Surgical instruments are incredibly important for hospitals around the country. They represent a significant investment hospitals make to take care of their patients. As such, they must always be maintained in good working order. Better care and maintenance leads to better patient care as well as cost savings by increasing the tools’ lifespan.
Using the Central Line Bundle
Hand Hygiene
Remove Unnecessary Lines
Use of Maximal Barrier Precautions
Chlorhexidine for Skin Antisepsis
Avoid femoral lines
Report CLABSI rates to the units
Celebrate success!!
Surgical instruments are incredibly important for hospitals around the country. They represent a significant investment hospitals make to take care of their patients. As such, they must always be maintained in good working order. Better care and maintenance leads to better patient care as well as cost savings by increasing the tools’ lifespan.
Using the Central Line Bundle
Hand Hygiene
Remove Unnecessary Lines
Use of Maximal Barrier Precautions
Chlorhexidine for Skin Antisepsis
Avoid femoral lines
Report CLABSI rates to the units
Celebrate success!!
Prevention of Central Line Associated Blood Stream Infection (CLABSI )[compa...drnahla
Infection Control Guidelines for Prevention of Central Line Associated Blood Stream Infection (CLABSI )
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Dr. Mary Ann Lansang teaches us how to use the concepts of evidence-based medicine in our daily lives as infection prevention and control practitioners
Prevention of Central Line Associated Blood Stream Infection (CLABSI )[compa...drnahla
Infection Control Guidelines for Prevention of Central Line Associated Blood Stream Infection (CLABSI )
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Dr. Mary Ann Lansang teaches us how to use the concepts of evidence-based medicine in our daily lives as infection prevention and control practitioners
Infection Control Guidelines for Endoscopy Unit [compatibility mode]drnahla
Infection Control Guidelines for Endoscopy Unit
Infection Prevention in Endoscopy Unit
Dr. Nahla Abdel Kader.MD, PhD. Infection Control Consultant, MOH Infection Control Surveyor, CBAHI Infection Control Director,KKH.
Phụ lục 1 tiêu chuẩn GMP EU về sản xuất thuốc vô trùng trong đó có các tiêu chuẩn về:
1. Hệ thống chất lượng thuốc vô trùng.
2. Nhân sự trong nhà máy thuốc vô trùng.
3. Nhà xưởng, trang thiết bị nhà máy thuốc vô trùng.
4. Hệ thống phụ trợ nhà máy thuốc vô trùng.
5. Công nghệ sản xuất.
6. Hệ thống giám sát, quản lý môi trường sản xuất và quá trình vận hành.
7. Kiểm soát chất lượng thành phẩm đầu ra
Prevention of Surgical Site Infection- SSI [compatibility mode]drnahla
Infection Control Guidelines for Prevention of Surgical Site Infection- SSI
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Phụ lục 3 tiêu chuẩn GMP EU về sản xuất thuốc thú y miễn dịch bao gồm:
1. Hệ thống chất lượng.
2. Nhân sự trong nhà máy thuốc thú y miễn dịch.
3. Nhà xưởng, trang thiết bị nhà máy thuốc thú y miễn dịch.
4. Hệ thống phụ trợ nhà máy thuốc thú y miễn dịch.
5. Công nghệ sản xuất.
6. Hệ thống giám sát, quản lý môi trường sản xuất và quá trình vận hành.
7. Kiểm soát chất lượng thành phẩm đầu ra
Infection Control Guidelines for Pharmacy [compatibility mode]drnahla
Infection Control Guidelines for Pharmacy
Infection Prevention in Pharmacy
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
With the widespread transmission of COVID-19, & the dental healthcare professionals at an increased risk of contracting the infection or being potential carriers, it is essential that we know about the recent protocols suggested by CDC, Ministry of Health and Family Welfare, FDI, WHO & constantly update our knowledge in par with the current research of COVID-19
Dr. Julie Lyn Hall, WHO Country Representative for the Philippines, discusses the strategies of the WPRO in handling and preventing EIDs like Ebola and MERS-CoV in our region
In the age of internet and social media, Dr. Carl Abelardo Antonio teaches us how to evaluate online health resources so we can tell which of them is gold and which of them is junk.
