorized medical institution, it is necessary to determine the responsible specialist for issuing antiretroviral drugs, where the drugs are stored in an accessible place, including at night and on weekends.

The procedure for registration and registration of emergency situations in the institution

In all institutions it is necessary to maintain an “Emergency Situations Log”.

Emergency log form:

ANTIAIDS (ANTI HIV) EMERGENCY FIRST KIT

First aid kit ANTIAIDS - (ANTI HIV) EMERGENCY according to SanPin 3.1.5 2826-10 The composition is current for 2017 and 2018

REGULATIONS ON THE PREVENTION OF HIV AND VIRAL HEPATITIS

The second most important, after the ANTI-SHOCK FIRST KIT, is the ANTIAIDS - (Anti HIV) first aid kit. According to SanPin, this first aid kit should be in every manipulation (procedure) room, in medical institutions, among ambulance workers, as well as in all enterprises whose employees, in one way or another, come into contact with infected persons and, to a certain extent, are at risk of infection. These include:

Hairdressers

Tattoo parlors

Manicure and pedicure salons

Beauty salons

Dental offices

Other medical institutions

Employees of melon establishments must be instructed about the completeness and correct use of the ANTIAIDS first aid kit.

It is also necessary to appoint a person responsible for monitoring expiration dates. medical supplies, and timely replenishment of the first aid kit.

Emergency situations in which it is necessary to use an Anti-AIDS emergency kit:

Accidental injection with a used syringe
Contact of blood of a presumably infected person with mucous membranes: eyes, nose, mouth
Contact of blood of a presumably infected person on the wound surface
Contact of blood of a presumably infected person with skin and clothing
Accidental injury from a tool used for various procedures and having the blood of an infected person on the surface (manicure or pedicure instrument, scissors, tattoo machine, etc.)

Composition of the first aid kit ANTIAIDS - (Anti HIV) SanPin 3.1.5 2826-10

How to use the Anti-AIDS emergency kit is described in paragraph Appendix 12 to SanPiN 2.1.3.2630-10 and in paragraph 8.3.3.1. SanPin 3.1.5 2826-10.

Emergency prevention of HIV infection and viral hepatitis:

As you can see, in the later edition of SanPin 3.1.5 2826-10 clause 8.3.3.1., if blood or other biological fluids of the face get on the mucous membranes (eyes, nose, mouth), the prevention of HIV infection is limited only to washing the mucous membranes with plenty of water, and rinsing the mouth with a 70% ethanol solution. In earlier SanPiN 2.1.3.2630-10 Appendix 12, in a similar emergency situation, more wide range activities using aqueous solution Boric acid, Protargol, potassium permanganate solution.

If HIV infection is suspected, in the first hours ( no later than 72 hours.) after infection, prophylaxis should be carried out with antiretroviral drugs: a combination of Polinavir (or Ritonavir) and Zidovudine (or Lamivudine).

Article 43 of Federal Law No. 323 Medical assistance to citizens suffering from diseases that pose a danger to others GO...

To avoid critical situations, basic safety measures should be observed:

Use personal protective equipment: gown, mask, cap, special safety glasses (if necessary), gloves (if there is even a slight risk of cutting, double-layer gloves are recommended). Avoid exposed areas of the body.
Exercise extreme caution when handling used medical material: needles, scalpels, syringes, tampons. Dispose of materials in tight bags with special markings.
Regularly disinfect instruments and materials that come into contact with suspected infected persons.
Clothing that has come into contact with blood or other body fluids should be soaked in hot water (70 degrees) for at least 25 minutes.
Exercise extreme caution when providing first aid to victims with open bleeding.
When performing artificial respiration using the mouth-to-mouth method, make sure that the victim is not bleeding from the mouth or lips. To avoid infection, it is necessary to use special a device for artificial respiration or improvised means (gauze, bandage, handkerchief, etc.)

You should know that HIV-infected persons can remain healthy for a long time (several years) and have no symptoms of the disease.

HIV can remain active for some time (presumably several weeks) in dried drops of blood, in frozen blood, or in a used syringe. The human immunodeficiency virus can even enter the body through small ulcers on the skin, which, formally, represent a wound surface, that is, “open doors” for the virus. If you follow all the above rules, there is a risk of infection not only with HIV, but also with other viruses, including incl. various forms hepatitis – minimal.

What should a first aid kit be like in an organization?

Every organization must have a first aid kit for employees according to Order 169n. Its composition cannot differ from the approved one. So what should be in such a first aid kit and what requirements does the Ministry of Health impose on its placement and use? The answers are in the article.

According to the provisions of Article 223 Labor Code RF in every organization or individual entrepreneur where people work, sanitary and household facilities must be organized medical support workers. In addition to equipped places for eating and hygiene, rooms or areas for providing medical care must be equipped in accordance with these requirements. At each such post there must be medical first aid kits according to order 169n of the Ministry of Health and Social Development of the Russian Federation. This document defines the equipment and quantity of funds that should be on hand in case of unforeseen situations.

