From Flu Wiki 2

Forum: Setting Up a Sick Room

22 January 2006

anon_22 – at 19:01

There doesn’t seem to be a lot of discussion on preparing a room in case someone in your family comes down with the virus. Guidelines are available here http://www.fluwikie.com/index.php?n=Consequences.InfectionControl but please feel free to share your ideas or problems that you have encountered while planning this.

anon_22 – at 19:21

I have a room on top of the garage that has a separate entrance from the street. A flight of stairs from this entrance goes up to the landing where there is a bathroom (shower) immediately next to this bedroom. At the bottom of the stairs there is another door to the garage through which at the back you can exit to a small yard that is not part of the main garden. This whole setup is connected to the main house via a hallway and another door.

The reason why I explain all this is that I want to demonstrate how to design the space to create different levels of infection control, including a one-way system if someone is sick and a carer has to go in and out of the room and disinfect properly before returning to the main part of the house.

The carer goes in through the internal door from the main house, closes that door, and uses the hallway as changing area to put on whatever PPE needed. This may be some old clothes covered with apron, shower cap, gloves and mask. Also either disposable shoe covers or change into wellies (rubber boots).

For higher level of protection, I would use long-sleeve surgical gowns (these can be home-made) that tie at the back plus plastic apron. Use duct tape to seal the wrists of the gloves. Use two pairs of gloves if available.

It is important before entering the room to make sure that the other set of doors are closed ie at any point, there is at least one closed door between the patient area and the living quarters. If you don’t have 2 sets of doors, use plastic sheets to create an additional barrier.

anon_22 – at 19:31

The room that I have is long and so it can be separated into two areas. The patient can sleep on a bed at the far end. This area is semi-partitioned with the use of plastic sheet/shower curtain. Behind this, next to the bed, you would need to put basins for disinfection and all the paraphernalia that one would normally need if someone is ill/bored.

The big challenge in this case is toilet facilities. Because the bathroom in this case is on the outside, I want to reserve that for cleaning/disinfection purposes. I tried to come up with different ideas to safely deal with waste, and the best so far is to get a chemical toilet from caravan companies. The neat(!) thing about this is that it has an enclosed compartment that receives waste. You can disconnect the lower portion as a fully enlosed container. If you put in disinfectant eg bleach ahead of time, then removing and disposing of that waste is not going to be hazardous.

anon_22 – at 19:37

The reason why it is better to partition the room, apart from the privacy issue, is that if the carer is to stay in for any length of time, any barrier would improve protection.

Any article/clothing from the room is to be disinfected with bleach. The easiest way for laundry is to get the biggest bucket you can find and fill it to half with diluted bleach. You can keep it just outside the room, in this case in the bathroom, so that the stuff goes straight in soon as you leave the room. That way, you are only handling contaminated laundry when still fully protected.

anon_22 – at 19:52

Before leaving the room, the carer should wash and disinfect the outer pair of gloves, remove and dispose of them, spray disinfectant on the inner gloves before opening the door. Once outside, close door immediately. Just outside the room, you can put a tray with a folded bath-towel or large cloth soaked with bleach. As the carer leaves, he should step on this and rub the bottom of the wellies vigorously. If using disposable shoe covers, step on the bleach, remove the covers and dispose of them.

Wash and disinfect remaining gloves. Take off apron and put immediately into wastebin, making sure that the bin closes completely. Take off gown and put into laundry bleach bucket. Wash and disinfect gloves again.

Now the carer is ready to leave. In this instance, he can exit through the garage door, making sure to touch only the door handles and nothing else. These can be disinfected later.

Walk through the garage and out the back. On the outside, prepare a shallow basin of bleach as footbath and plastic flip-flops (sandals). If wearing wellies, step into the basin and take off the wellies. Step out and put on flip-flops. Wash and disinfect gloves again. Take off glove, wash and disinfect hands.

Take off and dispose of mask and cap, taking care to not touch the outside of mask.

Wash and disinfect hands.

anon_22 – at 19:56

If you want to be extra careful, and if you live in a warm climate, consider getting a camping shower, which is just a bag filled with that you can hang up and use. You can shower right outside, change, before re-entering house from a different door.