This comprehensive lecture by Dr. Anthony Perez discusses the epidemiology, presentation, management and preventive strategies against surgical site infections
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
APSIC and WHO Sterilization and Instrument Reprocessing Guidelines
1. 1
Victoria D. Villanueva, RN
Consultant, Chong Hua Hospital, Cebu City
Former Associate Director, St. Luke’s Medical Center, QC & GC
Past President, Phil. Hospital Infection Control Society
Past President, Phil. Hospital Infection Control Nurses Association
Board Member, Asia Pacific Society of Infection Control (ASEAN)
2. The ASEAN Guidelines For Disinfection
and Sterilization of Instruments in
Healthcare Facilities
THE ASEAN GUIDELINES
FOR DISINFECTION AND STERILIZATION OF INSTRUMENTS IN
HEALTH CARE FACILITIES
3. Click to add title in here
Click to add title in here
Click to add title in here
Dr. Le Thi Anh Thu, Vietnam
Members:
Chairperson:
would like to acknowledge the contribution and expertise of the ASEAN
Chapter that developed this document:
Prof. Nordiah A Jalil, Malaysia1
2
3
4
5
Ms Saitip Arnpothong, Thailand
Ms. Victoria Villanueva, Philippines
Mrs Costy Pandjaitan, Indonesia
Dr Ling Moi Lin, Singapore
4. 4
1. Infection Control Association of Singapore (ICAS)
2. Philippine Hospital Infection Control Society Inc. (PHICS)
3. Philippine Hospital Infection Control Nurses Association Inc. (PHICNA)
4. Association of Infection Prevention Control Nurse Indonesia
5. Ho Chi Minh City Infection Control Society (HICS)
Endorsed by:
5. written in 2012
contains 70 pages
has 81 recommendations
http://apsic.info/documents/The-ASEAN-
Guidelines-for-Disinfection-and-Sterilisation-of-
Instruments-in-Health-Care-Facilities.pdf
clustered or grouped into topics which have
similarities (by the undersigned) for easier
understanding
5
6. 9) Oversight
10) Audit
11) Recall
12) Cleaning
13) Disinfection
(Pasteurization)
14) Disinfection of
Endoscopes
15) Sterilization
16) Single-use Device
1) Policies and Procedures
2) Physical Environment
3) Education and Training
4) Separation of Clean from
Dirty
5) Product Selection
6) Compatibility
7) Safety (to the worker,
medical equipment, and
environment)
8) Preventive Maintenance
Program 6
7. On all aspects of reprocessing based
on current recognized standards and
are reviewed annually. (i.e., cleaning,
disinfection, sterilization) (8)
7
8. Ideally, reprocessing should be done in a
centralized area that complies with the physical
and human resource requirements. (1)
Reprocessing performed outside the centralized
area must be kept to a minimum. (15)
The decontamination work area shall be physically
separated from clean areas by walls or partitions.
(16)
8
9. Air quality must be monitored when using
products that produce toxic vapors and
mists when disinfection and sterilization is
performed. (17)
Ventilation shall be such to remove toxic
vapors generated by or emitted from
cleaning and disinfecting agents.(50)
9
10. Specific requirements for, frequency of
education and training; competency
assessment for all personnel involved in
reprocessing of medical equipment/devices (11)
All aspects of reprocessing shall be supervised
and shall be performed by knowledgeable,
trained personnel. (12)
10
11. Managers, supervisors and staff
involved in reprocessing have
completed a recognized
qualification/certification course in
reprocessing practices. (13)
11
12. Contaminated equipment/devices shall
not be transported through areas
designated for storage of clean or sterile
supplies, client/patient/resident care areas
or high-traffic areas.(28)
Sterile and soiled equipment/devices
shall not be transported together.(29)
12
13. Products used for any/all stages in
reprocessing (i.e., cleaning, disinfection,
sterilization) must be approved by the
committee responsible for product
selection, by an individual with
reprocessing expertise and by an
individual with infection prevention and
control expertise. (39)
13
14. The process and products used for
cleaning, disinfection and/or
sterilization of medical
equipment/devices must be
compatible with the
equipment/devices.(42)
14
15. Occupational Health and Safety for the
healthcare setting will review all protocols for
reprocessing medical equipment/devices to
eliminate or minimize the risk of exposure of
hcws.(19)
Appropriate personal protective equipment
(PPE) should be worn for all reprocessing
activities.(21)
15
16. All staff working in reprocessing shall be
offered Hepatitis B immunization unless
they have documented immunity to
Hepatitis B. (22)
Prevent and manage injuries from sharp
objects.(23)
Immediate response to worker exposure
to blood and body fluids. (24) 16
19. Audits of the cleaning process must be
done on a regular basis. (7)
The process of high-level disinfection
