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| − | '''Infection control and health care epidemiology''' | + | 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. |
| − | is the discipline con setting.
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| − | As such, it is a practical (rather than an academic) sub-discipline of [[epidemiology]].
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| − | It is an essential (though often underrecognized and undersupported) part of the infrastructure of health care.
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| − | Infection control and hospital epidemiology are akin to [[public health]] practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole.
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| − | Infection control concerns itself both with prevention (hand hygiene/hand washing, cleaning/disinfection/sterilization, vaccination, surveillance) and with investigation and management of demonstrated or suspected spread of infection within a particular health-care setting (e.g. outbreak investigation). It is on this basis that the common title being adopted within health care is '''"Infection Prevention & Control".
| + | ==Types== |
| | + | ===Electrical=== |
| | + | Electric pads usually operate from household current and must have protections against overheating. |
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| − | ==Infection control in healthcare facilities==
| + | A '''moist heating pad''' is used dry on the user's 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 add more moisture to the treatment. |
| − | ===Hand hygiene===
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| − | Independent studies by [[Ignaz Semmelweis]] in [[1847]] in [[Vienna]] and [[Oliver Wendell Holmes, Sr.|Oliver Wendell Holmes]] in [[1843]] in [[Boston]] established a link between the hands of health care workers and the spread of [[Nosocomial infection|hospital-acquired]] disease.<ref>[http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm CDC Guideline for Hand Hygiene in Health-Care Settings]</ref> The [[Centers for Disease Control and Prevention|Centers for Disease Control and Prevention (CDC)]] has stated that “It is well-documented that the most important measure for preventing the spread of of pathogens is effective handwashing.” <ref>[http://www.cdc.gov/nceh/vsp/cruiselines/hand_hygiene_general.htm CDC General information on Hand Hygiene]</ref> In the United States, [[Hand washing#Medical hand washing|hand washing]] is mandatory in most health care settings and required by many different state and local regulations as well as good sense.
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| − | In the United States, [[Occupational Safety and Health Administration|Occupational Safety and Health Administration (OSHA)]] standards<ref>[http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051 OSHA Bloodborne Pathogens Regulations 1910.1030]</ref> require that employers must provide readily accessible hand washing facilities, and must ensure that employees wash hands and any other skin with soap and water or flush mucous membranes with water as soon as feasible after contact with blood or other potentially infectious materials (OPIM).
| + | ===Chemical=== |
| | + | Chemical pads employ a chemical heat reservoir or a one-time chemical reaction such as [[catalyst|catalyzed]] [[rusting]] of [[iron]]. |
| | + | [[image:Hand warmer.jpg|right|thumb|A sodium acetate heat pad]] |
| | + | 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. |
| | + | 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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| − | ===Cleaning, disinfection and sterilization===
| + | 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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| − | Cleaning, [[disinfection]] and [[sterilization (microbiology)|sterilization]]...
| + | 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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| − | ===Personal protective equipment=== | + | ==High specific-heat capacity materials== |
| − | [[Image:Disp-med-ppe.jpg|thumb|120px|Disposable PPE]]
| + | 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. |
| − | [[Personal protective equipment|Personal protective equipment (PPE)]] is specialized clothing or equipment worn by a worker for protection against a hazard. The hazard in a health care setting is exposure to blood, saliva, or other bodily fluids or aerosols that may carry infectious materials such as [[Hepatitis C]], [[HIV]], or other blood borne or bodily fluid [[pathogen]]. PPE prevents contact with a potentially infectious material by creating a physical barrier between the potential infectious material and the healthcare worker.
