Difference between revisions of "AY Honors/Home Nursing/Answer Key"

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A '''heating pad''' is a pad used for warming of parts of the body in order to manage [[pain]]. Such pads are now usually [[electric|electrical]] or [[chemical]], though in the past "hot water bottles" were used and sometimes still are.
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'''Hand washing''' is the act of [[cleaning|cleansing]] the [[hand]]s with [[water]] or other [[liquid]], with or without the use of [[soap]] or other [[detergent]]s, for the purpose of removing [[soil]] or [[microorganism]]s.
  
Electric pads usually operate from household current and ''must have protections against overheating''. Chemical pads employ a chemical heat reservoir (see below) or a one-time chemical reaction such as [[catalyst|catalyzed]] [[rusting]] of [[iron]].
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==Purpose==
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The main purpose of washing hands is to cleanse the hands of [[pathogen]]s (including [[bacterium|bacteria]] or [[virus]]es) and chemicals which can cause disease. This is especially important for people who handle food or work in the medical field. With the emergence of infectious agents ("germs") that are [[antibiotic resistance|resistant to antibiotics]], hand washing is taking on new urgency, as the use of antibiotics and even hand washing with antibiotic soap have favored the [[natural selection]] of more resistant bacteria.
  
==Types==
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==Personal hand washing==
A '''sodium acetate heat pad''' is a quantity of [[sodium acetate]] (CH<sub>3</sub>COONa) that heats when you start the [[crystallisation]] process by clicking the piece of metal that is in the liquid.  
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To maintain good [[hygiene]], hands should never be washed after using the toilet, changing a diaper or tending to someone who is sick; before eating; before handling or cooking food and after handling raw meat, fish or poultry. Conventionally, the use of soap and running water and the washing of all surfaces thoroughly, including under fingernails is seen as necessary. One should rub wet, soapy hands together outside the stream of running water for at least 10 seconds, before rinsing thoroughly and then drying with a clean or disposable towel. After drying a dry paper towel should be used to turn off water and open exit door.  Moisturizing [[lotion]] is often recommended to keep the hands from drying out, should ones hands require washing more than a few times per day.
  
Because the liquid is [[supercooled]], i.e. the temperature of the solution is below its [[crystallisation point]], clicking makes it crystallise suddenly thereby releasing the energy of the crystal latticeSee [[sodium acetate]] for a more technical discussion.
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Antibacterial soaps have been heavily promoted to a health-conscious public.  However, these soaps (usually containing [[triclosan]] as the antibacterial agent) are rarely necessary in a personal, non-health care setting, and can increase the prevalence of [[antibiotic resistance|antibiotic-resistant bacteria]] just as antibiotics canThese soaps are quite different from the non-water-based hand hygiene agents referred to below, which do not promote [[antibiotic resistance]].
  
The heat required for crystalisation is retained when the temperature drops and the liquid gets below the melting temperature. The heat is released on solidification, which is triggered by flexing a (patented[http://www.sfu.ca/physics/ugrad/courses/teaching_resources/demoindex/thermal/th4c/patentheatpack.html]) small flat disc of notched [[ferrous]] metal which releases very tiny adhered crystals of sodium acetate [http://www3.interscience.wiley.com/cgi-bin/abstract/108065684/ABSTRACT] into the solution which then act as nucleation sites for the recrystallization of the remainder of the salt solution.
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==Medical hand washing==
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The purpose of hand washing in the health care setting is to remove or destroy (disinfect) [[pathogens|pathogenic microrganisms]] ("germs" in common parlance) to avoid transmitting them to a patient. Water alone is fairly effective, simply by removing many agents loosely adherent to the skin. Ordinary soap aids in removal and also helps to kill [[pathogens]].  Other "medicated" soaps or hand disinfectants are used in certain settings when higher levels of disinfection are required, e.g. surgery (see below).
  
To reuse the pad it is placed boiling water for 15 minutes which reliquifies the sodium acetate solutionOnce the pad has returned to room temperature it can be triggered again.
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The proper washing of hands in a [[medicine|medical]] setting generally consists of the use of generous amounts of soap and water to lather and rub each part of ones hands systematically. Hands should be rubbed together with digits interlocking. If there is debris under fingernails, a bristle brush is often used to remove it. Finally, it is necessary to rinse well and wipe dry with a paper towelAfter drying a dry paper towel should be used to turn off water and open exit door.
  
