Dispatch of natural needs. Vessel for a bedridden patient: types and applications How to use a duck for bedridden patients

If the patient is prohibited from walking even to the toilet, he must perform all physiological functions in bed. To empty the bowels, they use bedpans, which can be enameled, earthenware or rubber. A bedpan is given to a bedridden patient. Before serving, the vessel should be rinsed with hot water, as it should be clean and warm. The vessel should be handled very carefully.

Rice. 8. Correct position of the backing circle.

The left hand is brought under the patient’s sacrum and at the same time lifted, and with the right hand, a vessel is carefully placed and brought under the sacrum with the cape forward, so that the buttocks hang slightly over its opening (Fig. 8). Then the patient is covered with a blanket, and after bowel movements, the vessel is immediately taken away. It is advisable to isolate the patient with a screen during bowel movements. After defecation, the bedpan is carefully removed from under the patient so as not to spill the contents, covered with oilcloth or newspaper and taken to the toilet room. The patient is washed and the anus area is wiped dry. The contents of the vessel are poured into the toilet. The vessel is washed well with hot water and “Hygiene” and “News” powders. After this, the vessel is disinfected with a 2% chloramine solution or a 0.5% clarified bleach solution. Weak patients with a small subcutaneous fat layer, a tendency to form bedsores, and also with fecal incontinence should be given inflatable rubber bedpans, which, due to their elasticity, exert the least pressure on the sacrum and at the same time protect against contact with secretions, which is the prevention of bedsores. The vessel should not be tightly inflated. The bedpan should not be placed directly on the sheet, but an oilcloth should be placed under it. It must be emptied in a timely manner. Currently, there are special machines that wash and dry ships. The junior nurse constantly monitors the cleanliness and proper storage of the vessels. To empty the bladder, men and patients with urinary incontinence are given urinals, i.e. (ducks), they are placed between the patient’s legs, and the penis is lowered into the hole. These urinals can be glass or enameled. After each urination, they are emptied and washed well with one of the “Hygiene” or “News” products. To remove sediment from the walls, it is necessary to periodically wash it with a weak solution of hydrochloric acid. Before giving it to the patient, the urine bag should be rinsed with warm water. Each bedridden patient must have an individual urinal, which is located at the bedside, and a bedpan, which is stored in a special nest under the bed.

Did you know that: + + + + + OBROSOV Pavel Nikolaevich (1880-1937), one of the organizers of healthcare in the USSR. Since 1922 he headed the Kremlin Medical Directorate, Institute named after. N.V. Sklifosovsky, department of the 1st Moscow Medical Institute. Repressed; rehabilitated posthumously.
"OVERLORD" (English overlord - supreme ruler, overlord), code name of the Normandy landing operation.
RADIATION, exposure to radiation (infrared, ultraviolet, ionizing) on a substance or biological objects for therapeutic purposes (eg, ultraviolet, radiation therapy), accidental (eg, during an accident) and in persons working with a radiation source.
ENCOATING DRUGS, medicinal substances that form colloidal solutions with water that protect the nerve endings of the mucous membranes and skin from the action of irritating substances and complicate their absorption. Used for diseases of the stomach, intestines, and skin.
OSIPOV Viktor Petrovich (1871-1947), Russian psychiatrist, corresponding member of the USSR Academy of Sciences (1939), academician of the Academy of Medical Sciences (1944), lieutenant general of the medical service (1943). He developed the pathophysiological direction in psychiatry. Works on military psychiatry, etc.
OBRAZTSOV Vasily Parmenovich (1851-1920), Russian therapist, founder of a scientific school. Gave a classic description of the clinical picture of myocardial infarction (1910, together with N.D. Strazhesko). He developed a palpation method for examining the abdominal organs.

How to choose a bedpan for bedridden patients - expert advice

The disease is merciless. A complex fracture or serious illness can put a person in bed for a long time.

Recovery depends not only on correctly selected and timely treatment, but also on careful care.

A lying person is helpless. Many things that previously seemed natural and simple turn into problems. One of them is the administration of natural needs.

For partially walking patients, many devices have been invented to facilitate this process.

Those who cannot get out of bed have to use a traditional medical bed.

How to choose a bedpan for bedridden patients so that it is convenient to use? First of all, you need to pay attention to its shape and the material from which it is made.

Be sure to take into account the gender of a seriously ill person, since a female bedpan for bedridden patients and a male one differs in accordance with the characteristics of persons of different sexes, this is especially noticeable in urinals.

Types of medical vessel

Medical vessels for bedridden patients are manufactured in accordance with the anatomical features of the human body.

They must withstand repeated disinfection, be convenient to use, not cause injury to the patient, and be easy to clean.

Material

The most common materials for the manufacture of this item necessary for the care of bedridden patients:

metal - it can be stainless steel or steel coated with enamel;
plastic – polypropylene is most often used;
rubber - inflatable rubber vessels for bedridden patients are made from it.

Form

The traditional shape of the product is scaphoid. It allows you to cope with natural needs with the greatest comfort for the patient.

When using it, clothes and bedding are not contaminated.

There is a round bedstead for bedridden patients; it is less convenient, since there is always the possibility that some of the contents will spill and the linen will get dirty.

For patients who often have to give enemas, it is better to choose a capacious, deep product made of metal or plastic.

Advantages and disadvantages of a stainless steel vessel

It is usually used if there is no need to constantly keep the vessel under the patient.

Advantages of a stainless steel product:

durability – the service life of such a product is almost unlimited;
hygiene – smooth surface allows for thorough disinfection;
resistance to chemical agents - a special coating allows the product to be treated with any disinfectants;
capacity – can be used after giving an enema;
convenient shape - there are side skirts;
the presence of handles on many models makes using the product more convenient;
good appearance.

