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Use of gloves.
Most of nurses and doctors dislike gloves, and not for nothing. In gloves sensitivity of finger-tips is lost, skin on hands becomes dry and is shelled, and the tool strives to slip out hands. But gloves were and remain the most well-tried remedy of protection against an infection.
It is possible to allocate at least 3 reasons for which the medical personnel are forced to use gloves:
gloves reduce risk of professional infection at contact with the infected patients or their allocations (in this regard use of gloves is an important component of system of universal precautionary measures);
gloves reduce risk of infection of patients with the microbes which are part of resident flora of hands of health workers (for this reason, in particular, gloves are used when carrying out surgeries or bandagings burn wounds);
gloves reduce risk of a kontamination of hands of personnel tranzitorny activators and the subsequent their transfer to patients.
In the light of the above several councils which can be useful at the choice of gloves.
Gloves have to adjoin densely to a hand during all usage time.
Gloves should not create discomfort and cause fatigue or tension in hands. Special attention to it needs to be paid at simultaneous use of two couples.
Gloves have to keep good tactical sensitivity.
Gloves have to be rather reliable in risky situations (for example, during the work with kolyushche-cutting instruments)
Gloves have to contain the minimum quantity of the substances provoking allergic reaction (in particular, latex, and also the proteins which are contained in starched at prisypochny powder can cause it).
Medical gloves - not just attribute of modern clinic. It is the only opportunity to work, without putting at risk of either patients, or themselves.
Types of gloves.
Gloves happen two types: surgical and viewing. Surgical gloves thinner and long - they reach a forearm and completely repeat an anatomic shape of a hand. On packaging it is obligatory to eat marking: for the right hand, for left. On finger-tips rubber thin, on a cuff - strong. In modern models on a palm and on finger-tips of gloves a surface ridge that the tool was reliably fixed in the surgeon's hand. The thinnest gloves - are intended for microsurgeries, and here thick and strong gloves which are not torn even at considerable effort will be suitable for work in department of traumatology. For midwifes and gynecologists produce special superlong models of gloves.
Viewing gloves are universal, they can be put on any hand. They shorter are also most often supplied with the roller that kept on a hand stronger. In it there is also a back: gloves with the roller have unpleasant property to be rolled up at putting on. For work in department it not essentially, and here in the operating room creates certain difficulties. Besides, pleated, formed by the roller, settle bacteria therefore at surgical gloves the roller, as a rule, is absent.
Advantages and shortcomings of various types of gloves
Type of gloves
The sterile or passed the State Duma surgical gloves * are used at all procedures connected with contact with hypodermic fabrics
Are issued the different sizes, are convenient in work
Roads; do not use where it is possible to carry other types
Viewing gloves: are used at contact with mucous and not intact skin. These gloves are usually widely available
Are inexpensive, gloves for inspection cost from 1/4 to 1/3 costs of surgical gloves
Usually only three sizes
At a reuse of surgical gloves, they should be checked carefully regarding gaps and cuts. Researches showed that invisible gaps are probable when processing gloves. As a result it is considered uneconomical to process surgical gloves more than three times.
Surgical gloves can be washed up and either are sterilized by autoclaving, or have to pass deep disinfection by means of boiling or processing the ferry before a reuse
are applied during the work with
the used equipment which can be kontaminirovano blood or allocations, and also during the work with garbage and linen.
are inexpensive; can wash and repeatedly
to be used many times. Tolstaya
the rubber surface protects cleaners from the damages connected with a prick needles
• Neither boiling, nor processing kill with steam completely all bacterial endospores.
• Cheap - qualitative does not mean.
• Do not use gloves with cracks, peelings or holes and gaps.
Alternative to latex
Until recently all gloves made of latex. Natural latex is received from juice of rubber trees of family a hevea, subjecting it to curing process, it is the material saturated with proteins. The structure of material depends on quality of this process.