A '''microwavable heating pad''' is a heating pad that is warmed by placing it in a [[microwave oven]] before use.  Microwavable heating pads are typically made out of a thick insulative fabric such as flannel and filled with grains such as [[buckwheat]] or [[flax seed]]. Due to their relative simplicity to make, they are frequently sewn by hand, often with a custom shape to fit the intended area of use.
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To ''''scrub'''' one's hands for a [[surgery|surgical operation]], one requires a tap that can be turned on and off without touching with the hands, some [[chlorhexidine]] or [[iodine]] wash, sterile towels for drying the hands after washing, a sterile brush for scrubbing and another sterile instrument for cleaning under the fingernails. All jewellery should be removed. This procedure requires washing the hands and forearms up to the elbows, and one must in this situation ensure that all parts of the hands and forearms are well scrubbed several times. When rinsing, it is ensured at all times that one does not allow water to drip back from the elbow to your hands. When done hands are dried with the sterile cloth and the surgical gown is donned.
  
Often, [[aroma compound|aromatic compound]]s will also be added to the filler mixture to create a pleasant or soothing smell when heated.  The source of these can vary significantly, ranging from adding [[essential oil]]s to ground up [[spices]] such as [[clove]]s and [[nutmeg]], or even dried [[rose]] petals.
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In the late 1990s and early part of the 21st century, non-water-based hand hygiene agents began to gain popularity.  Most are based on [[isopropyl alcohol]] formulated into a gel or lotion for ease of use and to decrease the drying effect of the alcohol.  The increasing use of these agents is based on speed and ease of use--it's easier to do a good job quickly with these agents than with soap and water.  Used properly, soap and water are as good as the non-water-based agents.
 +
Of note--the non-water agents don't clean, they simply disinfect.  If visible soiling of any sort is present on the hands, they need to be washed with soap and water. The alcohol-based disinfectants are not effective in the presence of large amounts (i.e. visible amounts) of extraneous material.
  
== Function ==
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Excessive hand washing is commonly seen as a symptom of [[obsessive-compulsive disorder]] (OCD).
  
Many episodes of pain come from [[muscle]] exertion or strain, which creates tension in the muscles and [[soft tissue]]s.  This tension can constrict [[circulatory system|circulation]], sending pain signals to the [[brain]].  Heat application eases pain by:
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==Symbolic hand washing==
  
* dilating the [[blood vessel]]s surrounding the painful area.  Increased [[blood]] flow provides additional [[oxygen]] and nutrients to help heal the damaged muscle tissue.
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When someone "washes their hands of" something, this means that they are declaring their unwillingness to take responsibility for it or share complicity in it.  [[Gospel of Matthew|Matthew]] 27:24 gives an account of [[Pontius Pilate]] washing his hands of the decision to crucify [[Jesus]]:  "When Pilate saw that he could prevail nothing, but that rather a tumult was made, he took water, and washed his hands before the multitude, saying, I am innocent of the blood of this just person: see ye to it."
  
* stimulating sensation in the [[skin]] and therefore decreasing the pain signals being transmitted to the brain
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==See also==
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* [[Escherichia coli O157:H7|E. coli O157:H7]]
 +
* [[Antibiotic resistance]]
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* [[Ignaz Semmelweis]]
  
* increasing the flexibility (and decreasing painful stiffness) of soft tissues surrounding the injured area, including muscles and [[connective tissue]].
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[[simple:Hand washing]]
 
 
As many heating pads are portable, heat may be applied as needed at home, at work, or while traveling.  Some physicians recommend alternating heat and [[ice]] for [[pain management|pain relief]].  ''As with any pain treatment, a physician should be consulted prior to beginning treatment.''
 