Complete set with dressings and medicines

Production first aid kit according to order 169n of the Ministry of Health and Social Development of Russia dated 03/05/2011, the composition of which was developed taking into account the characteristics labor activity citizens, must be equipped with means for temporarily stopping bleeding and dressing wounds, as well as products for carrying out cardiopulmonary resuscitation. A complete list of medical products that should be included in each first aid kit is given in the appendix to this order. It is comprehensive. This means that the employer does not have the right to replace the products and drugs provided by him at his own discretion. In addition, everything should be complete, reducing the number necessary funds is not allowed, but their increase is not prohibited. Especially if the employer takes into account the specific needs of its employees and the characteristics of the activities.

At least one first aid kit is provided for one organization or individual entrepreneur, however, if the staff is large and there are many premises remote from each other, there should be several of them.

So, in the selection medicines main role order 169n plays. According to his version, the complete set of first aid kits should look like this:

Name of medical products

Regulatory document

Release form (dimensions)

Quantity (pieces, packages)

Medical products for temporarily stopping external bleeding and dressing wounds

Non-sterile medical gauze bandage

Medical gauze bandage sterile

Individual sterile medical dressing bag with a sealed shell

Sterile medical gauze wipes

At least 16 x 14 cm N 10

At least 4 cm x 10 cm

At least 1.9 cm x 7.2 cm

At least 1 cm x 250 cm

Medical products for cardiopulmonary resuscitation

A device for artificial respiration “Mouth - Device - Mouth” or a pocket mask for artificial ventilation of the lungs “Mouth - mask”

Other medical products

Lister bandage scissors

GOST 21239-93 (ISO 7741-86)

Antiseptic wipes made of paper textile-like material, sterile alcohol

GOST R ISO 10993-99

At least 12.5 x 11.0 cm

Medical non-sterile gloves, examination

GOST R 52238-2004

GOST R 52239-2004

Size no less than M

Non-sterile medical mask, 3-layer, made of non-woven material with elastic bands or ties

Isothermal rescue blanket

GOST R ISO 10993-99,

At least 160 x 210 cm

Steel safety pins with spiral

Case or sanitary bag

Tear-off notepad for notes

format no less than A7

Obviously, the table shows not just the names of items and medicines, but also GOSTs regulating their quality. You must pay attention to this when completing the configuration. A product that does not comply with GOST may be regarded by inspectors as unauthorizedly replaced. In addition, you cannot deviate from the established dimensions dressings, pins and gloves. The last two points of the table - a fountain pen and a notepad - are not items for first aid, but their presence is mandatory, and inspectors will have natural questions if these two items are not in the first aid kit.

Where should the first aid kit be kept and who is responsible for it?

Typically, the person responsible for providing workers with the items required by labor safety standards is the head of the organization. Therefore, first of all, he is personally responsible for how the order of the Ministry of Health 169n is observed: the list of first aid kits according to SanPIN, its availability and other related issues. It is advisable to issue an order for the enterprise on the configuration of the first aid kit and the appointment of a responsible person, as well as on determining the location for its storage.

Of course, ideally, if the company has a medical professional on staff, it is best to entrust him with purchasing all the necessary medications, monitoring their completeness and checking expiration dates (by the way, after they expire, all medications must be replaced with new ones). But if there is no such specialist, then this function can be taken on by a labor protection engineer with first aid skills, or any other employee. Labor legislation and general regulations do not provide a list of such workers, but in industry regulations you can find that this role can be taken on by:

the head of the organization himself;
heads of departments;
heads of departments or sections.

This, in particular, is discussed in paragraph 2.6.1 of the Sanitary Rules for the organization of freight transportation by rail, approved by the chief san. doctor 03/24/2000.

As for where to store the first aid kit, it must be stored in an easily accessible place. Therefore, the office of the responsible person will be a bad choice, because in the absence of it, access to medicines will be limited. Therefore, you need to choose a room that is not locked with a key during working hours.

Responsibility for the lack of a first aid kit

Responsibility for the fact that the enterprise does not have a first aid kit for employees, according to Order 169n, is provided for in Article 6.3 of the Code of Administrative Offenses of the Russian Federation. This article provides for administrative punishment for violation of legislation in the field of ensuring the sanitary and epidemiological well-being of the population. Therefore, if a company has violated current sanitary rules and hygiene standards, it may be subject to an administrative fine in the amount of 10,000 to 20,000 rubles, or its activities may be suspended for up to 90 days. Entrepreneurs may be fined from 500 to 1,000 rubles or banned from working for up to 90 days. Officials will pay a fine of up to 1000 rubles.

First aid kit order 654

1. Ethyl alcohol 70%, 100 ml*
2. Iodine solution 5%, 1 bottle
3. Boric acid solution 1%
4. Protargol solution 1%
5. Solution of potassium permanganate 0.05% (50 mg weighed portions of dry potassium permanganate)*
6. Distilled water in 100 ml containers
7. Glass pipettes - 5 pcs.
8. Cotton and gauze swabs - 5 pcs.
9. Antiseptic adhesive plaster - 1 pack.
10. Metal scissors
11. Finger pads - 5 pcs.
12. Toilet soap
13. Chloramine B solution 3% or any other disinfectant solution
14. Labeled metal box

Azidotimidine (retrovir, zidovudine)
Lamivudine (elivir)
Lopinavir/ritonavir (Kaletra)
Lamivudine+Zidovudine (combivir)

The stock of antiretroviral drugs should be stored so that they can be started within the first two hours after the accident, but no later than 72 hours.