If weather does not permit, then put on a big bathrobe to go in the house, making sure that you change your footwear again just as you enter. Go straight to the bathroom and shower completley.

anon_22 – at 20:07

This is just an example using my own house. Many elements can be varied but I think these considerations might be important:

1 try to get a 2-door or 2 barrier setup 2 Contaminated laundry should be handled minimally and put into disinfectant asap. 3 Pay a lot of attention to disposal of body waste. The ideal situation is if you have ensuite facilities for the patient’s sole use. No other disinfection/washing activities should go on here. If using bedpan or other open containers, make sure it always contains bleach even before use, cover as much as possible, even if only with a cloth, dispose asap wearing maximum protection. 4 If the area is quite near to the living areas of the rest of the family, consider putting in a powerful extractor fan which is always on. However, the direction of extraction in relation to where the carer is likely to spend most time inside the room is important. Make sure the airflow is from the carer/house to patient to extractor. 5 To increase the effectiveness of this one-way airflow, consider using draught-protectors under doors. These are just strips of rubber that allows air to go one-way only.

anon_22 – at 20:08

(edit)

1 try to get a 2-door or 2 barrier setup

2 Contaminated laundry should be handled minimally and put into disinfectant asap.

3 Pay a lot of attention to disposal of body waste. The ideal situation is if you have ensuite facilities for the patient’s sole use. No other disinfection/washing activities should go on here. If using bedpan or other open containers, make sure it always contains bleach even before use, cover as much as possible, even if only with a cloth, dispose asap wearing maximum protection.

4 If the area is quite near to the living areas of the rest of the family, consider putting in a powerful extractor fan which is always on. However, the direction of extraction in relation to where the carer is likely to spend most time inside the room is important. Make sure the airflow is from the carer/house to patient to extractor. 5 To increase the effectiveness of this one-way airflow, consider using draught-protectors under doors. These are just strips of rubber that allows air to go one-way only.

anon_22 – at 20:13

6 If there is no bathroom right next door that can be used for the carer’s disinfection, put basins of soapy water and bleach right outside for disinfection. Put wastebin and laundry bucket here as well. This area should be frequently cleaned and disinfected and should be used either not at all or as little as possible by anyone else in the family. The carer should again put on a bathrobe that covers the body as much as possible before walking through the rest of the house to shower.

anon_22 – at 20:14

Please feel free to add, comment etc.

anon_22 – at 20:33

BTW one of the reasons why I wrote this thread is to show the number of items that you may want to get ahead of time, such as plastic sheets. These and duct tape are always going to be handy. But the extra buckets, basins, etc need to be counted up as well. Other details to think through include stuff like how you’re going to get that water into and out of the laundry bucket if the bathroom is some ways off and the whole thing is too heavy to lug around the house.

dude – at 21:32

Funny, I did a post on here somewhere about going out to get food and what you should do to prepare to get it and you back inside your house. Maybe they should be combined in some spot on here.

M Fox – at 22:14

I have something I’d like to add to the “Home Alone” article - you should also keep a list of important phone numbers near the phone. You might know your mom’s number buy heart, but a 103 degree fever could make remebering it a challenge. I certainly wouldn’t remember my doctor’s!

anonymous – at 22:28

i have problem with this surgical gowns which are tied on the back…who will tir them for you?

anonymous – at 22:29

sorry tie them for you

23 January 2006

anon_22 – at 02:55

You should tie them if at all possible, loosely if necessary. Just so you can take it off on your own afterwards before leaving the immediate area without help. Also, there may be times when you need to take it off in a hurry. If you have problems reaching behind, use velcro in which case someone else can fasten for you and you can just pull it off.

Will – at 05:45

This may sound archaic, but will a UV light in the hallway or over the doorway in the room help to kill any of the exposed virus?

fredness – at 08:02

http://www.cdc.gov/ncidod/dvrd/spb/mnpages/vhfmanual.htm I have found this “Infection Control for Viral Haemorrhagic Fevers” manual to be a great help in setting up a sick room. Download the chapters you like. Section 3 and annex 3 are essential. Maybe this thread should be made a wiki page and placed in the index for easy reference. Good idea Anon_22.

crfullmoon – at 08:18

I’d be careful with UV; you wouldn’t want to set up something in a way that was harmful to you, too. http://www.newton.dep.anl.gov/askasci/gen99/gen99899.htm

Many people’s homes are not going to be able to set up such a high level of isolation room, but as much as they can possibly do, would help. Gloves, masks, buckets, disinfecting supplies.

Remember to write down anything you’re keeping track of; temperature, input/output, which meds/treatment when and more due when? Sleep deprivation/fear/stress may scatter things you thought you could remember, but can’t, later, if your caring for a very sick person.