Everything well and here the number of people who have an allergy to latex grows every year. And, business is not limited to erubescence and hypostasis, cases of an acute anaphylaxis are registered. Sometimes reaches ridiculous: high quality surgeons and instrument nurses are forced to refuse work only because cannot work in such gloves. The situation considerably changed with the advent of the new synthetic materials which are not causing an allergy - a neoprene, a nitrile and polyurethane. When testing it became clear that the latest gloves besides that antiallergenna, have the mass of advantages before old: they are thinner, are steadier against damages, do not collapse under the influence of chemical solvents that is especially important for work in microbiological laboratories. Besides, all synthetic gloves neopudrenny, they "breathe" and, so do not dry skin. But also the price at them corresponding - nitrile gloves is five times more expensive than latex.
Vinyl gloves were at one time popular: they did not cause an allergy too, were quite thin, rather cheap, but, unfortunately, fragile: were torn at the most inappropriate moment. Nevertheless, they are still used where there is no direct contact with blood, for example, in gynecologic offices.
On some packagings with latex gloves it is possible to see a mark "hypoallergenic". It means that gloves are made of well purified, qualitative latex, but, unfortunately, latex causes an allergy in any kind. So this mark - no more than an advertizing gimmick.
The congress of labor unions of Great Britain tries to obtain that the administration of medical institutions provided the workers with safe gloves. Today, by official calculations, every tenth physician has an allergy to latex and if the doctor or the sister have no alternative (the medical gloves made of other material), they are forced to change a profession. At some the allergy is so expressed that even approach to packaging with gloves from rubber causes an itch. Also cases of professional asthma and an acute anaphylaxis are registered.
Multi-colored, as balls
Gloves happen white, blue, green, brown. But it has to fashion no slightest relation: color of gloves is not obliged to be combined with color of a surgical suit. It is marking. White, yellowish, colors of an ivory and brown happen only latex gloves. There is an opinion as if, the they are more white, the more qualitatively. But this delusion - a shade of color depends only on type of latex and does not influence quality of gloves in any way. For a delicate work, under a microscope, let out brown gloves: they absorb excessive light and do not give patches of light therefore eyes of the surgeon are tired less.
Synthetic gloves happen blue or green - depending on material of which are made. So bright coloring warns allergic persons that they did not pull on hands by mistake latex gloves.
When to wear gloves
Gloves in itself are not the only well-tried remedy of prevention of infection therefore use of gloves is not alternative to washing and antiseptic processing of hands.
Any, even the most modern and superstrong gloves have the "weak places" which need to be known:
- often gloves "leak", and liquid gets through material; what is noted when using 43% of vinyl gloves and 9% latex; the most sad that this fact is noticed by no more than a third of health workers; So all who use gloves need to pay attention that leakages arise most often on finger-tips, and also on all area of a thumb;
- no gloves exist 100% impenetrable for microbes (according to different data, permeable were 4 - 63% of the studied vinyl gloves and 3 - 52% latex); viruses are capable to get in gloves as their sizes are comparable to the sizes of microholes in absolutely new glove;
- as gloves are made not of metal, they not in forces to protect skin from sharp objects. For example, during operations 20-30% of surgical gloves are damaged (one of options to create certain "margin of safety" - to put on at the same time two pairs of gloves);
- long work in gloves leads to accumulation of the so-called glove juice containing a large number of microorganisms;
- using gloves not only in operating time with patients, but also at disinfection processing of surfaces, sterilization of medical tools, etc., the applied chemicals lead to damage of gloves. For example, 15-minute contact from 75% ethanol causes considerable changes of structure of gloves;
- the accepted methods of processing of gloves of repeated use reduce their protective properties, promote increase of their permeability; i.e. gloves of single use should not be reused;
- washing of hands in gloves between patients or between carrying out pure and dirty manipulations with the same patient is not recommended. Besides that at the same time there is an increase of their permeability, there are data that even when performing full-fledged technology of washing of hands (friction, use of the clearing agent, drying) it is not always possible to remove completely available flora.
