OBSERVATION (Latin observatio observation) — medical observation in the conditions of isolation of healthy people, to-rye were in the center of a quarantine disease or are going to leave out of its limits.
The island treats the anti-epidemic measures which are carried out at to sanitary patrolling (see), it is also carried out when a dignity. - epid, the service considers that it is impossible to be limited to medical observation (without isolation).
Practically O. is entered only at plague, cholera and natural smallpox. The persons communicating with patients or who arrived from the centers of the specified diseases to terms, shorter than an incubation interval Observirutsya. Lakes subject also healthy faces before their departure from a quarantine zone. However in epidemiol, the practician O. it can be carried out also at nek-ry others inf. diseases when at the place of residence medical overseeing by persons, suspicious on a disease or communicating with patients, does not guarantee against further spread of an infection.
O.'s terms are established from the moment of dissociation with patients or inhabitants of a quarantine zone taking into account the maximum incubation interval of the corresponding disease (at plague of 6 days, at cholera of 5 days, at natural smallpox of 14 days etc.). The lake has clear advantages before observation at home since observiruyemy persons are under constant medical observation that allows to reveal the first symptoms of a disease which ached at emergence and timely to hospitalize them.
An observation as medical - a dignity. the measure directed to the prevention of delivery of cholera for the first time was recommended in 1893 on Dresden international a dignity. conferences. In our country O. is established and carried out according to Rules on sanitary patrolling of the USSR from a drift and spread of quarantine and other infectious diseases. In Rules requirements of the International medical and sanitary rules adopted at the XXII session of the World assembly of health care in 1969, and the subsequent changes and additions to them made by the XXVI Assembly of WHO in 1973
O. as a component of quarantine actions are considered (see. Karantin, karantinization ), provided by Rules, it is carried out in sea and river ports, the airports, on road trasses, through to-rye international transport is carried out; it is carried out by M3 institutions of the USSR, and on boundary. - stations — healthcare institutions of Min-va of means of communication.
The organization and O.'s carrying out in epid, the center quarantine and others dangerous inf. diseases are carried out by the extraordinary anti-epidemic commissions, to-rye are created according to decisions of executive committees of regional, city, regional (regional) Councils of People's Deputies, resolutions of councils of ministers of federal and autonomous republics.
Place observiruyemy in the special room or in territorial to lay down. - professional, establishment, a cut it is taken away for this purpose according to in advance approved plan. On water borders (in ports) observiruyemy can be placed in rooms as ashore, and onboard the vessel.
The lake includes sanitary cleaning observiruyemy, daily poll, medical examination and thermometry (e.g., communicating with the patient with pulmonary plague not less than three times a day shall be exposed to thermometry), a lab. researches (e.g., at cholera on a carriage of vibrioes). At nek-ry diseases the emergency prevention is necessary: carry out vaccination and appoint Methisazonum to the persons which were in communication with the patient with smallpox; the persons communicating with the patient with pulmonary plague take a course of preventive treatment with use of antibiotics.
Place observiruyemy, whenever possible, small groups with the identical term of contact with an estimated source of an infection at detection of new cases O.'s term lasted only for this group. At O. in connection with pulmonary plague individual placement is recommended. In the absence of such opportunity it is necessary to double the medical watch the diseased was nekhmedlenno isolated at emergence of the first symptoms of a disease since it is dangerous to people around only from this point.
At identification of the patient among observiruyemy it is isolated (see. Isolation of infectious patients ), and the persons communicating with it are subjected to sanitary cleaning again (after isolation of the patient) and transferred to other room or placed in the same room, but after its disinfection. O.'s term for this group of persons is resumed from the moment of isolation of the diseased. In view of that place in observation point (observator) healthy faces, it is necessary to provide, except medical observation, their cultural service (library, television, radio etc.). The personnel for service observirovanny (doctors, sisters, nurses, etc.) are allocated so that the round-the-clock medical observation was provided.
The observation of troops is carried out at emergence or threat of a drift to a part (on the ship) inf. diseases with the purpose to prevent distribution them out of limits of the center.