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| − | In the United States, the [[Occupational Safety and Health Administration|Occupational Safety and Health Administration (OSHA)]] requires the use of [[Personal protective equipment|Personal protective equipment (PPE)]] by workers to guard against blood borne pathogens if there is a reasonably anticipated exposure to blood or other potentially infectious materials. <ref>[http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051#1910.1030(d)(2)(i) OSHA Bloodborne Pathogens Regulations 1910.1030(d)(2)(i)]</ref>
| + | 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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| − | Components of [[Personal protective equipment|Personal protective equipment (PPE)]] include [[Medical gloves|gloves]], [[Hospital gown|gowns]], bonnets, shoe covers, [[Face shield|face shields]], [[CPR mask|CPR masks]], [[Goggles|goggles]], [[Surgical mask|surgical masks]], and respirators. How many components are used and how the components are used is often determined by regulations or the infection control protocol of the facility in question. Many or most of these items are [[Disposable|disposable]] to avoid carrying infectious materials from one patient to another patient and to avoid difficult or costly [[Disinfection|disinfection]]. In the United States, [[Occupational Safety and Health Administration|OSHA]] requires the immediate removal and disinfection or disposal of worker's PPE prior to leaving the work area where exposure to infectious material took place.<ref>[http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051#1910.1030(d)(3)(vii) OSHA 1910.1030(d)(3)(vii)]</ref>
| + | 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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| − | ===Vaccination of health care workers=== | + | == Function == |
| − | Health care workers may be exposed to certain infections in the course of their work. [[Vaccine|Vaccines]] are available to provide some protection to workers in a healthcare setting. Depending on regulation, recommendation, the specific work function, or personal preference, healthcare workers or first responders may receive vaccinations for [[Hepatitis_B#Prevention|hepatitis B]]; [[Flu vaccine| influenza]]; [[MMR vaccine|measles, mumps and rubella]]; [[TDaP|Tetanus, diphtheria, pertussis]]; [[Neisseria_meningitidis#Vaccines|N. meningitidis]]; and [[Varicella vaccine|varicella]]. In general, [[Vaccine|vaccines]] do not guarantee complete protection from disease, and there is [[Vaccine#Potential_for_adverse_side_effects_in_general|potential]] for adverse effects from receiving the vaccine. <ref>[http://www.cdc.gov/node.do/id/0900f3ec8005df1f CDC Vaccine Site]</ref>
| + | 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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| − | ===Surveillance for emerging infections===
| + | * dilating the [[blood vessel]]s surrounding the painful area. Increased [[blood]] flow provides additional [[oxygen]] and nutrients to help heal the damaged muscle tissue. |
| − | Surveillance is the act of infection investigation using the CDC definitions. Determining an infection requires an ICP to review a patient's chart and see if the patient had the signs and symptom of an infection. Surveillance definition cover infections of the bloodstream, Urinary tract, pneumonia, and sugical sites.
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| − | Surveillance traditionally involved significant manual data assessment and entry in order to assess preventative actions such as isolation of patients with an infectious disease. Increasingly, integrated computerised software solutions which actively assess each incoming risk message are becoming available. Such software significantly reduces the data workload of Infection Control Practitioners (ICP), freeing them to concentrate on clinical surveillance.
| + | * stimulating sensation in the [[skin]] and therefore decreasing the pain signals being transmitted to the brain |
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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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| − | As approximately [http://www.cdc.gov/ncidod/eid/vol4no3/weinstein.htm one third of healthcare acquired infections are preventable] , surveillance and preventative activities are increasingly a priority for hospital staff. In the United States, a study on the Efficacy of Nosocomial Infection Control Project (SENIC) by the CDC found that hospitals reduced their nosocomial infection rates by approximately 32 per cent by focusing on surveillance activities and prevention efforts. | + | 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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| − | ==Outbreak investigation== | + | ==See also== |
| − | When an unusual cluster of illness is noted, infection control teams undertake an investigation to determine whether there is a true outbreak, a pseudo-outbreak (a result of contamination within the diagnostic testing process), or just random fluctuation in the frequency of illness. If a true outbreak is discovered, infection control practitioners try to determine what permitted the outbreak to occur, and to rearrange the conditions to prevent ongoing propagation of the infection. Often, breaches in good practice are responsible, although sometimes other factors (such as construction) may be the source of the problem.