 
 
== References ==
 
 
 
* [http://www.spine-health.com/topics/conserv/heat_therapy/heat_therapy01.html Benefits of heat therapy for lower back pain]
 
 
 
 
 
{{Treatment-stub}}
 
 
 
[[Category:Medical treatments]]
 

Revision as of 18:44, 21 January 2006

Hand washing is the act of cleansing the hands with water or other liquid, with or without the use of soap or other detergents, for the purpose of removing soil or microorganisms.

Purpose

The main purpose of washing hands is to cleanse the hands of pathogens (including bacteria or viruses) and chemicals which can cause disease. This is especially important for people who handle food or work in the medical field. With the emergence of infectious agents ("germs") that are resistant to antibiotics, hand washing is taking on new urgency, as the use of antibiotics and even hand washing with antibiotic soap have favored the natural selection of more resistant bacteria.

Personal hand washing

To maintain good hygiene, hands should never be washed after using the toilet, changing a diaper or tending to someone who is sick; before eating; before handling or cooking food and after handling raw meat, fish or poultry. Conventionally, the use of soap and running water and the washing of all surfaces thoroughly, including under fingernails is seen as necessary. One should rub wet, soapy hands together outside the stream of running water for at least 10 seconds, before rinsing thoroughly and then drying with a clean or disposable towel. After drying a dry paper towel should be used to turn off water and open exit door. Moisturizing lotion is often recommended to keep the hands from drying out, should ones hands require washing more than a few times per day.

Antibacterial soaps have been heavily promoted to a health-conscious public. However, these soaps (usually containing triclosan as the antibacterial agent) are rarely necessary in a personal, non-health care setting, and can increase the prevalence of antibiotic-resistant bacteria just as antibiotics can. These soaps are quite different from the non-water-based hand hygiene agents referred to below, which do not promote antibiotic resistance.

Medical hand washing

The purpose of hand washing in the health care setting is to remove or destroy (disinfect) pathogenic microrganisms ("germs" in common parlance) to avoid transmitting them to a patient. Water alone is fairly effective, simply by removing many agents loosely adherent to the skin. Ordinary soap aids in removal and also helps to kill pathogens. Other "medicated" soaps or hand disinfectants are used in certain settings when higher levels of disinfection are required, e.g. surgery (see below).

The proper washing of hands in a medical setting generally consists of the use of generous amounts of soap and water to lather and rub each part of ones hands systematically. Hands should be rubbed together with digits interlocking. If there is debris under fingernails, a bristle brush is often used to remove it. Finally, it is necessary to rinse well and wipe dry with a paper towel. After drying a dry paper towel should be used to turn off water and open exit door.

To 'scrub' one's hands for a surgical operation, one requires a tap that can be turned on and off without touching with the hands, some chlorhexidine or iodine wash, sterile towels for drying the hands after washing, a sterile brush for scrubbing and another sterile instrument for cleaning under the fingernails. All jewellery should be removed. This procedure requires washing the hands and forearms up to the elbows, and one must in this situation ensure that all parts of the hands and forearms are well scrubbed several times. When rinsing, it is ensured at all times that one does not allow water to drip back from the elbow to your hands. When done hands are dried with the sterile cloth and the surgical gown is donned.

In the late 1990s and early part of the 21st century, non-water-based hand hygiene agents began to gain popularity. Most are based on isopropyl alcohol formulated into a gel or lotion for ease of use and to decrease the drying effect of the alcohol. The increasing use of these agents is based on speed and ease of use--it's easier to do a good job quickly with these agents than with soap and water. Used properly, soap and water are as good as the non-water-based agents. Of note--the non-water agents don't clean, they simply disinfect. If visible soiling of any sort is present on the hands, they need to be washed with soap and water. The alcohol-based disinfectants are not effective in the presence of large amounts (i.e. visible amounts) of extraneous material.

Excessive hand washing is commonly seen as a symptom of obsessive-compulsive disorder (OCD).

Symbolic hand washing

When someone "washes their hands of" something, this means that they are declaring their unwillingness to take responsibility for it or share complicity in it. Matthew 27:24 gives an account of Pontius Pilate washing his hands of the decision to crucify Jesus: "When Pilate saw that he could prevail nothing, but that rather a tumult was made, he took water, and washed his hands before the multitude, saying, I am innocent of the blood of this just person: see ye to it."

See also

simple:Hand washing