MaMaat 14:24

First of all-thanks anon_22 for starting this thread and giving such detailed step-by-step info. Any recommendations on when setting up an area such as this would be best?/// Alot of people are planning to go into self-quarantine at some point. If this is maintained and the incubation period is 5–17 days as speculated, wouldn’t your need for an isolation area be in the first two weeks (if someone was unfortunate enough to catch the virus before self-quarantine)? Maybe it’s a good idea to add this to general prep plans and put into place when you begin self-quarantine. For those who are unable to self-quarantine (essential services) and have to sleep in their own home, should an area be designated for their use (near exit/entrance) and isolated from the rest of the household? Something to consider. It might be a good idea to have two copies of ‘tracking’ info as mentioned immediately above, one in the isolation area and one outside so you can refer to it when not actually providing care. New info could be added right after you leave the isolation area. BTW I’ve decided to make two physical copies of all of my prep plans (including the ones on my computer) and keep them in two different places- this might be especially important for those who will try to self-medicate if they become ill-a glass of spilled juice could erase your recommended dosages, etc. I wouldn’t want to have to trust someone’s life to my memory, especially if I’m tired and worried.

Doc watgone – at 17:32

Again

Shootem

Torange – at 17:45

Some hospitals are buying hvac equipment with UV plenums. Build a box with UV lights and a fan.

owl – at 21:23

To seal off a room:

There is a great zipper door unit at Home Depot which contractors use to seal off rooms in houses. It is probably 8 feet long and gets taped into the center of a sheet of plastic whihc you tape to a door frame and then you slit the pastic as you unzip the zipper. I bought several thinking that with 6mm. plastic sheeting it can create a barrier. A second one can make a changing chamber outside a sick room.

I also bought an Aller Air unit on caster, with a UV germicidal light. It can be brought into a sick room or just run in the house if there is power. We have a parrot so the dander and dust are an issue.

24 January 2006

Doc watgone – at 07:35

Duct tape AGAIN!!!!

Shootem

Lorelle – at 08:57

ANON 22: Do you know how long a bucket of bleach-water will still be useful before pouring out? Think of limited supplies of bleach - how long can it stretch? Also, what is the ratio of bleach to water that you’re using? Is it the same ratio used in child care centers for wiping down tables etc? I forgot what that was, but it makes for difficult breathing in the room for a while.

anon_22 – at 09:00

I will write a follow-up post tomorrow to include details like disinfectants, mattress covers, etc. Right now I have to go watch webcast http://www.sph.umich.edu/micphp/

See you later :-)

25 January 2006

MaMaat 11:37

Just wanted to bump this so it doesn’t get lost. Alot og good info here. Looking forward to additions.

knowflu – at 16:12

That is what this is.

26 January 2006

MaMaat 23:01

Same reason as yesterday. Really good info anon_22!

27 January 2006

anon_22 – at 14:54

OK, I’m back.

I realized that I forgot something really important. YOu need to wear goggles if you are within a close distance of someone shedding virus. The best ones are the clear ones with unvented sides. Those with small vents are not a problem but if you want to be extra careful, especially if there is a risk of being splashed then tape over the vents. Swim or ski goggles will also do the job. However, it’s important to make sure that these do not affect the fit of the mask. A useful hint is that if your goggles are fogging up (on the outside), the mask is not working properly.

Lily – at 15:23

I keep thinking of our habits of social distancing. Yesterday a man seated next to me, leaned over to me and I could feel spit as he spoke hitting my face, even though I instinctively leaned back. I am so conscious of this, but people will crowd into elevators and other places. I almost feel like wearing a mask now. Its strange but even when doctors wear masks in an operating room, as well as the anesthesiolgist you can sense concern and the person behind the mask. Perhaps before this even happens, in airports for example, once it has spread beyond Turkey, that such simple precautions will become standard.What it sounds like is the medeival and renaisance physicans had it right when they suited up and covered themselves completely head to toe.

Grace RN – at 15:29

Lorelle- bleach is only good for one day after mixing with water- make a fresh batch up daily.

anon_22 – at 17:18

Bleach: for normal household bleach, which is approx 5%, use 1:100 (10ml in 1L of water) for general cleaning and disinfection. For body fluids, waste, and spillages, use 1:10 (10ml in 100 ml of water). Bleach needs to be made up each day, otherwise it degrades very quickly. Now that can add up to a lot of bleach over a few months. Instead of buying bottles, you can buy bleach tablets. These come in packets of 10 where each one makes 1L of bleach, which can then be diluted as above. I don’t know if it’s sold in the US but in the UK it costs only £1.00 for a packet. Remember that bleach is corrosive to hands but the fumes are quite toxic if you breathe a lot of it. Make sure there is plenty of ventilation.