The disadvantages include the following:

it is difficult to see the color of the patient’s stool;
hard edges do not allow the product to be used for patients with bedsores.

Advantages and disadvantages of a plastic vessel

These products are made from medical grade polypropylene, which easily adapts to the temperature of the human body.

They are light in weight, making them easy to use. The shape of plastic vessels creates maximum comfort for patients.

The part that is placed under the sacrum has a smaller height and serves as a support for it.

This is especially convenient for those patients who do not have the ability to lift the sacrum on their own.

The absolute inertness of plastic with respect to aggressive chemicals allows disinfection by any means.

The plastic vessel is easy to clean and does not retain the odors of urine and feces. Most models have a measuring scale that allows you to control the amount of bowel movements. They also have a convenient transparent lid.

The disadvantages include the small volume, which does not allow you to use the product after giving an enema. Blue and green models do not allow you to clearly see the color of urine and feces.

How to place a bedpan under a bedridden patient

This procedure should not cause a negative reaction in the patient.

Therefore, it must be carried out tactfully, ensuring confidentiality whenever possible.

Before placing a bedpan under a bedridden patient, you need to prepare the following:

the ship itself;
talc;
hygiene products – soap, toilet paper, wet wipes;
a vessel with warm water for washing;
oilcloth or waterproof fabric.

The following algorithm will help answer the question of how to place a bedpan on a bedridden patient.

Wash your hands and put on rubber gloves, preferably disposable ones.
Place an oilcloth or waterproof fabric under the patient's pelvic part. It can be replaced with a large clean towel.
Heat the vessel by pouring hot water into it. Before placing a bedpan under a bedridden patient, the water must be poured out, leaving just a little on the bottom.
The edges of the vessel are sprinkled with a thin layer of talc. This will make it easier to slide it under the patient. If he has bedsores or skin injuries, talc should not be used.
Free the lower part of the patient’s body from clothing by removing it or tucking it up. Move the blanket, leaving only the lower legs covered.
If possible, ask the patient to lie on his back with his knees bent. Further actions depend on whether he can complete this action.
Place the bedpan with the wide part towards the feet on the bed as close as possible to the patient next to his hips. Encourage him to raise his hips, at the same time helping him with one hand and supporting his sacrum, and with the other hand moving the vessel under his buttocks.
When placing the bedpan under the bedridden patient, make sure that the buttocks are completely resting on the sides and the hole is where it is needed.
If the patient does not move independently, he is turned over on his side, a bedpan is brought to the buttocks and the patient is carefully turned back so that the buttocks are on the sides.
If there is no risk to the life and health of the patient, it is better to leave him alone during the exercise of natural needs, giving him the opportunity to report its end.
Carefully remove the bedpan from under the patient, holding him under the sacrum or turning him on his side.
Cover it with a lid or towel and carry out hygiene procedures.

Conclusion

His health largely depends on how well a person’s excretory system functions.

Many bedridden patients, and especially the elderly, develop.

To ensure comfortable discharge of natural needs, a medical bedpan must take into account all the characteristics of a bedridden patient.

Therefore, in a house in which there are frail elderly people or seriously ill people, the question of how to choose a vessel for bedridden patients is not idle. This is an essential item.

Along with high-quality and competent treatment, a correctly chosen vessel allows you to care for the patient with maximum comfort, and, therefore, brings his recovery closer.

Video: Vessel for a bedridden patient

Sequencing

1. Before serving the vessel, rinse it with warm water and leave a little warm water in it;

2. Place your left hand under the sacrum, helping the patient raise the pelvis (the patient’s legs should be bent at the knees);

3. With your right hand, bring the vessel under the patient’s buttocks so that the perineum is above the hole;

4. After defecation and urination, wash the patient;

5. Pour the contents of the vessel into the toilet, rinse the vessel with hot water, and disinfect it with a 10% chloramine solution;

6. Wash your hands.

In patients with urinary incontinence, permanent urinals are used (photo series)

For bedridden patients, bed urinals (glass or plastic) - ducks - with a capacity of 1 - 2 liters are used.

The bed of a patient with involuntary urination and fecal discharge should have special devices. The mattress and pillow are covered with oilcloth. In addition, for such patients, special mattresses consisting of 3 parts are used; the middle part has a device (niche) for a vessel. Bed linen for such patients is changed more often than usual - as it gets dirty. If a sick woman has copious vaginal discharge, then to keep the bed clean, an oilcloth and a small soft pad are placed under the patient. Diapers are widely used in caring for bedridden patients. (photo series)

CHAPTER 7. Basic hygienic procedures

Skin care

Personal hygiene is a broad concept that includes the implementation of rules that contribute to the preservation and strengthening of human health. The first priority is to maintain cleanliness of the body.

The skin of the body performs a protective function (protects the body from mechanical damage, penetration of harmful and toxic substances and microorganisms from the external environment), participates in metabolism (respiratory, excretory functions), and is a component of one of the sense organs - the skin analyzer.

During physical activity, with an increase in body temperature, with diseases of the kidneys, liver, respiratory system, digestive tract and the skin itself, the excretory function of the skin is in a state of tension. Gas exchange through the skin increases, and the amount of substances released by the skin increases many times. At the same time, products of impaired metabolism begin to be released through the skin.

Obviously, in order for the skin to function normally, it must be kept clean and protected from damage.

Patients on a general regime wash themselves in a bath or shower at least once every 7 days. The nurse should maintain a schedule for administering a hygienic bath to walking patients with a note in the medical history. After washing, the patient changes bed and underwear.

For patients on a regimen with limited physical activity, the nurse helps carry out elements of personal hygiene.

Carrying out a hygienic shower

Indications: skin contamination, pediculosis.

Contraindications: The patient's serious condition.

Equipment: bath bench or seat, brush, soap, washcloth, gloves, bath treatment products.

