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

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[[Image:SchoolchildrenWashingHands.jpg|right|thumb|Schoolchildren washing their hands before eating lunch.]]
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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.
'''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.
 
  
==Purpose==
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==Types==
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 infection. {{Fact|date=February 2007}}
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===Electrical===
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Electric pads usually operate from household current and must have protections against overheating.
  
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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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.
  
==Personal hand washing==
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===Chemical===
{{Not verified|date=February 2007}}
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Chemical pads employ a chemical heat reservoir or a one-time chemical reaction such as [[catalyst|catalyzed]] [[rusting]] of [[iron]].
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 doorMoisturizing [[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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[[image:Hand warmer.jpg|right|thumb|A sodium acetate heat pad]]
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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 latticeSee [[sodium acetate]] for a more technical discussion.
  
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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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.
</ref> However, antibacterial soaps contain common antibiotics such as Triclosan, which has an extensive list of resistant strains of organisms. So, even if antibacterial soaps do not select for antibiotic resistant strains, they might not be as effective as they are marketed to be. These soaps are quite different from the non-water-based hand hygiene agents referred to below, which also do not promote [[antibiotic resistance]].
 
  
==Medical hand washing==
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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 solutionOnce 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.
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 patientWater alone is fairly effective, simply by removing many agents loosely adherent to the skin. Ordinary soap aids in removal and also helps to kill [[pathogen]]s. Other "medicated" soaps or hand disinfectants are used in certain settings when higher levels of disinfection are required (e.g. surgery).
 
  
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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==High specific-heat capacity materials==
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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.
  
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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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.
  
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 is easier to do a good job quickly with these agents than with soap and water. However, soap and water are as good as the non-water-based agents when used properly.  
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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.
  
Despite their effectiveness, the non-water agents do not clean hands, they simply disinfect themVisible soiling of any sort on the hands must be washed with soap and water. Alcohol-based disinfectants are similarly ineffective in the presence of large, visible amounts of extraneous material.
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== Function ==
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Many episodes of pain come from [[muscle]] exertion or strain, which creates tension in the muscles and [[soft tissue]]sThis tension can constrict [[circulatory system|circulation]], sending pain signals to the [[brain]]. Heat application eases pain by:
  
The [[New England Journal of Medicine]] reports that 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> One study has shown 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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* dilating the [[blood vessel]]s surrounding the painful areaIncreased [[blood]] flow provides additional [[oxygen]] and nutrients to help heal the damaged muscle tissue.
  
==Hand washing as compensation==
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* stimulating sensation in the [[skin]] and therefore decreasing the pain signals being transmitted to the brain
  
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]].
  
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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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.''
Vol. 313. no. 5792, pp. 1451 - 1452</ref>
 
 
 
==Symbolic hand washing==
 
{{main|ablution}}
 
*[[Ablution]] in the [[Hebrew Bible]]
 
*[[Ablution in Judaism]]
 
*[[Wudu]] in [[Islam]]
 
*[[Ablution]] in the [[Bahá'í Faith]]
 
*[[Ablution]] in [[Hinduism]]
 
*[[Misogi]] in [[Shintoism]]
 
 
 
==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.  [[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==
* [[Escherichia coli O157:H7|E. coli O157:H7]]
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*[[Hand warmer]]
* [[Antibiotic resistance]]
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* Portable electric footwarmer mats [http://www.speedheat.com.au/speedheat-floor-heating-products/heated-foot-mats.html]
* [[Ignaz Semmelweis]]
 
* [[Soap dispenser]]
 
  
==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/>
  
==External links==
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[[Category:Medical treatments]]
* [http://www.tufts.edu/med/apua/Patients/handwashing.html Alliance for Prudent Use of Antibiotics on hand washing]
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[[Category:Medical equipment]]
* [http://www.cdc.gov/handhygiene/ Centers for Disease Control on hand hygiene in healthcare settings]
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[[Category:Heat]]
* [http://www.publichealthgreybruce.on.ca/Communicable/Handwashing/  Hand Washing Video - Grey Bruce Health Unit, Canada ]
 
  
[[Category:Hygiene]]
 
[[Category:Medical hygiene]]
 
  
[[de:Händedesinfektion]]
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[[de:Wärmekissen]]
[[fr:Lavage des mains]]
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[[nl:Natriumacetaat-verwarmertje]]
[[simple:Hand washing]]
 

Revision as of 05:37, 13 March 2007

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 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.

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