* - subject to subject-quantitative accounting, in accordance with the requirements of the Decree of the Government of the Russian Federation dated June 30, 1998 No. 681 “On approval of the list narcotic drugs, psychotropic substances and their precursors subject to control in Russian Federation"and the order of the Ministry of Health and Social Development of the Russian Federation dated December 14, 2005 No. 785 "On the Procedure for Dispensing Medicines."

These recommendations on the composition of the Anti-AIDS first aid kit have been prepared taking into account the provisions of: Resolution of the Chief State Sanitary Doctor of the Russian Federation dated May 18, 2010 N 58 “On approval of SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations carrying out medical activities"(Appendix 12 to SanPiN 2.1.3.2630-10); Resolution of the Chief State Sanitary Doctor of the Russian Federation dated January 11, 2011 No. 1 “On approval of SP 3.1.5.2826-10 “Prevention of HIV infection”; Methodological recommendations “Prevention of HIV infection in state forensic medical institutions” (letter of the Ministry of Health of Russia dated March 22, 2013 No. 14-1/10/2-2018); Methodological recommendations: Prevention of occupational HIV infection among ambulance and emergency medical workers.

Option 1: Emergency prevention of parenteral viral hepatitis and HIV infection (Appendix 12 to SanPiN 2.1.3.2630-10)

To avoid infection with parenteral viral hepatitis and HIV infection, you should follow the rules for working with piercing and cutting instruments.
In case of cuts and injections, immediately treat and remove gloves, squeeze out blood from the wound, wash your hands with soap and running water, treat your hands with 70% alcohol, lubricate the wound with a 5% iodine solution.
If blood or other biological fluids come into contact with the skin, the area is treated with 70% alcohol, washed with soap and water and re-treated with 70% alcohol.
If blood gets on the mucous membranes of the eyes, they are immediately washed with water or a 1% solution of boric acid; in case of contact with the nasal mucosa, treat with a 1% solution of protargol; on the oral mucosa - rinse with a 70% alcohol solution or a 0.05% solution of potassium permanganate or a 1% solution of boric acid.
The mucous membranes of the nose, lips, and conjunctiva are also treated with a solution of potassium permanganate at a dilution of 1:10,000 (the solution is prepared ex tempore).
For the purpose of emergency prevention of HIV infection, azidothymidine is prescribed for 1 month. The combination of azidothymidine (Retrovir) and lamivudine (Elivir) enhances antiretroviral activity and overcomes the formation of resistant strains.
If there is a high risk of contracting HIV infection ( deep cut, hit visible blood on damaged skin and mucous membranes from patients infected with HIV) to prescribe chemoprophylaxis, you should contact the territorial Centers for the Control and Prevention of AIDS.
Persons exposed to the threat of HIV infection are under the supervision of an infectious disease specialist for 1 year with mandatory examination for the presence of a marker of HIV infection.
Personnel who have had contact with material infected with the hepatitis B virus are simultaneously administered specific immunoglobulin (no later than 48 hours) and a vaccine against hepatitis B in different parts of the body according to the scheme 0 - 1 - 2 - 6 months. with subsequent monitoring of hepatitis markers (not earlier than 3 - 4 months after the administration of immunoglobulin).
If the exposure occurred in a previously vaccinated health care worker, it is advisable to determine the level of anti-HBs in the blood serum. If there is an antibody concentration in the titer of 10 IU/l or higher, vaccine prophylaxis is not carried out; in the absence of antibodies, it is advisable to simultaneously administer 1 dose of immunoglobulin and a booster dose of the vaccine.

Option 2: Actions of a medical worker in an emergency (Resolution of the Chief State Sanitary Doctor of the Russian Federation dated January 11, 2011 No. 1 “On approval of SP 3.1.5.2826-10 “Prevention of HIV infection”).

- in case of cuts and injections, immediately remove gloves, wash your hands with soap and running water, treat your hands with 70% alcohol, lubricate the wound with a 5% alcohol solution of iodine;
- if blood or other biological fluids come into contact with the skin, the area is treated with 70% alcohol, washed with soap and water and re-treated with 70% alcohol;
- if the patient’s blood and other biological fluids come into contact with the mucous membranes of the eyes, nose and mouth: rinse the oral cavity with plenty of water and rinse with a 70% solution of ethyl alcohol, the mucous membrane of the nose and eyes is washed generously with water (do not rub);
— if the patient’s blood or other biological fluids get on the gown or clothing: remove the work clothes and immerse them in a disinfectant solution or in a tank for autoclaving;
— start taking antiretroviral drugs as soon as possible for post-exposure prophylaxis of HIV infection.