Sequencing

1. Put on gloves;

3. Place a bench in the bath and seat the patient;

4. Wash the patient with a washcloth: first the head, then the torso, upper and lower limbs, groin and perineum;

5. Help the patient dry himself with a towel and get dressed;

6. Remove gloves;

7. Escort the patient to the room.

CARRYING OUT A HYGIENIC BATH

Indications: skin contamination, pediculosis.

Contraindications: The patient's serious condition.

Equipment: brush, soap, washcloth, gloves, footrest, bath treatment products.

Sequencing

1. Put on gloves;

2. Wash the bathtub with a brush and soap, rinse with a 0.5% bleach solution or 2% chloramine solution, rinse the bathtub with hot water (you can use household cleaners and disinfectants);

3. Fill the bath with warm water (water temperature 35 – 37 0 C);

4. Help the patient take a comfortable position in the bath (the water level should reach the xiphoid process);

5. Wash the patient with a washcloth: first the head, then the torso, upper and lower limbs, groin and perineum;

6. Help the patient get out of the bath, dry himself with a towel and get dressed;

7. Remove gloves;

8. Escort the patient to the room.

The duration of the bath is no more than 25 minutes.

Possible complications: deterioration of health – pain in the heart, palpitations, dizziness, change in skin color. If such signs appear, it is necessary to stop taking the bath, transport the patient on a gurney to the ward, and provide the necessary assistance.

SKIN CARE FOR SERIOUSLY ILL PERSONS

For patients who are prescribed bed rest or strict bed rest, the use of a hygienic bath or shower is contraindicated due to the severity of the condition and the high risk of complications. However, maintaining skin hygiene in this category of patients is also necessary.

These patients daily, at least 2 times, wipe the patient's skin with a swab or the end of a towel moistened with warm water or an antiseptic solution (10% camphor alcohol solution, vinegar solution - 1 tablespoon per glass of water, 70% ethyl alcohol in half with water, 1% salicylic alcohol). Then wipes it dry.

The nurse washes the patient (face, neck, hands) using a sponge moistened with warm water. Then he dries the skin with a towel. The patient’s feet are washed 2-3 times a week, placing a basin on the bed, after which the nails are cut short if necessary.

With poor skin care, diaper rash, bedsores and other complications can occur that worsen their condition.

Especially thoroughly wash and dry the folds of skin under the mammary glands in women (especially obese women), armpits, and inguinal folds, since otherwise there is a high risk of developing diaper rash. At the same time, the protective properties of the skin are reduced, and microorganisms are able to penetrate through damaged skin.

In order to prevent diaper rash, it is necessary to examine the folds of skin under the mammary glands, armpits, and inguinal folds daily. After washing and drying, these areas of the skin must be powdered with powder.

A bedsore is a necrosis of the skin and underlying soft tissues that develops as a result of prolonged compression and impaired local circulation. Features of skin care for patients with pressure ulcers or at high risk of developing them are described in the industry standard for the management of patients with pressure ulcers (see Appendix 1).

Washing feet in bed

Equipment: rubber oilcloth, basin, warm water at a temperature of 34-37 degrees 0 C, washcloth, soap, towel, Vaseline or softening cream.

Sequencing

Wear gloves;
Place the oilcloth on the mattress;
Place the basin on the oilcloth;
Pour water up to half the basin;
Lower the patient's legs into the pelvis with minimal physical exertion for the patient;
Lather your feet well, especially the interdigital spaces and nail beds;
Rinse the patient's legs with clean water, raising them above the pelvis;
Dry your feet with a towel;
Lubricate the soles and heels with cream;
Remove the oilcloth;
It is convenient to place your feet on the bed and cover them with a blanket;
Wash the hands.

Washing the patient

Patients who can care for themselves wash themselves with boiled water and soap every day, preferably in the morning and evening.

Seriously ill people who are in bed for a long time and are unable to regularly take a hygienic bath should be washed after each act of defecation and urination. Patients suffering from urinary and fecal incontinence must be washed several times a day, since the accumulation of urine and feces in the perineum and inguinal folds can cause diaper rash, bedsores or infection.

Indications: perineal hygiene.

Equipment: 8-16 cotton swabs, oilcloth, vessel, forceps, jug, Esmarch mug with a rubber tube, clamp and tip with an antiseptic solution (light pink solution of potassium permanganate or furatsilin solution 1:5000)

Sequencing

1. Put on gloves;

2. Lay the patient on his back, his legs should be bent at the knees and spread apart;

3. Lay an oilcloth under the patient and place a bedpan;

4. Take a forceps with a napkin or cotton swab in your right hand, and a jug with a warm antiseptic solution or water at a temperature of 30-35 degrees in your left hand. Instead of a jug, you can use an Esmarch mug with a rubber tube, clamp and tip;

5. Pour the solution onto the genitals, and use a napkin (tampon) to move from the genitals to the anus (from top to bottom).

The sequence of washing the patient:

First, wash the labia minora (with two different tampons or one large one, but on different sides), then wash the labia majora, inguinal folds, and lastly, wash the anus area, changing tampons each time.

Sequencing

6. Dry in the same sequence, constantly changing tampons;

7. And at the end of the procedure, remove the vessel and oilcloth;

5. Wash your hands.

ORAL CARE

Oral care is a necessary procedure for all patients, since microorganisms accumulate in the oral cavity, causing bad breath and causing inflammatory changes in the teeth, mucous membranes of the oral cavity, and the excretory ducts of the salivary glands. Assistance in such care should be provided to patients who are not able to do this themselves.

Patients should brush their teeth thoroughly, especially near the gums, 2-3 times a day, preferably after each meal. If it is impossible to do this, you should rinse your mouth after eating with lightly salted water (1/4 teaspoon of table salt per glass of water) or a solution of baking soda (1/2 teaspoon per glass of water). This procedure is also necessary for people who have no teeth.

