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 and nociception|pain]]. Localized application of heat causes the blood vessels in that area to [[vasodilator|dilate]], enhancing [[perfusion]] to the targeted tissue. Types of heating pads include [[electric|electrical]], [[chemical]] and [[hot water bottle]]s.
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[[Image:SchoolchildrenWashingHands.jpg|right|thumb|Schoolchildren washing their hands before eating lunch.]]
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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.
  
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==Types==
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==Purpose==
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===Electrical===
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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 personal harm or disease. This is especially important for people who handle food or work in the medical field.  Washing your hands is one of the most effective ways to maintain health and prevent the spread of disease.
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Electric pads usually operate from household current and must have protections against overheating.
 
  
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A '''moist heating pad''' is used dry on the users skin. These pads register temperatures from 170 to 180 degrees Fahrenheit (76 to 82 °C) and are intended for deep tissue treatment and can be dangerous if left turned on unattended. Moist heating pads are used mainly by physical therapists but can be found for home use.  A moist cloth can be added with a stupe cover to ad more moisture to the treatment.
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While hot water may more effectively clean your hands, this is primarily due to its increased capability as a solvent, and not due to hot water actually killing germs.  Hot water is more effective at removing dirt, oils and/or chemicals, but contrary to popular belief, it does not kill micro organisms.  A temperature that is comfortable for hand washing (about 45c) is not nearly hot enough to kill any micro organism.  It would take more than double that temperature to effectively kill germs (100c, which is boiling).
  
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===Chemical===
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==Personal hand washing==
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Chemical pads employ a chemical heat reservoir or a one-time chemical reaction such as [[catalyst|catalyzed]] [[rusting]] of [[iron]].
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{{Cleanup-verify}}
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[[image:Hand warmer.jpg|right|thumb|A sodium acetate heat pad]]
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To maintain good [[hygiene]], hands should always 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 20 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 one's hands require washing more than a few times per day. [http://www.tufts.edu/med/apua/Patients/handwashing.html]
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A '''sodium acetate heat pad''' contains a [[supersaturated]] solution of [[sodium acetate]] (CH<sub>3</sub>COONa) that heats when the [[crystallization]] process is started by pressing a piece of metal that is embedded in the liquid.
 
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Because the liquid is [[supersaturated]], pressing the metal makes the solution crystallize suddenly, thereby releasing the energy of the crystal lattice.  See [[sodium acetate]] for a more technical discussion.
 
  
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The heat is released on solidification, which is triggered by flexing a (patented <ref>[http://www.sfu.ca/physics/ugrad/courses/teaching_resources/demoindex/thermal/th4c/patentheatpack.html Physics course on thermal heat packs]</ref>) small flat disc of notched [[ferrous]] metal which releases very tiny adhered crystals of sodium acetate<ref>[http://www3.interscience.wiley.com/cgi-bin/abstract/108065684/ABSTRACT Article on sodium acetate]</ref> into the solution which then act as [[nucleation]] sites for the recrystallization of the remainder of the salt solution.
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Antibacterial soaps have been heavily promoted to a health-conscious public.  To date, there is no evidence that using recommended antiseptics or disinfectants selects for antibiotic-resistant organisms in nature. <ref>Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. (Infect Control Hosp Epidemiol) 2006 Oct; 27(10): 1107-19
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</ref>.  These soaps are quite different from the non-water-based hand hygiene agents referred to below, which do not promote [[antibiotic resistance]].
  
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The pad can be reused by placing it in boiling water for 10-15 minutes, which redissolves the sodium acetate in the contained water and recreates a supersaturated solution.  Once the pad has returned to room temperature it can be triggered again.  Triggering the pad before it has reached room temperature results in the pad reaching a lower peak temperature, as compared to waiting until it had completely cooled.
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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).
  
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==High specific-heat capacity materials==
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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 towel.  After drying, a dry paper towel should be used to turn off water and open exit door.
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Heating packs can also be made by filling a container with a material that has a high [[specific heat capacity]], which then gradually releases the heat over time.  A hot water bottle is the most familiar example of this type of heating pad.
 
  
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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. These types of pads have been known to ignite during or after the microwave process and cause fires.
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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.
  
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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.
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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.
  
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== Function ==
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Hand washing remains at unacceptable levels in most medical environments, with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients.<ref>{{cite journal |quotes= |last=Goldmann |first=Donald  |authorlink= |coauthors= |year=2006 |month=July |title=System Failure versus Personal Accountability — The Case for Clean Hands |journal=[[New England Journal of Medicine]] |volume=355 |issue=2 |pages=121-123 |id= |url=http://171.66.123.143/cgi/content/full/355/2/121 |accessdate=2007-01-05 }}</ref> For example, a recent study showed that proper hand washing and other simple procedures can decrease the rate of catheter-related bloodstream infections by 66 percent.<ref>{{cite journal |quotes= |last= Pronovost |first=Peter |authorlink= |coauthors=Dale Needham, M.D., Ph.D., Sean Berenholtz, M.D., David Sinopoli, M.P.H., M.B.A., Haitao Chu, M.D., Ph.D., Sara Cosgrove, M.D., Bryan Sexton, Ph.D., Robert Hyzy, M.D., Robert Welsh, M.D., Gary Roth, M.D., Joseph Bander, M.D., John Kepros, M.D., and Christine Goeschel, R.N., M.P.A |year=2006 |month=December |title=An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU |journal=[[New England Journal of Medicine]] |volume=355 |issue=26 |pages=2725-2732 |id= |url=http://content.nejm.org/cgi/content/abstract/355/26/2725 |accessdate=2007-01-05 }}</ref>[http://www.technewsworld.com/story/54899.html]
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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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* 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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==Hand washing as compensation==
  
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* stimulating sensation in the [[skin]] and therefore decreasing the pain signals being transmitted to the brain
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Excessive hand washing is commonly seen as a symptom of [[obsessive-compulsive disorder]] (OCD).
  