Necessary as possible short time after contact, test for HIV and viral hepatitis B and C the person who may be a potential source of infection, and the person in contact with him. HIV testing of a potential source of HIV infection and a contact person is carried out using rapid testing for HIV antibodies after an emergency with the obligatory sending of a sample from the same portion of blood for standard HIV testing in an ELISA. Samples of plasma (or serum) from the blood of a person who is a potential source of infection and a contact person are transferred for storage for 12 months to the AIDS center of a constituent entity of the Russian Federation.
The victim and the person who may be a potential source of infection must be interviewed about the carriage of viral hepatitis, STIs, inflammatory diseases of the genitourinary tract, and other diseases, and counseled regarding less risky behavior. If the source is infected with HIV, determine whether he or she received antiretroviral therapy. If the victim is a woman, a pregnancy test should be performed to determine if she is breastfeeding. In the absence of clarifying data, post-exposure prophylaxis begins immediately when additional information the scheme is being adjusted.

Carrying out post-exposure prophylaxis of HIV infection with antiretroviral drugs:
Antiretroviral medications should be started within the first two hours after the accident, but no later than 72 hours.
The standard regimen for post-exposure prophylaxis of HIV infection is lopinavir/ritonavir + zidovudine/lamivudine. In the absence of these drugs, any other antiretroviral drugs can be used to initiate chemoprophylaxis; If it is not possible to immediately prescribe a full-fledged HAART regimen, one or two available drugs are started.
The use of nevirapine and abacavir is possible only in the absence of other drugs. If the only available drug is nevirapine, only one dose of the drug should be prescribed - 0.2 g (repeated administration is unacceptable), then when other drugs are received, full-fledged chemoprophylaxis is prescribed. If chemoprophylaxis is started with abacavir, testing for hypersensitivity reactions to it should be carried out as soon as possible or abacavir should be replaced with another NRTI.

Registration of an emergency situation is carried out in accordance with established requirements:
— LPO employees must immediately report each emergency to the head of the unit, his deputy or a senior manager;
— injuries received by health workers must be taken into account in each health care facility and registered as an industrial accident with the drawing up of an Industrial Accident Report;
— you should fill out the Occupational Accident Register;
— it is necessary to conduct an epidemiological investigation of the cause of the injury and establish a connection between the cause of the injury and the performance of official duties by the health worker.

All healthcare facilities should be provided with, or have access to, rapid HIV tests and antiretroviral drugs as needed. A stock of antiretroviral drugs should be stored in any health care facility at the discretion of the health authorities of the constituent entities of the Russian Federation, but in such a way that examination and treatment can be organized within 2 hours after an emergency.
The authorized health care facility must identify a specialist responsible for the storage of antiretroviral drugs, a storage location with access, including at night and on weekends. Judge Korchagin Alexander Yurievich Graduated in 1992 Faculty of Law Kubansky state university. In 2008 he defended his dissertation and has academic degree Doctor of Law, Professor. Labor activity in judicial […]

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Passport of a citizen of the Russian Federation 1997 Decree of the Government of the Russian Federation of July 8, 1997 N 828 “On approval of the Regulations on the passport of a citizen of the Russian Federation, a sample form and description of a passport of a citizen of the Russian Federation” (as amended from 25 […]
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GOVERNMENT OF THE SARATOV REGION

MINISTRY OF HEALTH

On measures to prevent occupational HIV infections among medical personnel of healthcare institutions in the region

Revoked based on
Order of the Ministry of Health of the Saratov Region dated 08.08.2017 N 117-p.
________________________________________________

In the context of the continued unfavorable epidemiological situation regarding HIV infection (at the beginning of 2013, there were 8,931 HIV-infected people living in the region with a population prevalence rate of 356.0 per 100 thousand) and an increase in the demand for medical help from these patients (more than 2000 HIV-infected), the risk of occupational infection with the human immunodeficiency virus among medical workers of various specialties remains real.

In 2012, a total of 69 emergency situations were registered in medical institutions in the region (in 2011 - 41 cases). Among the victims, 17 medical workers worked with HIV-infected patients. In 15 cases there was a needle prick, in 1 case there was a cut with a scalpel, in 1 case there was contact of infected material with the mucous membrane of the eye.

The main causes of “emergency situations” remain carelessness of medical workers when performing manipulations, violation of the technique of performing complex manipulations, as well as insufficient use of modern disposable and other safe technologies.

In these situations, it is necessary to correctly, clearly and timely organize emergency measures to prevent occupational infection, including preventive treatment using antiretroviral drugs. Thanks to the complex of measures taken, no cases of professional infection of medical workers with HIV infection have been registered in the region.