For seriously ill patients who cannot brush their teeth themselves, a nurse should clean the oral cavity after each meal. Patients rinse their mouth. After this, the gums are carefully and thoroughly wiped with a cotton ball or gauze, secured with a clamp or forceps and moistened with an antiseptic solution.

Rinsing the mouth.

To do this, you need to prepare a towel, tray, glass, antiseptic solutions (furatsilin solution 1:5000, 2% soda solution, 0.5% potassium permanganate solution, 5% boric acid solution). It is necessary to sit the patient down and place a towel on his chest and neck. It is necessary to give a glass of antiseptic solution in your hand. Place a tray under your chin. Invite the patient to rinse the mouth.

WIPPING THE ORAL CAVITY.

Indications: regular oral care.

Equipment: spatula, cotton balls, clamp or tweezers, tray, antiseptic solutions listed earlier, gloves.

Sequencing

1. Put on gloves;

2. Ask the patient to open his mouth wide;

3. Using a cotton ball on a clamp or tweezers, moistened with an antiseptic solution, carefully remove plaque from the tongue, teeth, gums, changing the balls. When wiping the upper molars and gums, you need to pull back the cheek with a spatula so as not to introduce infection into the excretory duct of the parotid salivary gland. To treat the tongue, ask the patient to stick it out, and if this is not possible, then wrap the tip of the tongue in a sterile gauze cloth and pull it out of the mouth;

4. Ask the patient to rinse his mouth with boiled water.

During this manipulation, the mouth, tongue, and gums are carefully examined.

If inflammatory changes occur in the oral cavity, rinse and treat the gums with a solution of furatsilin 1:5000, 2% solution of boric acid. Sometimes applications with the same solutions are applied and removed after 1-2 hours. Treatment is carried out under the guidance of a dentist.

As a first aid, areas of inflammation of the mucous membranes can be treated with a solution of brilliant green. This procedure is repeated 2-3 times a day. Sometimes this procedure in the early stages allows the patient to be completely cured long before the dental consultant arrives.

In patients who are on bed rest for a long time and consume few vitamins, stomatitis may develop: round ulcers appear on the red mucosa. Then they turn yellow and pain in the mouth appears. Sometimes ulcers appear along the edge of the tongue, on the gums, inside the lips and cheeks.

Local treatment - applications or irrigation of the oral cavity with antiseptic solutions listed earlier are used. The ulcers are lubricated with specially prepared ointments or vegetable oil.

The medicinal effect on the oral mucosa consists of application or irrigation.

ORAL IRRIGATION.

Indications: phenomena of stomatitis.

Equipment: spatula, cotton balls, clamp or tweezers, tray, antiseptic solutions, gloves, oilcloth, pear-shaped balloon or Janet syringe.

Sequencing

1. Put on gloves;

2. Place a warm antiseptic solution into a pear-shaped balloon or into a Zhanna syringe;

3. Turn the patient’s head to the side so that the solution does not enter the respiratory tract (if possible, sit the patient down);

4. Place an oilcloth (or diaper) on the patient’s chest and neck and place a tray under the chin;

5. Pull back the corner of the mouth with a spatula, insert the tip into the vestibule of the mouth;

6. Rinse the left and right cheek space alternately with a stream of liquid under moderate pressure.

Manipulation of oral irrigation is not used in seriously ill patients due to the risk of fluid entering the respiratory tract and sudden death of the patient.

Application is the application of sterile gauze wipes soaked in some disinfectant solution (0.1% furatsilin solution) to the mucous membrane for 3-5 minutes. This procedure is repeated several times a day. You can make applications with painkillers.

Patients who have impaired nasal breathing and who breathe almost entirely through their mouths often suffer from dry lips and mouth. After some time, cracks form in the corners of their mouth, which is very painful, especially when talking, yawning, or eating. The patient must be taught not to touch these wounds with his hands and not to open his mouth wide. The lips are carefully wiped with a swab moistened with a solution of furatsilin 1:4000, and then lubricated with vegetable oil, sea buckthorn oil, olive or petroleum jelly.

For patients in a coma with artificial ventilation of the lungs, to prevent the formation of cracks and drying of the lips, apply a gauze cloth moderately moistened with a solution of furatsilin, which is replaced as it dries.

Patients with a high fever, a viral infection, or severe circulatory problems sometimes develop aphthous stomatitis, which causes a strong odor from the mouth. In order to get rid of this smell, it is necessary to treat, first of all, the underlying disease. Be sure to rinse your mouth with disinfectants (0.2% sodium bicarbonate solution, 1% sodium chloride solution or dental elixir).

If the patient has removable dentures, they are removed at night, washed thoroughly with running water and stored in a dry glass. In the morning, before putting it on, rinse again.

EAR CARE

Patients on a general regimen wash their ears themselves during the morning daily toilet.

Patients on bed rest need to periodically clean the external auditory canals.

Removal of dirt, sulfur, including cerumen plug is carried out by a nurse in the following way:

Sequencing

1. Put on gloves;

2. Make the patient sit;

4. Place a few drops of a 3% hydrogen peroxide solution into the ear (the solution should be warm);

5. Pull the auricle back and up and insert the cotton wool into the external auditory canal with rotational movements;

6. After changing the turunda, repeat the manipulation.

Do not use hard objects to remove wax from your ears to avoid damaging the eardrum.

PLAYING OINTMENT INTO THE EAR

Sequencing

1. Put on gloves;

2. Make the patient sit;

3. Tilt the patient's head in the opposite direction;

4. Apply the required amount of ointment to a sterile cotton swab;

5. pull the auricle back and up and, using rotational movements, insert the turunda with ointment into the external auditory canal;

INSTALLING DROPS INTO THE EARS.

