INSULATOR — specially equipped room for accommodation of infectious patients, suspicious on an infectious disease, and the persons constituting epidemic danger to people around adjoining to them.
The first And. shelters for leprous — the infirmaries which arose in the Middle Ages were. And. played a positive role in fight against leprosy later with plague. However in the shelters and hospitals created in later time, no devices for dissociation of infectious patients from noninfectious existed. In the Parisian hospital Hotel-Dieu at the end of 18 and the beginning of 19 century patients with smallpox were in one room with noninfectious patients; about 20% of all patients perished from intrahospital infections. Only in the middle of 19 century as a result of persistent requirements of the advanced doctors construction of hospitals of stage and barrack-type type in which infectious patients accommodated separately from the others began. Allocation in pavilions and barracks of the isolated rooms for isolation of certain patients belongs to the same time. However originally scientific justification of need of separate keeping of diverse infectious patients was received after opening of an etiology of infectious diseases. The international agreements on fight against so-called «conventional» diseases promoted implementation And. in anti-epidemic practice.
And. is an integral part of almost each medical institution. And. arrange: in the general hospitals, out-patient clinics, policlinics, child care facilities, sanatoria, rest houses on a case of identification of persons with highly infectious diseases and need of their separation from people around before sending to infectious diseases hospital; in infectious diseases hospitals for separate accommodation of patients with the obscure diagnoses, and also with the mixed infectious diseases and for the organization of separate reception of patients in priyemnosortirovochny departments for the purpose of the prevention intrahospital infections (see); at sanitary and quarantine points at the international airports and on the road trasses located on frontier of the USSR at sanitary and quarantine departments in the international sea and river ports, medical medical aid stations of stations for temporary isolation of the infectious patients and persons adjoining to them before their evacuation in specially intended hospital.
Room And. it has to be isolated from other rooms, it is free from mosquitoes, mosquitoes, mites, flies, fleas, rodents and other sources and carriers of contagiums. And. shall have a lock for personnel (part I which is fenced off, adjoining to an entrance.), in Krom there is a wash basin and overalls (the second dressing gown, a cap, galoshes, wadded and gauze masks) which are put on by personnel in holding time of the patient are stored. For And. the necessary property is fixed: clothes and linen for patients, overalls for personnel, bedding, ware, objects of a nosotrophy, a towel, a bast, soap, tools, a bucket with a cover for collecting and disinfecting of allocations, and also a sufficient reserve of disinfectants. In equipped And. there are a bathtub, a wash basin and the certain bathroom.
The most perfect type I. the meltserovsky boxing with a separate entrance and an exit is. Such boxes are obligatory in reception sorting rooms of children's infectious diseases hospitals, in a large day nursery and hospitals where they contain sick, suspicious on especially dangerous diseases. In the shlyuzovanny chambers, boxes and semi-boxes of a modern design used as well as., the separate system of ventilation in order to avoid transmission of infection through air is provided. In large infectious diseases hospitals there can be special insulating departments. At isolation at home And. the certain room serves.
If necessary to subject to isolation a large number of the persons adjoining to patients all suitable rooms are used for what the reserve equipment is provided.
V I. the high anti-epidemic security with the purpose to prevent infection of patients and personnel inside is observed And. and spread of an infection out of its limits. At arrival of the patient in And. it passes cleansing (see). To work in And. on care of infectious patients the permanent well trained staff is allowed only; in certain cases to service personnel surely make the corresponding infection inoculations. Twice a day make wet disinfecting cleaning And., all allocations of the patient immediately disinfect. After each manipulation on a nosotrophy the personnel process hands disinfecting solution. At the end of work of the person, servicing patients with especially dangerous infections, are exposed to cleansing with use of desinfectants. The personnel strictly watch purity of patients. In the presence of patients, the extending activators in the airborne way, personnel And. it is obliged to wear wadded and gauze masks. In certain cases, napr, at communication with patients with plague, the personnel of the insulator are obliged to put on a protivochumny suit (see. Plague ). Visit isolated by relatives and other persons is forbidden. The property from the insulator is taken out only after its preliminary disinfecting. The extract of patients is made under control of laboratory researches after the patient ceased to constitute epidemic danger to people around.
Insulators at stages of medical evacuation are developed for the temporary maintenance of the infectious faces, sore or suspicious on infection, constituting danger to people around.
And. are created on medical aid stations, in field and evacuation hospitals usually on two infections. They are placed in tents, tents, dugouts, houses away from ways of the movement of the struck and somatic patients, from food subjects and sources of water supply.
And. are developed in PMP, MSB and hospitals. In infectious hospitals function I. usually carry out reception and diagnostic departments; but at suspicion on emergence of a disease, unusual to this hospital, And. can be created also in hospital departments (see. Infectious field mobile hospital ).
For service of patients in And. allocate the medical staff trained in rules of care of infectious patients, disinfection of infectious material and measures of personal prevention. For patient care allocate with especially dangerous infections personnel, beforehand proimmunizirovanny against these infections.
And. at stages of medical evacuation are equipped as well as in other treatment and prevention facilities (see above).
Organization of work And. shall provide protection of service personnel against infection and prevent spread of an infection in a stage and out of its limits. Provide cleansing arriving in And. patients, prohibit visit And. the persons which are not belonging to the personnel servicing them and also an exit of patients out of its limits.
Before evacuation in IPPG patients can be late in the insulator PMP no more than one, and in MSB and hospitals — two days.
Peculiar look And. is anaerobic, intended for wounded with manifestations of a mephitic gangrene. Anaerobic it is created in MSB and in surgical hospitals. It consists of a hospital on several places and a dressing room. The dressing room and a hospital are equipped by the general rules. At service of wounded with a mephitic gangrene special value has all complex of the actions directed to the prevention of dispersion of an infection.
Bibliography: see bibliogr, to St. Isolation of infectious patients .
I. D. Fine, B. L. Schur Borax; V. D. Kucherenko (soldier.)