In order to prevent cases of professional infection of medical workers with HIV infection in medical institutions of the region, as well as in compliance with the sanitary and epidemiological rules SP 3.1.5.2826-10 “Prevention of HIV infection,” I ORDER:

1. To the heads of government bodies and healthcare institutions in the region:

1.1. Ensure the immediate implementation of a set of measures to prevent HIV infection in the event of an “emergency situation” among health workers when providing medical care to an HIV-infected patient (or a patient with an unknown HIV status) in accordance with the requirements of clause 8.3 of the sanitary and epidemiological rules SP 3.1.5.2826- 10 “Prevention of HIV infection” and methodological recommendations for the prevention of occupational infections with HIV infection (appendix to this order). Duration: permanent

1.2. Conduct training on safety precautions and actions in case of “emergency situations” when hiring employees and thereafter 2 times a year. Duration: permanent

1.4. Ensure the availability of first aid kits for the prevention of occupational HIV infection at the workplaces of medical workers who have contact with biomaterials. Duration: permanent

1.8. Send responsible persons (trusted HIV/AIDS doctors or infectious disease doctors) to the State Health Institution "AIDS Center" in order to train them in the tactics of chemoprophylaxis of HIV infection. Deadline: until July 15, 2013

2. To the chief physician of the State Healthcare Institution "Saratov Regional Center for the Prevention and Control of AIDS and Infectious Diseases" (State Healthcare Institution "AIDS Center") Potemina L.P.:

2.3. Provide methodological assistance to specialists responsible for providing medical care in “emergency situations” in determining the degree of risk of HIV infection in victims, in choosing a preventive treatment regimen, and in monitoring tactics for victims. Duration: permanent

3. Consider the order of the Ministry of Health of the region dated June 2, 2003 N 144 “On measures to prevent occupational HIV infection of medical personnel of health care institutions in the region” to be considered invalid.

4. Entrust control over the implementation of this order to First Deputy Minister Zh. A. Nikulina.

Minister
A. N. Danilov

In conditions of high prevalence of HIV infection, an increase in the number of patients with HIV infection in the stage of secondary diseases, the terminal stage of HIV, more and more patients infected with the human immunodeficiency virus are seeking medical help.

The number of HIV patients receiving specific antiretroviral therapy is increasing, which increases the risk of professional contact with the biological fluids of a patient infected with resistant strains of HIV.

Preventive measures in medical institutions are carried out on the basis that each patient is regarded as a potential source of blood-borne infections (HIV infection, hepatitis B and C). Therefore, general precautions must be observed when working with blood, body fluids (sperm, vaginal secretions, any fluids mixed with blood, containing HIV cultures and culture media, synovial fluid, cerebrospinal fluid, pleural fluid, pericardial fluid, amniotic fluid).

A medical organization must take a set of measures to prevent emergency situations when performing various types of work.

Emergency situation- contact of blood or other biological fluids of the patient with the mucous membranes, injured skin of a medical worker, traumatization of the skin and mucous membranes during medical procedures (injection, cut). In addition, anti-epidemic measures are necessary in an emergency situation when a pathogenic agent is released into the air of a production area, the environment, or onto equipment during an accident at a laboratory centrifuge.

In preventing the infection of medical personnel with HIV infection, the main directions of an integrated approach to this problem can be identified:

Preventing direct contact with the patient’s blood and body fluids;

Practicing skills for safe manipulation and operation of equipment;

Compliance with the work and rest regime of medical workers;

Compliance with requirements for the disposal of epidemiologically hazardous waste;

Timely and complete implementation of measures to reduce the risk of infection in the event of an emergency.

Measures to prevent HIV infection among medical workers

When performing manipulations, the medical worker must be dressed in a gown, cap, and removable shoes. Protective gowns, aprons, shoe covers protect clothing and skin from contact with blood and biological fluids.

Medical personnel with skin lesions are removed from work and sent for examination and treatment. If it is necessary to perform work, all damage must be covered with adhesive tape and finger pads.

All manipulations during which hands may become contaminated with blood, serum or other biological fluids should be carried out with gloves. Gloves are put on immediately after the skin antiseptic has completely dried. The same pair of gloves should not be used between patients. For operations with a high risk of glove failure, two pairs of gloves or heavy-duty gloves should be worn.

You cannot draw blood with a needle without a syringe; you cannot store infected material with blood and its components in open containers without disinfectants.

During work it is necessary to use technical means that ensure safety. These are containers for sharps (contact-free disposal of medical waste), hand washing devices (dispensers), needle destructors, needle capping devices, vacutainers, self-closing syringes, non-dismountable self-locking syringes, disposable safety scarifiers, etc.

Piercing and cutting instruments (needles, scalpels, scissors) should not be passed from hand to hand. They must be placed on the table/tray and then picked up or warned by a colleague about the transfer of sharp objects. When opening bottles, vials, test tubes with blood or serum, you should avoid pricks, cuts on gloves and hands.

After use, syringes are considered epidemiologically hazardous waste (class B) or extremely epidemiologically hazardous (class B) medical waste. Collection, disinfection, temporary storage, transportation, destruction and disposal of used single-use injection syringes are carried out in accordance with San-PiN 2.1.7.2790-10 "Sanitary and epidemiological requirements for the management of medical waste."

Do not put caps on used needles!

Do not bend or break used needles. Disassembly, washing, rinsing of medical instruments, pipettes, laboratory glassware, instruments or apparatus that have come into contact with blood or serum should only be carried out using rubber gloves after preliminary disinfection (disinfection).