Sequencing

1. Put on gloves;

2. Make the patient sit;

3. Tilt the patient's head in the opposite direction;

4. Take the required number of drops into the pipette (the drops must be warm);

5. pull the auricle back and up and introduce drops into the external auditory canal;

6. Upon completion of the procedure, place a cotton swab into the external auditory canal.

NOSE CARE.

Walking patients take care of their nose on their own during the morning toilet. Seriously ill patients who are unable to independently monitor nasal hygiene must daily clear the nasal passages of secretions and crusts that form. The nurse cleans the patient's nasal passages daily.

TREATMENT OF THE NASAL PASSES

Sequencing

1. Put on gloves;

2. In a lying or sitting position (depending on the patient’s condition), slightly tilt the patient’s head back;

3. Moisten cotton pads with Vaseline or vegetable oil, or glycerin;

4. Insert the turunda into the nasal passage with rotational movements and leave there for 2-3 minutes;

5. then remove the turunda and repeat the manipulation;

Another way to clean the patient's nose is by instilling drops.

INSTALLATION OF DROPS INTO THE NOSE.

When instilling drops into the nose, use a sterile pipette. Patients are in a sitting or lying position (depending on the patient’s condition), their head is tilted to the opposite shoulder and slightly thrown back. The nurse should check that the drops comply with the doctor’s prescription by sitting the patient down and drawing the required number of drops into the pipette. The drops are instilled first into one, and then after 2-3 minutes into the other nasal passage, after first changing the position of the head.

HELP WITH NOSELEEDINGS.

The causes of nosebleeds are varied. Bleeding can be the result of local changes (trauma, scratching, ulcers of the nasal septum, skull fractures), as well as various diseases (blood diseases, infectious diseases, influenza, hypertension, etc.).

When a nosebleed occurs, blood flows not only out through the nasal openings, but also into the pharynx and oral cavity. This causes coughing and often vomiting (when blood is swallowed). The patient becomes restless, which increases bleeding.

TACTICS FOR NOSE BLEEDING:

Sequencing

1. Sit or lay the patient down and calm him down;

3. Press the wings of the nose to the nasal septum;

4. Place a cold compress or ice pack on the septum;

5. If the bleeding does not stop, insert cotton balls (dry or moistened with 3% hydrogen peroxide) into the nasal passages;

6. If nosebleeds recur or the bleeding is massive, consultation with an otolaryngologist is indicated.

EYE CARE

Walking patients take care of their eyes independently during the morning toilet. Seriously ill patients often develop discharge from the eyes, sticking together the eyelashes and making it difficult to see. Such patients need to wipe their eyes daily with sterile gauze or cotton swabs soaked in disinfectant solutions. It is necessary to remember that a separate sterile swab is taken for each eye. After manipulating the treatment of the patient’s eyes, the nurse should thoroughly wash her hands with soap and wipe them with alcohol.

RUBBING THE EYES

Indications: eye hygiene.

Equipment: sterile tray, sterile gauze balls, antiseptic solutions, gloves.

Sequencing

Wear gloves;
Place 8-10 sterile balls in a sterile tray and moisten them with an antiseptic solution (furatsilin solution 1:5000, 2% soda solution, 2% boric acid solution, 0.5% potassium permanganate solution), 0.9% sodium chloride solution or boiled water;
Lightly squeeze the swab and wipe the eyelashes with it in the direction from the outer corner of the eye to the inner;
Repeat rubbing 3 - 4 times;
Blot the remaining solution with dry swabs;
Wash the hands.

EYE WASHING

Indications: disinfection of the conjunctival sac, removal of mucus and pus from it, first aid in case of eye burns with chemicals.

Equipment: tray, sterile rubber can, antiseptic solutions, gloves.

Sequencing

Wear gloves;
Lay the patient down;
Tilt the patient's head back slightly;
Place a tray on the temple side;
Fill a rubber can with an antiseptic solution;
Spread both eyelids with the thumb and index finger of your left hand;
Rinse the eye with a stream from a spray can, directing the stream from the temple to the nose;
Wash the hands.

For seriously ill patients whose eyelids do not close during sleep for one reason or another, it is necessary to apply gauze pads moistened with warm saline solution to the eyes (to prevent drying out of the conjunctiva).

1. Put on gloves;

2. Sit or lay down the patient;

3. Place ointment on a sterile glass rod so that it covers the entire shoulder blade;

5. Place a spatula with ointment behind the lower eyelid so that the ointment is directed towards the eyeball, and the free surface towards the eyelid;

6. Lower the lower eyelid and ask the patient to close his eyelids;

7. Remove the spatula from under the closed eyelids and then lightly press the ointment onto the eyeball;

8. Remove excess ointment with a cotton ball;

9. Wash your hands.

SIMPLE MANIPULATIONS IN EYE CARE

EVERION OF THE UPPER EYELID

Indications

Diseases of the conjunctiva of various etiologies (bacterial, viral, allergic) ( rice. 1).

Foreign body.

Wearing contact lenses.

Contraindications Fig.1. Conjunctivitis

Pronounced cicatricial fusion of the conjunctiva of the eyelids with the conjunctiva of the eyeball.

Consequences of injuries.

Consequences of burns.

Pain relief methods

Not required.

Equipment

Desk lamp.

Glass rod.

Magnifying glass 20x.

Binocular loupe (if necessary).

When inverting and examining the conjunctiva of the upper eyelid, ask the subject to look down at his knees.

Execution technique

Y way.

Everting the upper eyelid with your fingers. The subject looks down. Doctor:

a) raises the upper eyelid with the thumb of the left hand;

b) with the thumb and forefinger of the right hand, fixes the eyelid by the edge and eyelashes, pulling it down and forward;

c) with the thumb or index finger of the left hand, moves the upper edge of the cartilage down;

d) press the inverted eyelid by the eyelashes to the upper edge of the orbit and hold it in this position until the end of the examination.