| + | *[[Hand warmer]] |
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| − | ==Training in infection control and health care epidemiology== | + | == References == |
| − | Practitioners can come from several different educational streams. Many begin as nurses, some as medical technologists (particularly in clinical microbiology), and some as physicians (typically infectious disease specialists). Specialized training in infection control and health care epidemiology are offered by the professional organizations described below. Physicians who desire to become infection control practitioners often are trained in the context of an infectious disease fellowship.
| + | * [http://www.spine-health.com/topics/conserv/heat_therapy/heat_therapy01.html Benefits of heat therapy for lower back pain] |
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| − | In the United States, [http://www.cbic.org Certification Board of Infection Control and Epidemiology] is a private company that certifies infection control practitioners based on their educational background and professional experience, in conjunction with testing their knowledge base with standardized exams. The credential awarded is CIC, Certification in Infection Control and Epidemiology. One must have 2 years of Infection Control experience in order to sit for the boards. Certification must be renewed every five years.
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| − | A [http://www.shea-online.org/about/shea_courses.cfm course] in hospital epidemiology (infection control in the hospital setting) is offered jointly each year by the Centers for Disease Control and Prevention (CDC) and the Society for Healthcare Epidemiology of America.
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| − | http://www.apic.org/ offers a training course for practitioners called EPI 101 and 102.
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| − | == Footnotes ==
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| | <references/> | | <references/> |
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| − | == See also ==
| + | [[Category:Medical treatments]] |
| − | * [[Infectious disease]]
| + | [[Category:Medical equipment]] |
| − | * [[body substance isolation]]
| + | [[Category:Heating devices]] |
| − | * [[Nosocomial infection]]
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| − | ==External links==
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| − | * [http://www.apic.org Association for Professionals in Infection Control and Epidemiology] is primarily composed of infection prevention and control professionals with nursing or medical technology backgrounds
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| − | * [http://shea-online.org The Society for Healthcare Epidemiology of America] is more heavily weighted towards practitioners who are physicians or doctoral-level epidemiologists.
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| − | * [http://www.comtec-presentations.com/icna The 37th Annual Infection Control Conference, September 24th to 26th 2007, The Brighton Centre, Brighton, England
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| − | [[Category:Epidemiology]] | |
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| − | [[ja:感染管理]] | + | [[de:Wärmekissen]] |
| | + | [[nl:Natriumacetaat-verwarmertje]] |
A heating pad is a pad used for warming of parts of the body in order to manage pain. Localized application of heat causes the blood vessels in that area to dilate, enhancing perfusion to the targeted tissue. Types of heating pads include electrical, chemical and hot water bottles.
Types
Electrical
Electric pads usually operate from household current and must have protections against overheating.
A moist heating pad is used dry on the user's 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 add more moisture to the treatment.
Chemical
Chemical pads employ a chemical heat reservoir or a one-time chemical reaction such as catalyzed rusting of iron.
A sodium acetate heat pad
A sodium acetate heat pad contains a supersaturated solution of sodium acetate (CH3COONa) that heats when the crystallization process is started by pressing a piece of metal that is embedded in the liquid.
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.
The heat is released on solidification, which is triggered by flexing a (patented &) small flat disc of notched ferrous metal which releases very tiny adhered crystals of sodium acetate& into the solution which then act as nucleation sites for the recrystallization of the remainder of the salt solution.
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.
High specific-heat capacity materials
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.
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.
Often, aromatic compounds 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 oils to ground up spices such as cloves and nutmeg, or even dried rose petals.
Function
Many episodes of pain come from muscle exertion or strain, which creates tension in the muscles and soft tissues. This tension can constrict circulation, sending pain signals to the brain. Heat application eases pain by:
- dilating the blood vessels surrounding the painful area. Increased blood flow provides additional oxygen and nutrients to help heal the damaged muscle tissue.
- stimulating sensation in the skin and therefore decreasing the pain signals being transmitted to the brain
- increasing the flexibility (and decreasing painful stiffness) of soft tissues surrounding the injured area, including muscles and connective tissue.
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 relief. As with any pain treatment, a physician should be consulted prior to beginning treatment.
See also
References
de:Wärmekissen
nl:Natriumacetaat-verwarmertje