Safe containers for sharps are located at arm's length. Do not overfill containers with used sharps! Collect needles that fall on the floor with a magnet.

Referral forms to a clinical diagnostic laboratory are strictly prohibited from being placed in blood tubes or wrapped around blood tubes.

Biological material for laboratory research cannot be transported in open containers with cotton-gauze stoppers. The blood tubes are closed with ground-in rubber stoppers or Parafilm "M" laboratory film. When centrifuging, the tubes must also be closed with ground-in rubber stoppers or laboratory film. Transportation of biomaterial is carried out in closed containers subject to disinfection treatment. Test tubes with broken edges should not be used. It is prohibited to pour liquid infectious material over the edge of a vessel (test tubes, flasks, bottles), or remove undisinfected blood clots from test tubes or bottles by shaking them out.

During the manipulation, you must not take notes, touch the telephone receiver, etc. Eating food or using cosmetics is prohibited in the workplace. Work clothes and shoes must be individual, match the size of the workers and be stored separately from personal clothing.

Before leaving the workplace, all personal protective equipment should be removed and placed in special containers.

When performing manipulations, a patient with HIV infection must:

1. Make sure the emergency first aid kit is intact.

2. Perform manipulations in the presence of a second specialist, who can continue to perform it in the event of a rupture of gloves or a cut of the skin and mucous membranes.

3. Treat the skin of the nail phalanges with iodine before putting on gloves.

4. Work with two pairs of gloves or heavy-duty gloves.

5. Use instruments and other disposable medical products as much as possible.

1. Iodine 5% alcohol solution - 1 bottle.

2. Ethyl alcohol 70% - 100.0 ml.

3. Bactericidal patch - 1-2 pcs. per one security office employee.

4. Antiseptic napkin for injections - 2 pcs. per employee of the security office for treatment of the injection site.

5. Finger pads - 1-2 pcs. per one security office employee.

Actions of a medical worker in emergency situations

If an emergency occurs, it is necessary to immediately provide first aid to the victim. In case of cuts or punctures on the skin:

Remove gloves (if the gloves are heavily contaminated with biological material, treat them with a disinfectant before removing the gloves), treat your hands with 70% alcohol, then wash with soap and water under running water, lubricate the wound with a 5% alcohol solution of iodine.

If blood or other biological fluids come into contact with the skin:

Treat the skin with 70% alcohol, wash with soap and water and re-treat with 70% alcohol.

If blood or other biological fluids of the patient come into contact with the mucous membranes of the eyes, nose and mouth:

Rinse the oral cavity with plenty of water and rinse with a 70% solution of ethyl alcohol;

The mucous membrane of the nose and eyes is washed generously with water (do not rub).

If the patient's blood or other biological fluids come into contact with a gown or clothing:

Remove work clothes and immerse in a disinfectant solution;

Wipe the skin of the hands and other areas of the body under contaminated clothing with 70% alcohol;

Remove and disinfect gloves.

Shoes treated by wiping twice with a rag soaked in a solution of one of the disinfectants.

If biological material gets on the floor, walls, furniture, equipment and other surrounding objects: fill the contaminated area with any disinfectant solution according to the viral hepatitis regime.

In case of an accident while operating a centrifuge The lid is slowly opened only after 30-40 minutes. (after the aerosol settles). Centrifuge beakers and broken glass are placed in a disinfectant solution, the surface of the lid, the internal parts of the centrifuge, and its outer surface are disinfected. The centrifuge is disinfected after disconnecting it from the power supply. Activities are carried out in personal protective equipment (mask, goggles, gloves, robe, cap). Final disinfection is carried out in the room where the accident occurred.

The injured medical worker must immediately report the accident (cut, puncture, contact of biomaterial on mucous membranes, accident at a centrifuge) to the person responsible for implementing measures to prevent HIV infection and the occupational safety engineer of the institution. Make an entry in the emergency log.

In case of injury When providing medical care to an HIV-infected patient, the injured medical worker must begin taking antiretroviral drugs as quickly as possible, which he can obtain at the AIDS Center (on weekdays) or at his place of work from the person responsible for implementing HIV prevention measures. -infections.

Measures in the institution in the event of an emergency

After receiving information about an emergency, the actions of the administration of the institution and the injured medical worker should be aimed at immediately determining the HIV status of the patient (if the status is unknown at the time of the accident) and providing the injured medical worker with drugs for antiretroviral prevention of HIV infection.

To do this, it is necessary to conduct an HIV examination of the patient with whom the accident occurred, using a rapid test with the obligatory sending of a sample from the same portion of blood to the AIDS laboratory for standard HIV testing in ELISA.

Conduct an HIV test of the injured medical worker to determine the HIV infection status at the time of the emergency.

Inform the State Health Institution "AIDS Center" about the emergency situation by phone: 55-34-45 by a representative of the administration of the health care facility with the subsequent provision of an Accident Report.

HIV testing is carried out with mandatory pre-test counseling on HIV infection.