Y way.

Inversion of the upper eyelid using a glass rod.

All stages are performed in the same way as in method 1, only when performing step “c”, a glass rod is used, onto which the upper eyelid is turned out. To examine the conjunctiva of the upper transitional fold with the upper eyelid inverted, it is necessary to lightly press on the eyeball through the lower eyelid. In this case, the conjunctiva of the upper transitional fold, loosely connected with the underlying tissues, becomes

Possible complications

Infection of the conjunctival cavity,

If the procedure is performed roughly, corneal erosion may occur.

INSTILLATION OF EYE DROPS

Indications

Treatment.

Diagnostics.

Anesthesia during various manipulations.

Contraindications

Drug intolerance.

Pain relief methods

Not required.

Equipment

Instilled solution.

Pipette.

Raise your chin.

Fix your gaze upward and inward.

Execution technique

Wear gloves. Sit or lay down the patient. Immediately before the procedure, it is necessary to check that the medication being administered is correct. Ask the patient to tilt their head back slightly and look up. With your left hand, take a cotton ball, place it on the skin of the lower eyelid and, holding the cotton wool with your thumb, pull the lower eyelid down, and hold it with the index finger of the same hand upper eyelid. Without touching the tip of the pipette to the eyelashes and edges of the eyelids, inject 1 drop of solution into the space between the eyelids and the eyeball closer to the inner corner of the palpebral fissure. Remove any portion of the medication that leaks from the eyes with a cotton ball. You can also instill drops on the upper half of the eyeball - when the upper eyelid is retracted and when the patient is looking down. When instilling potent drugs (for example, atropine) into the eyes, to avoid getting them into the nasal cavity and to reduce the overall effect, you should press the area of the lacrimal canaliculi with your index finger for 1 minute. At the end of the procedure, wash your hands.

Close your eyes and gently press on the inner corner of the eye for 3-5 minutes.

Possible complications

Allergic reaction to the drug.

Damage to the conjunctiva.

Damage to the cornea due to careless manipulation.

PLAYING EYE OINTMENT

Indications

Introduction of a soft drug into the conjunctival sac for inflammatory diseases of the anterior segment of the eye of various etiologies.

Contraindications

Drug intolerance.

Suspicion of a penetrating injury to the eyeball.

Pain relief methods

Not required.

Equipment

Ointment used.

Sterile glass rod.

Raise your chin.

Fix your gaze upward.

Execution technique

Wear gloves. Sit or lay down the patient. Draw ointment onto a sterile glass rod so that it covers the entire scapula and, holding it parallel to the eyelids, place the tip of the stick behind the lower eyelid with the ointment to the eyeball, and the free surface to the eyelid. After the patient closes his eyes, remove the stick from the palpebral fissure. Perform circular stroking with a cotton ball over closed eyelids to evenly distribute the ointment over the eye. Remove excess ointment with a cotton ball. The ointment can be administered directly from a tube specially produced by industry. At the end of the procedure, wash your hands.

REMOVAL OF SUPERFICIAL FOREIGN BODIES FROM THE CONJUNCTIVAL

Indications

Foreign body of the cornea or conjunctiva.

Contraindications

Pain relief methods

When removing a foreign body from the conjunctiva, anesthesia is not required.

When removing from the cornea, installation anesthesia with a 0.25% solution of dicaine (or another anesthetic).

Equipment

Anesthetic solution.

Cotton swab.

Injection needle or spear.

Slit lamp or binocular loupe.

Fix your gaze at the request of the doctor.

Execution technique

Removal of foreign bodies from the conjunctiva is done using a small cotton swab moistened with some disinfectant eye drops.

To remove foreign bodies located on the conjunctiva of the upper eyelid, it is first necessary to turn it out. After removing the foreign body, a 0.25% solution of chloramphenicol is instilled into the conjunctival sac. In case of a corneal foreign body, a local anesthetic solution is instilled into the eye. Superficial foreign bodies are removed with a damp cotton swab. Foreign bodies embedded in the surface layers of the cornea are removed with an injection needle or spear (this procedure is performed by a doctor).

FOREIGN BODY IN THE CONJUNCTIVAL SAC

The search for a foreign body should begin by retracting the lower eyelid. If detected, it can be removed using a cotton swab. If there is no foreign body behind the lower eyelid, then you need to look for it on the inner surface of the upper eyelid, for this you must first turn it out. It is important to remember that a foreign body in the conjunctival sac should be looked for without prior anesthesia. After

To remove a foreign body, drops containing an antibiotic are instilled into the affected eye.

CHEMICAL EYE BURNS

If a powdery chemical substance gets behind the eyelids, it is necessary to remove it with a dry “bath”, and only after that you can start rinsing the eye. For burns caused by liquid chemicals, eye rinsing should begin as soon as possible. It is better to rinse with a weak stream of water for 10-15 minutes. If the burn is caused by alkali, a 2% boric acid solution or a 0.1% acetic acid solution is used for rinsing. For acid burns, use 2% sodium bicarbonate solution or isotonic sodium chloride solution. In no case should you limit yourself to 1-2 minutes of rinsing, especially for burns with powdered chemicals. After irrigation, the burned skin of the eyelids and face is lubricated with an antibiotic-containing ointment: 1% tetracycline ointment, 1% erythromycin ointment, 10-20% sodium sulfacyl ointment. A 0.25% solution of dicaine or a 3% solution of trimecaine is instilled into the conjunctival sac and an antibiotic-containing ointment is applied. 1500-3000 IU of antitetanus serum is injected subcutaneously. For burns of 2, 3 and 4 degrees, urgent hospitalization is required.

Specific antidotes

Lime, cement - 3% solution of disodium salt of ethylenediaminetetraacetic acid (EDTA).