requires monitoring and auditing. If a
chemical product is used, the
concentration of the active ingredient(s)
must be verified and a logbook of daily
concentration test results is to be
maintained. (34)
19
20. Recall of improperly reprocessed
medical equipment/devices. (10)
The recall procedure should include
assessment of client/patient/resident risk
and a procedure for subsequent
notification of physicians,
clients/patients/residents, other facilities
and/or regulatory bodies if indicated. (73)
20
21. Health care settings shall have a
process for receiving and
disseminating medical device alerts
and recalls originating from
manufacturers or government
agencies. (74)
21
22. There must be a regular schedule for
environmental cleaning in the Sterile
Processing Department that includes
written procedures and clearly defined
responsibilities.(18)
Reusable medical equipment/devices
must be thoroughly cleaned before
disinfection or sterilization.(3)
22
23. If cleaning cannot be done immediately, the
medical equipment/device must be submerged
in tepid water and detergent or enzymatic
cleaner to prevent organic matter from drying
on it.(4)
The process for cleaning should include
written protocols for disassembly, sorting,
soaking, physical removal of organic material,
rinsing, drying, physical inspection, lubrication
and wrapping.(6) 23
24. Two major methods of disinfection:
Chemical
Pasteurization
Pasteurization is a process of hot water
disinfection (minimum 71°C for 30 minutes),
which is accomplished through the use of
automated pasteurizers or washer disinfectors.
Semi-critical medical equipment/devices suitable
for pasteurization include equipment for
respiratory therapy and anesthesia. 24
25. Disposable sheaths/condoms placed over the
endoscope reduce the numbers of microorganisms
on the scope but do not eliminate the need for
cleaning/disinfection/sterilization between uses. (47)
Endoscope cleaning shall commence immediately
following completion of the clinical procedure. (51)
Patency and integrity of the endoscope sheath
should be verified through leak testing, performed
after each use. (52)
25
26. Critical endoscopes shall be sterilized. (54)
Semi-critical endoscopes and accessories
(excluding biopsy forceps and brushes) must
receive at least high-level disinfection after
each use. (55)
If an automated endoscope reprocessor
(AER) is used, ensure that the endoscope and
endoscope components are compatible with
the AER. (57) 26
27. Semi-critical endoscopes shall be stored
hanging vertically in a well-ventilated area in a
manner that minimizes contamination or
damage. Endoscopes shall not be coiled,
allowed to touch the floor or bottom of the
cabinet while hanging, or stored in their cases.
(59)
27
28. Healthcare settings shall have policies in place
providing a permanent record of endoscope
use and reprocessing, as well as a system to
track endoscopes and patients/residents that
includes recording the endoscope number in
the patient/resident record. (62)
28
29. The preferred method for sterilization of heat-
resistant equipment/devices is steam. (pre-vacuum
sterilizers are preferred). The preferred
sterilization method for heat sensitive instruments
would be low temperature sterilization. (63)
All sterilizers must be tested for performance
using physical, chemical and biological monitors
and indicators. Chemical indicators do not replace
the need to use a biological indicator. (64)
29
30. Flash sterilization shall only be used in
emergency situations and must never be used
for implantable equipment/devices. (65)
Boiling, use of ultraviolet light, glass bead
sterilization, and use of microwave ovens are
NOT acceptable methods of sterilization. (66)
30
31. The health care setting must have written
policies regarding single-use medical
equipment/devices. (75)
Critical and semi-critical medical
equipment/devices that are SUDs must not be
re-used unless the reprocessing is done by a
licensed reprocessor. (76)
Needles must be single-use and must not be
reprocessed. (77)
31
32. Catheters, drains and other medical
equipment/devices with small lumens
(excluding endoscopy) be designated as
SUD and not be reprocessed and re-
used, even if designated as reusable by
the manufacturer. (78)
32
33. Victoria D. Villanueva, RN
Consultant, Chong Hua Hospital, Cebu City
Former Associate Director, St. Luke’s Medical Center, QC & GC
Past President, Phil. Hospital Infection Control Society
Past President, Phil. Hospital Infection Control Nurses Association
Board Member, Asia Pacific Society of Infection Control (ASEAN)
, 2016
39. It is not recommended that
housekeeping staff be involved in
cleaning medical devices unless they
have been trained and certified and
moved into the SSD staffing structure.