Carrying out chemoprophylaxis in case of a positive result of a patient’s blood test for antibodies to HIV

If a patient receives a positive rapid test result, the affected health care worker is immediately given antiretroviral drugs.

Antiretroviral medications should be started within the first two hours after the accident, but no later than 72 hours.

If the HIV status of a potential source of infection is unknown and cannot be determined, chemoprophylaxis can be prescribed for epidemic indications.

Stock of antiretroviral drugs must be kept in a medical institution chosen by the heads of the territorial health authorities, with the expectation that examination and treatment of the victim can be organized within 2 hours after an emergency.

In an authorized medical institution, it is necessary to determine the responsible specialist for issuing antiretroviral drugs, where the drugs are stored in an accessible place, including at night and on weekends.

The procedure for registration and registration of emergency situations in the institution

Injuries sustained by healthcare workers should be reported in every facility and treated as an occupational accident. The causes of the injury and the connection between the cause of the injury and the performance of one’s official duties are determined. The registration of an emergency is carried out in accordance with laws and regulations adopted at the federal level.

An Industrial Accident Report is drawn up in form N-1 in two copies (approved by a decree of the Ministry of Labor of the Russian Federation). One copy of the act is sent to the State Health Institution "AIDS Center".

In all institutions it is necessary to maintain an "Emergency Situations Log".

Emergency log form:


Date and time of the accident	Branch	FULL NAME. health worker	Job title	Circumstances of the emergency. Nature of injury*	FULL NAME. sick. Patient's diagnosis.	Taken measures	Medical examination results employee

* In the column "Nature of injury" indicate - needle prick with gloves, without gloves, cut with a scalpel (with gloves, without gloves), exposure to blood, cerebrospinal fluid, contents birth canal on mucous membranes, skin.

Examination and clinical observation of the injured medical worker

The injured medical worker is registered at a dispensary at the place of residence in the office of infectious diseases.

Examination of a medical worker for the presence of antibodies to HIV and markers of viral hepatitis B and C is carried out:

In the first 5 days after the emergency (a positive result indicates that the health worker was already infected with HIV, and the contact is not the cause of infection);

In case of a negative result, the examination is carried out 3, 6, 12 months after the emergency.

During clinical observation, the medical worker’s compliance with the antiretroviral drug regimen is assessed. When identifying side effects from the use of drugs, changes in health and emotional state, the appearance of fever, rash, lymphadenopathy, the victim is sent to a specialist from the State Healthcare Institution "AIDS Center".

The victim should be warned that he or she may be a source of HIV infection throughout the observation period and should therefore take precautions to avoid possible transmission of HIV. It is recommended to practice safe sexual relations, not plan pregnancy, and refuse donation for 12 months.

Those responsible for implementing HIV infection measures in a medical institution (hospital epidemiologist, assistant epidemiologist) monitor the examination of the victim within the specified time frame.

Removal from dispensary observation is carried out 12 months after the emergency if the test results for HIV infection are negative.

The State Health Institution "AIDS Center" is being informed of the results of the examination and follow-up of the injured medical worker.

Compliance with a set of measures to prevent emergency situations, timely and full implementation of provisions to prevent undesirable consequences related to emergency situations, will help prevent HIV infection among medical workers.

List of regulatory documents:

1. Federal Law “On the Sanitary and Epidemiological Welfare of the Population” dated March 30, 1999 N 52-FZ (amendments dated December 30, 2001; January 10, 2002, June 30, 2003; August 22, 2004).

2. Federal Law No. 38-FZ of March 30, 1995 “On preventing the spread in the Russian Federation of the disease caused by the human immunodeficiency virus “HIV infection.” As amended by Federal Laws of August 12, 1996 No. 112-FZ, dated January 9. 1997 N 8-FZ, dated August 7, 2000 N 122-FZ, dated August 22, 2004 N 122-FZ.

3. Resolution of the Ministry of Labor of the Russian Federation dated October 24, 2002 N 73 “On approval of the forms of documents required for the investigation and recording of industrial accidents, and provisions on the features of the investigation of industrial accidents in certain industries and organizations.”

4. Resolution dated May 18, 2010 N 58 of the Chief State Sanitary Doctor of the Russian Federation G. G. Onishchenko “On approval of sanitary and epidemiological rules SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities”" .

5. Resolution No. 1 of 11.01.2011 of the Chief State Sanitary Doctor of the Russian Federation G. G. Onishchenko “On approval of sanitary and epidemiological rules Sp 3.1.5.2826-10 “Prevention of HIV infection””.

6. Resolution dated December 9, 2010 N 163 of the Chief State Sanitary Doctor of the Russian Federation G. G. Onishchenko “On approval of sanitary and epidemiological rules SanPiN 2.1.7.2790-10 “Sanitary and epidemiological requirements for the management of medical waste.”

8. Order of the USSR Ministry of Health dated July 12, 1989 N 408 “On measures to reduce the incidence of viral hepatitis in the country.”

9. Order of the Ministry of Health and Medical Industry of the Russian Federation dated August 16, 1994 N 170 “On measures to improve the prevention and treatment of HIV infection in the Russian Federation.”