Iodine - 5% sodium hyposulfite solution.

Potassium permanganate - 10% sodium thiosulfate solution or 5% ascorbic acid solution.

Aniline dyes - 5% tonin solution.

Phosphorus - 0.25-1% solution of copper sulfate.

Resins - fish oil, vegetable oil.

THERMAL EYE BURNS

The substance that caused the burn is carefully removed from the skin of the face, eyelids and mucous membrane of the eyes with tweezers or a stream of water. The conjunctival sac is washed with water, a 3% solution of trimicaine, a 0.25% solution of dicaine, a 20% solution of sulfacyl sodium, and a 0.25% solution of chloramphenicol are instilled into the eye. 1% tetracycline or erythromycin ointment is applied behind the eyelids. If there are blisters on the skin, they must be cut off and

generously lubricate the wound surface with antibiotic-containing ointments. Antitetanus serum (1500-3000 IU) is injected subcutaneously. An aseptic bandage is applied to the eye.

TRANSPORTATION AND HANDLING OF THE PATIENT

The severity of the condition determines the method of transporting the patient. The doctor decides how the patient will be transported: on a stretcher, manually, on a wheelchair, or on foot. Patients who are in satisfactory condition are sent to the department on foot, accompanied by medical personnel. personnel. Weakened patients, disabled people, elderly and senile patients are often transported in a wheelchair. Seriously ill patients are transported on a stretcher (manually or on a gurney) while lying down.

There are no contraindications for transportation within the hospital.

For transportation on a stretcher, you should prepare

· sheet

· pillow, oilcloth.

The patient must be explained the peculiarities of his behavior during transportation.

Transportation on a gurney

Sequencing:

1. Prepare the gurney for transportation, check its serviceability.

2. Place a sheet (oilcloth if necessary) on the gurney, a pillow and a blanket.

3. Place the gurney with the foot end at an angle to the head end of the couch or in another way that is more convenient in this situation.

4. Raise the patient - one healthcare worker places his hands under the patient's neck and torso, the other - under the lower back and legs.

5. Place the patient on the gurney.

6. Cover the patient with the other half of the blanket or sheet.

7. Stand: one health care worker is in front of the gurney with his back to the patient, the other is behind the gurney facing the patient.

8. Inform the department that a patient is being transported to them.

9. Transport the patient to the department with medical history.

10. Place the gurney next to the bed, depending on the area of the room.

11. Remove the blanket from the bed.

12. Place the patient on the bed.

It is necessary to monitor the patient's condition during transport. When lifting or lowering a patient on a stretcher down the stairs, the stretcher is held with the head end forward when ascending and the foot end forward when descending.

Transporting the patient to the department on a wheelchair

Sequencing:

1. Prepare the wheelchair for transportation, check its serviceability.

2. Tilt the wheelchair forward by stepping on the footrest.

3. Ask the patient to stand on the footrest, sit him down, supporting him in the chair, and cover him with a blanket.

4. Place the wheelchair in its original position.

5. During transport, ensure that the patient’s arms do not extend beyond the armrests of the wheelchair.

The patient can be transported on a wheelchair in a sitting, reclining or lying position, changing the position of the backrest and foot panel.

Various events lead to a serious condition of a person in a hospital bed, and the most difficult thing in this situation is to ensure cleanliness and comfort when performing natural needs.

Care for seriously ill patients is carried out in accordance with the localization of the problem, trying not to aggravate the pain - this applies to the choice of positions for sleeping, resting, eating and using the toilet.

Types of medical vessel

In most cases, for bedridden patients who are unable to move independently and do not use crutches or walkers for the disabled, there is a special system for the discharge of natural needs, for which a medical vessel is used.

The special design of the vessel bowl allows the patient to get rid of urine and feces in an acceptable form, without contaminating bed linen and clothing.

Medical vessels are manufactured in a wide range of designs from various materials:

enameled metal;
faience;
rubber;
plastic.

All vessels are more or less similar in shape - smoothed round shapes, low height, an oval hole in the center, closed with a lid and a side pipe for draining the contents. The choice of the type of vessel should be made depending on the age and weight of the patient. Processing and disinfection of all types is the same. The vessel should be stored on a stool under the patient’s bed.

Vessel feeding technique

Before starting sanitary measures, the patient’s bed is fenced off with a screen, the place under the vessel is lined with waterproof oilcloth, and the vessel is rinsed with warm water. Gently moving your hand under the patient's sacrum, slowly raise the pelvis, while the patient's legs are directed upward and bent at the knees. The narrow part of the vessel is placed under the sacrum until the opening of the vessel aligns with the perineum.

Upon completion of emptying, the vessel is removed from under the patient in a similar way, closed with a lid and placed on a stool. The patient's perineum is cleaned with a damp cloth and treated with baby cream or Vaseline.

The bedpan is emptied by emptying the contents into the toilet, after which it is rinsed with water for final cleaning, disinfected with chloramine, and put away under the bed.

- this is the most important condition for his speedy recovery or maintaining health in good condition for a long time. In modern conditions, it is not difficult to choose a care product that will be most comfortable for such a patient, as well as convenient for his family, friends and medical personnel providing care. One of the necessary means is a bedpan (duck) for bedridden patients.

Types of care products for bedridden patients

People of different ages and genders quite often find themselves bedridden for a certain period of time due to complete or partial loss of the ability to move. In such a situation, it is not possible to go to the toilet, and you have to use special duck devices.

Until a few years ago, a medical bedpan was an enamel-coated metal tank that was used to collect food from men and women and to collect urine from women. The second variety was a duck for bedridden male patients, which was an enameled metal urinal. These two types of care products still exist, but are represented by a variety of models. For example, there are design options made of plastic.

Important! Good care and regular hygiene procedures improve not only the physical but also the psychological condition of the patient.