40. Educational requirements and qualifications:
Entry level operator: high school leaving certificate
Two-year trained operator: completion of the basic
SSD curriculum
Five-year trained operator or supervisor: completion
of the intermediate SDD curriculum
More than 8 years of training or manager level:
completion of the advanced SDD curriculum
41. Medical devices processed outside the
SSD cannot be controlled and are
considered unsafe unless these processes
are under the supervision of highly-
trained staff of a similar calibre to those
in the SSD.
41
42. The of the SSD is to provide
safe, reprocessed, reusable, invasive
medical devices for clinical procedures,
carried out on wards, critical care areas,
ambulatory surgery, nutrition, dialysis and
endoscopy.
The of the SSD is to
receive, clean, decontaminate, package,
sterilize and distribute medical devices.
43. All spaces used for the reprocessing
of medical instruments must be
equipped with hand hygiene facilities
at the entrance and exit points.
44.
45. Preparing devices at the point of use does not
replace the cleaning process - it is the beginning of
the cleaning process.
46. Cleaning is the first and most essential step before
any process of disinfection or sterilization can be
carried out.
One can clean without sterilizing, but one cannot
sterilize without cleaning!
Enzymatic cleaners are NOT disinfectants; they only
remove protein from surfaces.
47. Brushes should be thermally disinfected and
dried at the end of the day. If this is not
possible, they should be cleaned and left dry.
Brushes must be replaced when damaged.
Chemical disinfection prior to cleaning is
unnecessary, ineffective and of little value in
the presence of organic matter.
48.
49. Sterilization wrap made from cellulose fibres and
non-wovens made from a combination of cellulosic
and synthetic fibres may be used. Both types are
suitable for porous-load steam sterilization and
most gas processes because they are permeable to
air, steam and other gases.
Rigid reusable sterilization containers should be
suitable for the method of sterilization used and
compatible with the cleaning method and cleaning
agent
50. Transparent pouches should be placed paper to
plastic for sterilization. Single instruments only
should be packed in pouches
51. Metal (sterilization) drum trays with holes that can
be opened and closed manually. These do not
guarantee sterility of its contents
Newspapers, brown paper bags and other products
that do not allow air removal or penetration of
steam must not be used
Recycled material packaging because these have lost
their integrity and the bacterial barrier and do not
allow adequate air removal or steam penetration
52. The total weight of instrument sets and
their packaging should not exceed 10 kg
and the total weight of wrapped basin sets
should not exceed 3 kg.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69. The preferred method for
sterilization of heat-resistant critical
devices is steam/moist heat
sterilization (pre-vacuum sterilization
is preferred).
71. Also known as Flash Sterilization.
This sterilization method should be avoided as
the material is sterilized without packaging and
the cycle eliminates drying. As a result, the
possibility of recontamination of the material
increases.
72.
73.
74.
75.
76.
77.
78.
79.
80.
81.
82.
83.
84.
85. Any person who reprocesses or reuses a device
intended by the manufacturer for single use bears
full responsibility for its safety and effectiveness and
becomes the manufacturer.
86. A reusable device, such as a surgical instrument, is
designed to be used many times on different
patients, and the manufacturer provides detailed
instructions on how it can be safely reprocessed
between each patient.
A single-use device is designed by a manufacturer to
be used on a single patient only and then discarded.
Emphasis is on a “single patient” and a device may
be used multiple times on the same patient,
depending on its design and manufacturers’
instructions.
87. Don’t do it, but if you do it,
very good reprocessing systems
must be in place