In the second half of the 20th century the problem of quality became not just actual, but super-topical - because of all of the increasing number infected with AIDS and hepatitis. Now protection was required not only to patients, but also medics. And, in effect, the thin layer of latex on medical staff hands became the only well-tried remedy of protection.
At the beginning of the 19th century production of medical gloves was put on a flow, and it became mass. Automation of production allowed producers to lower the prices of the products and to provide with it the consumer market. However industrial revolution extremely sharply put a quality problem. In the conditions of mass production to control quality of each couple it was not represented possible. From here - inevitable percent of marriage.
"Barrier" (protective) function of gloves is influenced by a set of factors: their type and grade, types of procedures, duration socks, use conditions (for example, contact with chemicals). Therefore first of all it is necessary to compare physical characteristics of different types of gloves (distensibility, permeability degree, ease of putting on, electric conductivity) with features and specifics of specific work.
How to distinguish qualitative products from low-quality? First of all - attentively studying packaging where all main information on goods is provided. If gloves are made by the solid firm delivering the products to the different countries of the world and working according to the uniform standard it duplicates this information in languages of all consuming countries. Thus, physicians of all countries obtain the same information. Other important sign of quality of gloves - packaging. The special covering provides protection of gloves against destructive effect of ozone.
At careful observance of all norms of curing it becomes impenetrable for bacteria and viruses. But if in technology there is a failure, then marriage is inevitable; in gloves defects appear, and they do not protect medical staff from infections, in particular from the infected blood any more.
Quality of gloves is characterized by the following parameters:
1. allergenicity (purity of gloves from the point of view of the content of allergens);
2. durability and resistance to mechanical damages: natural latex is exposed to curing process. At careful observance of all norms of curing latex has to become impenetrable for bacteria and viruses. But if in technology there is a failure, then in gloves defects appear, and they do not protect medical staff from an infection, in particular from the infected blood any more.
The first and most widespread type of marriage - a microcrack and a hole.
The second - the uneven thickness of a glove (at a tension it most likely will tear).
The third - gloves which length does not conform to the standard (in a short glove it is impossible to fill a dressing gown sleeve). All above-mentioned reasons are explained by one - desire of the producer to save on raw materials. In a case production.
And, at last, many gloves have no the fixing roller which interferes with their slipping from a hand.
In the conditions of mass production it is impossible to control quality of each product therefore control is applied only to small part a product, and quality of this part has to give an idea of quality of all party. There is a criterion by which choose gloves and other products of medical prescription modern clinics, is a so-called coefficient of AQL (in translation from the English Acceptable Quality Level - "the acceptable qualitative level"). According to the European standard the coefficient should not be lower than 1,5. it means that from party, for example in 10000 couples, 630 units are selectively checked. Their that also put to destructive tests: to a tension water, to inflation, microbiological control, measurement rn. If upon termination of check the quantity of the rejected units equals 20 or less, then all party is allowed to sale, except for the revealed rejected products. At AQL 1,0 the quantity of the rejected units has to be no more than 16.
Carriers of a virus of hepatitis B and HIV-positive patients even more often occur among patients of clinics. They, naturally, need the help not less other patients, but doctors often refuse to operate them. And their refusal is motivated - fear to catch as gloves it is easily damaged by a needle or a scalpel. Especially for such cases the heavy-duty kolchuzhny gloves steady against any cuts are developed. They are done of the same materials, as by bulletproof vests, it is almost impossible to damage them. These gloves reusable: at contact with the infected patient put on at first kolchuzhny gloves, then thin latex. Protection against infection absolute, but sensitivity of hands, of course, not that. Because of complexity of production these gloves are extremely expensive - they on a pocket only to "rich" hospitals.
Very important point which is extremely dangerous both for patients, and for medics who use gloves is powder for gloves. It is under vigilant control of the authoritative FDA organization in the USA (Management on control of quality of foodstuff and medicines).