How to choose a care product for a bedridden patient

If you need a vessel for bedridden patients at home, then when choosing you need to take into account several aspects:

a form that best suits the individual characteristics of the patient and does not cause inconvenience or pain;
ease of use and disinfection of the vessel (duck) for a bedridden patient;
design corresponding to the patient’s weight characteristics;
material, its flexibility and elasticity, etc.

To ensure that the collection of waste products is not perceived by the patient as an unpleasant procedure, it is necessary to carefully select the models of special medical equipment required in this case.

There are various modifications for patients of different sexes: for example, a duck or a bedpan for women is made in accordance with the anatomical features and is intended for use as comfortable as possible from a physiological and psychological point of view.

If your patient has bedsores or there is a danger of their occurrence, then you need to purchase a rubber bedspread for bedridden patients. In addition, to choose the right product, it is important to consult a doctor about the characteristics of the condition and the course of the disease.

Types of medical vessel (ducks)

Medical equipment intended for receiving human waste products is available in several varieties, for example, you can choose a duck or a bedpan for bedridden sick men, as well as for women.

The first type is the vessel itself, that is, an oval (or round) shaped container-tray placed under the pelvic area and used to empty both the bladder and intestines at the same time. The boat vessel for bedridden patients is used in the care of men and women. Modern bed models are made from materials that make care minimally painful. You can place a bedpan under a bedridden patient if he is in a supine position. For severe illnesses, this is a very convenient and ergonomic option, since there is no need to turn the patient on his side. Comparison of the characteristics of a vessel (duck) for bedridden patients made of various materials will help you choose the best option (table).

Parameter	Enameled metal	Rubber	Synthetic material (plastic, polypropylene)
Weight	1200-1500	300-400 g	500-700 g
Material properties	rigidity, long-term preservation of air temperature	flexibility, plasticity	atraumatic, flexible
How to disinfect	sterilized in an autoclave or washed with a disinfectant solution	soaked in a special solution	cleaned with special cleaners
Advantages	strength, durability, ease of sanitization	takes the shape of the body, does not put pressure on the tissue, it is possible to adjust the height of the vessel	does not cause discomfort or pain, does not put pressure on the sacral area
Flaws	the need to warm up before serving to the patient	fragility	the appearance of an unpleasant odor with prolonged use

Each of the presented models has its own characteristics. For example, a rubber inflatable for bedridden patients is not suitable for patients with a large body weight, as it may deflate. In addition, a rubber boat is not as durable as equipment made from other materials. A plastic duck or bedpan for bedridden patients combines several advantages such as long service life and strength, but is distinguished by its ability to absorb even with regular treatment and disinfection. An enameled metal bed for a bedridden patient cannot be used for bedsores or after injuries to the lumbosacral region or femoral neck.

The soft rubber bedpan for bedridden patients is available in three sizes and has a special valve for inflation. Reservoirs made of plastic or metal are made with lids; you can also additionally purchase a cover or comfortable hygroscopic pads that increase the comfort of defecation or urination.

Duck models for women and men

Medical equipment with a long neck for receiving secretions from the bladder is popularly called a duck. Modern manufacturers of medical equipment offer a wide range of products for the care of women and men. Such devices are convenient and can be used not only when the patient is turned on his side, but also in a supine position. Ducks, like vessels for bedridden patients, are made from different materials: metal, glass, plastic.

Important! It is convenient to use a duck for bedridden patients, since special modifications have been developed for males and females that correspond to the anatomical structure of their genitourinary organs.

Rules for leaving with a vessel

In order not to create additional discomfort for a sick person, you need to use a bedpan carefully and quickly, following a few simple rules:

If possible, ensure the confidentiality of the procedure by using a medical screen;
before placing a bedpan on a bedridden patient, you must put on medical gloves, prepare oilcloth (or), wet wipes for intimate hygiene, cotton wool, warm water, toilet soap, a towel or soft cloth;
warm up and wipe the vessel (duck) dry and make sure that the surface temperature is equal to ;
remove the blanket;

ask the patient to raise his pelvis and bend his knees to place the oilcloth, or, in case of immobility, perform these manipulations independently;
It is necessary to correctly position the vessel for a bedridden patient by lifting or supporting the sacral part with one hand, and with the other hand, carefully bringing the vessel so that the buttocks are located above the hole;
make sure that the patient is lying comfortably, cover him with a blanket or sheet and give him time to empty his bowels and bladder;
at the end of the procedure, after defecation and urination, it is necessary to clean the skin from the remains of feces and urine with toilet paper or wet wipes, then wash the genital area with warm water and soap, carefully wipe dry, then remove the vessel (duck) and oilcloth.

In some cases, it is not possible to empty the intestines while lying on your back, so you will need to turn the patient on his side and protect his skin from contamination with a diaper or napkin. After the procedure, you can lubricate the surface of the skin with cream or treat it with powder.

Important! The vessel (duck) for bedridden patients is washed, disinfected and dried immediately after the manipulation.

Rules for caring for a bedridden patient using a duck

However, if the condition is serious, it is necessary to place a duck in a bedridden patient, based on knowledge of several rules:

Before manipulation, you must wash your hands and put on medical gloves;
to place a duck on a bedridden patient, you need to fold back the blanket, provide access to the genitourinary organs and bring the reservoir so as to prevent urine from leaking onto bedding or clothing;
After use, the duck should be washed immediately using a stiff brush and a disinfectant solution of chloramine or other substances.

When purchasing, those who have suffered injuries and other diseases, or an elderly person, you need to carefully study the technical specifications and instructions, which tell you how to correctly position the bedpan for a bedridden patient. In addition, you can invite a medical professional and get specialist advice. It must be remembered that good care will help the patient recover faster and feel comfortable even in the most difficult condition.