Part 29

3. Tincture of myrrh, ♏︎xxx; Water, f℥j.

Mouth-Wash.

A solution of potassium chlorate and cinnamon water.

DISINFECTION OF ROOMS.

Seal all crevices about doors and windows. Keep the room closed for twenty-four hours to allow dust to settle. At the end of this time vaporize in a lamp from fifty to sixty paraform tablets to each 1000 cubic feet of space or vaporize 1 pound of formaldehyd solution in a special apparatus designed for the purpose. If no special apparatus is obtainable, sprinkle sheets with the following solution, using a gallon of the mixture for a medium-sized room, and fill the room with steam:

Formaldehyd sol., 4 parts; Glycerin, 1 part; Water, 2 parts.

The steam and glycerin prevent to some extent the conversion of the formaldehyd gas into paraform, which in itself is useless.

Another and more modern method is to pour 12 ounces of formaldehyd into a vessel and then add 4 ounces of crystals of potassium permanganate. Place the vessel in the room and leave the room closed for from four to six hours. To get rid of the fumes quickly after the disinfection is completed, sprinkle 4 ounces of ammonia on a sheet and leave the sheet in the room until the ammonia is evaporated.

Sulphate of copper solution is a very cheap disinfectant, and may be used to advantage in typhoid fever.

After this treatment again keep the room closed for four or five hours. Then wipe floor, walls, and woodwork with corrosive sublimate solution (1: 2000) or carbolic acid solution (3 per cent.).

DISINFECTION IN PRIVATE NURSING.

In a private home (M. D. P., American Journal of Nursing) if contagion has taken the family by surprise and a room has not been especially prepared, leave in the room all the furniture and fittings in order that everything may be disinfected finally.

During the progress of the disease no blankets, coverings, etc., must ever be shaken from the windows. They can only be aired within the room, or rooms, occupied by the patient. Moist sheets hung outside the door leading to the rest of the house prevent the passage of dust from the sick-room. It is sufficient to keep them sprinkled with plain water, as the important thing is the moisture. However, a solution of carbolic acid may be used. They should be kept wet by some one on the clean side of the house. Soiled linen from the sick-room should be placed in a wash-boiler or metal can full of water, never taken to the laundry in a dry condition. Here also a weak solution of carbolic acid maybe used, or a very weak solution of soda. However, plain water will be sufficient. They should be boiled for at least half an hour. Patients’ dishes and silver should be kept in the room, and before returning to the house should be boiled.

All cleaning within the patient’s room during illness should be done with moist cloths, which should be put into paper bags and burnt.

Upon leaving the room the patient should receive an unusually thorough bath, hair and all, with tincture of green soap, a dilute alcohol rub, and finally a sponge-bath of bichlorid of mercury, 1: 2000 to 1: 4000, according to age.

The mode of disinfecting rooms is, generally, to use formaldehyd.

Before setting free formaldehyd in any form the nurse should put on rubber gloves, glasses, and a thick mouth and nose protector, as the fumes are very irritating. After leaving the room she should seal up the door and leave all over night, and then thoroughly air and house-clean on the morrow. Mattresses and pillows had better be steam-sterilized if there is any sterilizing plant in the town, or, in the country, made over and sunned thoroughly.

SURGICAL SUPPLIES.

TO STERILIZE INSTRUMENTS.

1. All instruments should be boiled for at least fifteen minutes in a 1 per cent soda solution. Wrap the blades of knives and scissors in cotton, put them in a separate towel, and in one corner stick the needles before folding it. Some surgeons prefer to have the latter simply washed and placed in absolute carbolic acid and then in alcohol for a few minutes. Water must boil before instruments are put in and the boiler must be kept closely covered.

2. In a German medical journal, published at Leipsic, Gerson corroborates his former assertions as to the efficacy of disinfection of instruments with tincture of soap, citing extensive bacteriologic tests in evidence. He wraps the blades in Brun’s cotton, impregnated with tincture of soap. The cotton protects them from the air and the tincture is an efficient disinfectant. The instruments are then ready for use at any moment. After using them he rubs them clean with cotton moistened with the same tincture, then wraps them in a fresh piece and lays them aside. No boiling or steaming is required, and the instruments are not harmed by the process. He recommends this method especially for military and other practice where steam disinfecting appliances are not available. He has found that instruments infected with pus, etc., and not even wiped off after having been used, proved perfectly sterile after a few days in the wet cotton wrapper. No colonies developed when they were rubbed on agar plates or soaked in bouillon.

To Arrange Instruments for the Convenience of the Operator.—Instruments for immediate use are laid in trays on a small movable table on the operator’s right hand. Instruments that may not be needed are kept in another tray. A separate tray is used for suturing material, needles, a pair of sharp-pointed scissors, and long forceps. Before placing instruments in the tray, dry with sterile towels.

TO CLEAN INSTRUMENTS.

First of all, the knives, scissors, and needles should be laid carefully aside and cleaned at once. Scrub all instruments in cold water to remove blood and pus, then in hot water with plenty of soap. Rinse thoroughly in hot water, then place in boiling water, take them out singly and dry; do not drain. Following pus cases all instruments must be boiled for at least fifteen minutes in 1 per cent. soda solution.

TO STERILIZE GLOVES.

Examine carefully to see that they are in perfect condition. Select a pair, then wrap each one in a separate piece of gauze, fasten together, and boil at least 15 minutes in salt solution.

TO DRY STERILE GLOVES.

Cover a table with a sterile sheet. Prepare hands and person as for an operation, and draw on a pair of sterile gloves. Then dry gloves with sterile towel, and powder them inside with sterile powdered talcum.