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* increasing the flexibility (and decreasing painful stiffness) of soft tissues surrounding the injured area, including muscles and [[connective tissue]].
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It has also been found that people, after having recalled or contemplated unethical acts, tend to wash hands more often than others, and tend to value hand washing equipment more. Furthermore, those who are allowed to wash their hands after such a contemplation are less likely to engage in other "cleansing" compensatory actions, such as volunteering.<ref>Benedict Carey. Lady Macbeth Not Alone in Her Quest for Spotlessness. ''[[The New York Times]]'', 12 September 2006</ref><ref>Chen-Bo Zhong and Katie Liljenquist. [http://www.sciencemag.org/cgi/content/abstract/313/5792/1451?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Liljenquist&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT Washing Away Your Sins: Threatened Morality and Physical Cleansing]. ''[[Science (journal)|Science]], 8 September 2006:
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Vol. 313. no. 5792, pp. 1451 - 1452</ref>
  
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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.''
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==Symbolic hand washing==
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{{main|ablution}}
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*[[Ablution]] in the [[Hebrew Bible]]
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*[[Ablution in Judaism]]
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*[[Wudu]] in [[Islam]]
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*[[Ablution]] in the [[Bahá'í Faith]]
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*[[Ablution]] in [[Hinduism]]
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*[[Misogi]] in [[Shintoism]]
 +
 
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==Idioms==
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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."
  
 
==See also==
 
==See also==
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*[[Hand warmer]]
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* [[Escherichia coli O157:H7|E. coli O157:H7]]
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* [[Antibiotic resistance]]
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* [[Ignaz Semmelweis]]
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* [[Soap dispenser]]
  
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== References ==
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==References==
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* [http://www.spine-health.com/topics/conserv/heat_therapy/heat_therapy01.html Benefits of heat therapy for lower back pain]
 
 
<references/>
 
<references/>
  
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[[Category:Medical treatments]]
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==External links==
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[[Category:Medical equipment]]
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* [http://www.tufts.edu/med/apua/Patients/handwashing.html Alliance for Prudent Use of Antibiotics on hand washing]
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[[Category:Heat]]
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* [http://www.cdc.gov/handhygiene/ Centers for Disease Control on hand hygiene in healthcare settings]
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* [http://www.publichealthgreybruce.on.ca/Communicable/Handwashing/  Hand Washing Video - Grey Bruce Health Unit, Canada ]
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* [http://www.arrowscientific.com.au/educational-material/handwashing---dos--donts.html Hand washing - Do's and Dont's]
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* [http://www.highlighthealth.com/2007/02/14/the-best-way-to-stay-healthy-and-avoid-getting-sick/ The Best Way to Stay Healthy and Avoid Getting Sick]
  
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[[Category:Hygiene]]
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[[Category:Medical hygiene]]
  
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[[de:Wärmekissen]]
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[[de:Händedesinfektion]]
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[[nl:Natriumacetaat-verwarmertje]]
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[[fr:Lavage des mains]]
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[[simple:Hand washing]]

Revision as of 17:46, 16 February 2007

Schoolchildren washing their hands before eating lunch.

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 personal harm or disease. This is especially important for people who handle food or work in the medical field. Washing your hands is one of the most effective ways to maintain health and prevent the spread of disease.

While hot water may more effectively clean your hands, this is primarily due to its increased capability as a solvent, and not due to hot water actually killing germs. Hot water is more effective at removing dirt, oils and/or chemicals, but contrary to popular belief, it does not kill micro organisms. A temperature that is comfortable for hand washing (about 45c) is not nearly hot enough to kill any micro organism. It would take more than double that temperature to effectively kill germs (100c, which is boiling).

Personal hand washing

Template:Cleanup-verify To maintain good hygiene, hands should always 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 20 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 one's hands require washing more than a few times per day. [1]

Antibacterial soaps have been heavily promoted to a health-conscious public. To date, there is no evidence that using recommended antiseptics or disinfectants selects for antibiotic-resistant organisms in nature. &. 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.

Hand washing remains at unacceptable levels in most medical environments, with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients.& For example, a recent study showed that proper hand washing and other simple procedures can decrease the rate of catheter-related bloodstream infections by 66 percent.&[2]

Hand washing as compensation

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

It has also been found that people, after having recalled or contemplated unethical acts, tend to wash hands more often than others, and tend to value hand washing equipment more. Furthermore, those who are allowed to wash their hands after such a contemplation are less likely to engage in other "cleansing" compensatory actions, such as volunteering.&&

Symbolic hand washing

Template:Main

Idioms

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

References

  1. ↑ Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. (Infect Control Hosp Epidemiol) 2006 Oct; 27(10): 1107-19
  2. ↑ Template:Cite journal
  3. ↑ Template:Cite journal
  4. ↑ Benedict Carey. Lady Macbeth Not Alone in Her Quest for Spotlessness. The New York Times, 12 September 2006
  5. ↑ Chen-Bo Zhong and Katie Liljenquist. Washing Away Your Sins: Threatened Morality and Physical Cleansing. Science, 8 September 2006: Vol. 313. no. 5792, pp. 1451 - 1452

External links

de:Händedesinfektion fr:Lavage des mains simple:Hand washing

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