10. Order of the Ministry of Health of the SSR of the Russian Federation dated December 5, 2005 N 757 “On urgent measures to organize the provision of medications to patients with HIV infection.”

11. Guidelines dated January 15, 2008 N 3.1.2313-08 “Prevention of infectious diseases. Requirements for disinfection, destruction and disposal of single-use injection syringes.”

13. Methodological recommendations dated 06.08.2007 N 5959-РХ “Accounting, storage and use of drugs for the treatment of patients with HIV infection in medical organizations.”

Revision of the document taking into account
changes and additions

IPS "Kodeks" - Center "Uniklass".

On improving the system for recording certain infectious and parasitic diseases. Emergency situations in which it is necessary to use an Anti-AIDS emergency kit

2. The procedure for registering in medical institutions persons who are subject to personal registration at sanitary and epidemiological stations

3. The procedure for filling out an emergency notification and transmitting information to the territorial sanitary and epidemiological station

4. Additional instructions for completing and sending emergency notifications by personnel of certain types of healthcare institutions

5. The procedure for information about the admission of patients with infectious diseases (suspected infectious diseases) for inpatient treatment, about clarification or change in the diagnosis of an infectious disease

6. Maintaining a “Register of Infectious Diseases” (Form N 060/у) in medical institutions

7. Accounting for influenza and acute upper respiratory tract infections of multiple and unspecified localization

8. Officials responsible for organizing records and providing information in medical institutions

9. The procedure for keeping records of infectious diseases in sanitary and epidemiological stations

10. Maintaining a Register of Infectious Diseases (form N 060/u) in sanitary and epidemiological stations

Composition of an ANTI - AIDS first aid kit in the regions

ANTIAIDS (ANTI HIV) EMERGENCY FIRST KIT

First aid kit ANTIAIDS - (ANTI HIV) EMERGENCY according to SanPin 3.1.5 2826-10 The composition is current for 2017 and 2018

REGULATIONS ON THE PREVENTION OF HIV AND VIRAL HEPATITIS

Emergency situations in which it is necessary to use an Anti-AIDS emergency kit:

Composition of the first aid kit ANTIAIDS - (Anti HIV) SanPin 3.1.5 2826-10

Emergency prevention of HIV infection and viral hepatitis:

SEE ALSO:
Initial symptoms of AIDS in men and women

Article 43 of Federal Law No. 323 Medical assistance to citizens suffering from diseases that pose a danger to others GO...

To avoid critical situations, basic safety measures should be observed:

You should know that HIV-infected persons can remain healthy for a long time (several years) and have no symptoms of the disease.

What should a first aid kit be like in an organization?

Complete set with dressings and medicines

Where should the first aid kit be kept and who is responsible for it?

Responsibility for the lack of a first aid kit

First aid kit order 654

New on the site

symbol of the fight against a terrible disease

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2. The procedure for registering in medical institutions persons who are subject to personal registration at sanitary and epidemiological stations

3. The procedure for filling out an emergency notification and transmitting information to the territorial sanitary and epidemiological station

4. Additional instructions for completing and sending emergency notifications by personnel of certain types of healthcare institutions

5. The procedure for information about the admission of patients with infectious diseases (suspected infectious diseases) for inpatient treatment, about clarification or change in the diagnosis of an infectious disease

6. Maintaining a “Register of Infectious Diseases” (Form N 060/у) in medical institutions

7. Accounting for influenza and acute upper respiratory tract infections of multiple and unspecified localization

8. Officials responsible for organizing records and providing information in medical institutions

9. The procedure for keeping records of infectious diseases in sanitary and epidemiological stations

10. Maintaining a Register of Infectious Diseases (form N 060/u) in sanitary and epidemiological stations

Composition of an ANTI - AIDS first aid kit in the regions

ANTIAIDS (ANTI HIV) EMERGENCY FIRST KIT

First aid kit ANTIAIDS - (ANTI HIV) EMERGENCY according to SanPin 3.1.5 2826-10 The composition is current for 2017 and 2018

REGULATIONS ON THE PREVENTION OF HIV AND VIRAL HEPATITIS

Emergency situations in which it is necessary to use an Anti-AIDS emergency kit:

Composition of the first aid kit ANTIAIDS - (Anti HIV) SanPin 3.1.5 2826-10

Emergency prevention of HIV infection and viral hepatitis:

SEE ALSO: Initial symptoms of AIDS in men and women

Article 43 of Federal Law No. 323 Medical assistance to citizens suffering from diseases that pose a danger to others GO...

To avoid critical situations, basic safety measures should be observed:

You should know that HIV-infected persons can remain healthy for a long time (several years) and have no symptoms of the disease.

What should a first aid kit be like in an organization?

Complete set with dressings and medicines

Where should the first aid kit be kept and who is responsible for it?

Responsibility for the lack of a first aid kit

First aid kit order 654

New on the site

Most popular

POPULAR SECTIONS

SEE ALSO:
Initial symptoms of AIDS in men and women