INFECTIOUS DISEASES HOSPITAL in the USSR — the public specialized medical and anti-epidemic institution which is carrying out the stationary qualified and specialized medical help to infectious patients or establishment of the diagnosis at suspicion of an infectious disease.
Hospitalization of infectious patients is an important link in system of anti-epidemic actions; - she provides not only rational treatment and care of the infectious patient, but also his reliable isolation for people around, prevents possible spread of this infectious disease.
Up to the second half of 19 century patients with infectious diseases were hospitalized together with noncontagious. Only for contempt «leprous» Saint Lazar's award organized special shelters for patients — infirmaries (see). L. Pasteur and R. Koch's opening proved need of separate hospitalization of patients with infectious and noninfectious diseases. In Russian army isolation methods of infectious patients were applied long before these opening, on the basis of empirical observations of medical officers (see. Infectious field mobile hospital ).
At the beginning of the 70th 19 century construction barrack-type type in St. Petersburg, intended for patients sypny, returnable and a typhoid would begin. In 1876 at K. A. Raukhfus's insistance for each infection separate cases were allocated. The design of these cases differed in further improvement of the principles of isolation of patients. In 1882 in St. Petersburg on an initiative and under the leadership of S. P. Botkin construction of the Russia's first large modern infectious would begin, edges nowadays bears his name (see. Botkina hospital ).
In France for individual isolation of patients in 1888 it was offered to divide big chambers into the separate cells called boxes. This system considerably reduced a possibility of intrahospital infection and formed a basis for construction new and reconstruction of old infectious BCs in various countries, including and in Russia where further improvement by her E. F. Melzer formed a basis for construction of the boxed departments (see. Boxes ).
Projects of infectious BCs and departments repeatedly changed, but the boxing of infectious cases, the device of meltserovsky boxes with the obligatory individual exhaust ventilation was always provided. Their structural and planning schemes include all elements for strict isolation of infectious patients (see. Hospital construction ).
Infectious-tsy depending on the volume of work and subordination share on city (in republican, regional, the Region and the Region of subordination the cities) which are under construction not less than on 100 — 150 beds, and-tsy in rural areas. If in the cities are absent special infectious, then in city infectious departments with a capacity not less than 75 beds, and in central regional-tsakh (in districts of rural areas) on 25 — 40 beds would be created.
Existing rules provide the following rooms for infectious patients: boxes and semi-boxes on one or two beds; the pro-thinned-out departments for group hospitalization of patients with the same disease and with chambers on 2 — 4 — 6 beds.
Infectious would have to have reception and viewing and medical cases. The reception and viewing case consists of viewing boxes, an administrative and help part, the insulator and disinfection department (with a disinfection chamber). Medical cases shall include specialized departments for hospitalization with one type of an infection: the boxed (diagnostic) departments in which boxes for reception of patients with especially dangerous infections shall be prepared; the semi-boxed departments for sick children with the acute respiratory and not specified intestinal diseases; departments (chamber) of an intensive care; X-ray diagnostic department; sanatorium department for the children who had acute dysentery and a viral hepatitis (in nurseries-tsakh); wedge, and bacterial, laboratories where are also carried out immunol. researches; drugstore, the central sterilizing; pathoanatomical department with a morgue, and also catering department with milk kitchen, a laundry and warehouse utility rooms. In infectious-tsakh on 400 and more beds, besides, the laboratory and intensive care unit are provided virusol. The intensive care unit in nurseries infectious would will be organized irrespective of the power of a hospital.
Large infectious-tsy on 800 and more beds develop also surgical, otorhinolaryngological, physiotherapeutic and other specialized departments which are intended for rendering specialized medical aid at emergence at infectious sick associated diseases. Infectious-tsa can be mixed (for hospitalization of patients with various infections) and specialized (for patients with a certain infection) for adults and children or only children. In most the BC constructed in 1930 — 1950 exist two - and three-storyed cases. On the project of the three-storyed case on 216 beds (Mosproject, hard currency, 1959) the I floor — boxes, II and III — semi-boxes.
The main structural divisions infectious would be specialized departments. Their number and a profile depend on number of beds, epidemic, a situation and the nature of the prevailing diseases. The most important functions of an infectious hospital are: cleansing of the arriving patients and disinfection of their clothes, the correct accommodation of patients (in provisional chamber, boxing or directly in specialized department), establishment of the final diagnosis, ensuring due patient care and purpose of rational therapy, observance of the high anti-epidemic security in hospital, including prevention of intrahospital infections, the emergency notice of higher bodies of health care on the arriving patients, an extract of the recovering patients with observance of rules (laboratory control, purpose of dispensary observation etc.).
Basic elements of the anti-epidemic mode in And. are: reception of patients and their placement on departments through provisional chambers or to individual boxes; existence at personnel of hospitals of production clothes; an entrance of personnel in-tsu and going away from work through a sanitary lock (propusknik); obligatory boiling of ware; disinfecting of drain waters; existence in departments for patients with droplet infections of forced ventilation with disinfecting of the deleted air; protection of rooms against penetration of flies, mosquitoes, mosquitoes; regular cleansing of patients; disinfecting by bucking bed and underwear of patients; prohibition of visit of patients. Many large would be a wedge, (educational) base of departments of infectious diseases of medical in-t and base for a work practice of students of medical in-t and pupils of medical schools.
In large infectious-tsakh republican, regional and Regions of subordination are available organizational and methodical departments for studying together with a dignity. - epid, service of dynamics of infectious incidence in the republic, the region, area and for development of actions for its decrease and upgrading of diagnosis and treatment of infectious patients.
Bibliography: L. M., Vyalov Yu. A. is Abelian. and Kapustin I. N. Experience of the organization and design of infectious diseases hospitals, M., 1974, bibliogr.; Gayet and certain A. Ya., etc. Hospitals, M., 1953; Design of hospitals, under the editorship of A. G. Safonov, M., 1977; Sealy-vanik K. E. Infectious diseases hospitals, L., 1962, bibliogr.
Yu. A. Ilyinsky.