The lake of troops is established by the order of the commander of a part (ship), connection, garrison on the basis of the report of the chief of medical service; it provides: restriction of entrance, departure and transit of all means of transport through the territory, on a cut are the observiruyemy contingents; prohibition of export from a zone O. of property, products, etc. without preliminary disinfecting; restriction of contact with staff of the next divisions, parts and local population; medical observation, active identification inf. patients, their isolation and hospitalization; the emergency prevention, vaccination and a revaccination (after establishment of an etiology of a disease); strengthening of medical control of carrying out dignity. - a gigabyte. and anti-epidemic actions, establishment of an anti-epidemic duty of first-aid posts and to lay down. institutions.
If necessary departure out of limits of the center (a zone of a quarantine) is allowed only after performing the emergency prevention, sanitary cleaning with disinfection of linen, regimentals, footwear, equipment and an individual weapon.
Medical observation includes daily polls during the conducting evening checks, morning surveys and outpatient appointment. In necessary cases carry out thermometry and various a lab. researches. Persons with symptoms, suspicious on a disease, are isolated. The anti-epidemic mode in first-aid posts and to lay down. institutions shall ensure full safety for medical staff and exclude a possibility of spread of an infection.
Degree and the nature of the stated restrictions are defined epidemiol. features of an infection and specific conditions of a situation. At emergence of epidemic trouble in the part moving on. - to or waterways, O. of troops carry out special anti-epidemic facilities — observation points (see), developed on large. - nodes, water piers, etc. O.'s duration of troops is established for the term of an incubation interval of a disease and is estimated from the moment of isolation (hospitalization) of the last patient and completion of disinfection processing of the center.
The observation of the population in the conditions of wartime
the Observation of the population in the conditions of wartime is carried out at emergence mass inf. diseases of not clear etiology (before establishment of a type of the activator), at quarantine diseases, and also for overseeing by the persons needing departure from a zone of a quarantine. At O. limit departure, entrance and transit through the territory of the center, and also minimize communication of inhabitants among themselves. At the enterprises and in institutions the anti-epidemic duty providing early detection of patients among the working changes, their isolation and overseeing by the persons who were in contact, observance by workers and employees of rules of personal hygiene, disinfection, the emergency prevention, inoculations, etc. is set. All these events are held under the leadership of medics of SES, district clinics and out-patient clinics, health centers and MSCh of objects of the national economy. Staff dignity. posts interviews workers and employees about the state of health and twice takes at them body temperature — at the beginning and the end of the working day (change), and also at the complaint to feeling sick. For identification of patients among the population which is in the center and is not occupied on production household (apartment) bypasses will be organized. They are carried out by forces to lay down. - the prof. of institutions by territorial local principle of service with attraction a dignity. teams and dignity. posts. Sandruzhinnits assign to certain houses and apartments. The territory assigned to each policlinic (rural out-patient clinic) is divided into microsites on number of local groups. For ensuring the round-the-clock anti-epidemic work at these to lay down. - professional, institutions create control offices where from local crews data on results of household bypasses arrive, on the basis to-rykh evacuation of the revealed patients and final disinfection will be organized. Evacuation of patients with observance of the anti-epidemic mode is carried out by special evacuation crews, and disinfection in the center is carried out by disinfection crews, to-rye are completed and equipped at the expense of disinfection department of SES, the city disinfection station or mobile anti-epidemic group (see). At emergence mass inf. diseases and establishment of the mode O., except inf. hospitals, the network can be developed insulators (see).
Bibliography: Vasilyev K. G., Gold E. Yu., and Marchuk L. M. From sanitary protection of borders to sanitary patrolling, M., 1974; To M. S au cookings. Sanitary protection of borders of the USSR, M., 1951; International medical and sanitary rules (1969), M., 1976; The Collection of instructive-methodological materials on sanitary patrolling of the USSR from a drift and spread of quarantine diseases, under the editorship of. I. D. Ladny, M., 1976; Encyclopaedic dictionary of military medicine, t. 3, Art. 1445, M., 1948.
I. D. Ladny; V. I. Agafonov, V. P. Volgin (soldier.).