The best alternative to bleach is Virkon. This is non-toxic, does not give out fumes, and not corrosive for surfaces so that you can use it for wood and metal. It is frequently used for animals. Just follow the dilution instructions on the package.

Citric acid is also useful and easy to obtain (from food product shops or people who sell chemicals to make bath-soap). It is safe to use on clothes etc and even on your body if you ever need decontamination. (You could also use Virkon at a pinch but do not use bleach.)

anon_22 – at 17:21

Having said all that about disinfectants, it is important to remember good old soap and water is the first line. Washing with soap especially under running water removes a significant amount of any contamination. You should always do that before disinfecting.

anon_22 – at 17:29

Bedding: Make sure you cover the mattress COMPLETELY with a plastic sheet. What you want is to make sure that the whole thing can be wiped clean every day. The normal mattress covers are useless because they do not go all the way round and often the surface cannot be wiped. Also get waterproof covers for pillows and duvet covers.

Floors: Carpets are useless in this situation because they cannot be cleaned/disinfected thoroughly. The best thing to do is again to cover it and tack it down with plastic sheet. (Are you counting the no of plastic sheets and roles of duct tape needed yet?) Make sure everything is secure cos loose edges can cause serious accidents.

Curtains: Replace fabric curtains with wipe-clean (yes) plastic or blinds.

This might seem a lot of trouble but it is worth the effort because anything that catches dirt and is difficult to disinfect will raise your hazard level and also add to your angst. Remember that this whole setup won’t be used unless someone is suspected to have bird flu, in which case you will be so stressed out that mistakes will be very likely. So anything that you can do or plan ahead of time will reduce that and allow you to concentrate on helping the person to get well.

anon_22 – at 18:04

Going back to toilets again. Depending on how your system is plumbed, (and if you are like me you don’t know anything about it), it might be better to assume that the system is contaminated if someone in the house is sick. If you live in an apartment so that your plumbing is connected to others’ then just assume that it is contaminated. Again the best thing to use is bleach. Remember in this instance you are not worried about the water in the tank but rather the stuff in the toilet bowl so make sure that you put some in there.

In addition, to reduce splashing, always close the lid before flushing. During SARS when people were actually infected by such routes in HOng Kong, gentlemen were advised to use the facilities sitting down!

Some bathrooms or sometimes even kitchens have floor drains to remove any accidental spillage. A huge outbreak of SARS (300+ people infected, 35 died, most of them from one apartment tower block) was caused by waste back-flow or back-log in the system and when people turn on extractor fans to shower, tiny contaminated aerosols were sucked into the room air. The solution to that is again to put a small amount of bleach into the drain, wait 5 minutes and then flush. Do this several times a day.

Go here http://tinyurl.com/bpqp4 for a short summary of the outbreak in Hong Kong.

And here http://tinyurl.com/8hm66 for the HK government’s recommendations.

anon_22 – at 19:06

Ventilation: The gold standard for an isolation room is the negative pressure room. This is basically a room that has a very powerful extraction system (6 air change per hour minimum) directed away from the rest of the house and ducted outside at a point that is far away from adjacent buildings or windows. To achieve a proper negative pressure, the air supply rate must be substantially less than the exhaust rate. Without the help of an engineer, this can be simplified to mean that the air supply inlet should be reasonably small eg under the door.

As I said before but is worth repeating, if you want to put in an extractor fan, you must make sure that you are creating the most direct and smoothest airflow that goes from door to carer to patient to extraction system. Mis-alignments can result in unexpected turbulent flow so that the point of maximum virus accumulation becomes unpredictable. The air is passed through a HEPA filter to the outside. There must of course be no other window or opening, so that air only enters through the doorway (under the door).

For most people this will not be possible. The next best alternative is to have windows open. A small oscillating fan to create a gentle breeze is helpful. If you live in a really cold area so that you can’t keep a window open then any small extraction system that you can put in will help.

Some stand-alone domestic air filter/purifiers have HEPA filters which theorectically can help reduce the virus load. In actual practice, however, many have filters that need changing or cleaning. It is possible to have significant virus deposit on these filters so that cleaning is probably more dangerous than not having the machine.

However I have found an air purifier by Sharp which claims that the machine can destroy viruses in the air including H5N1. It emits positive and negatively charged ions which supposedly attach to the coating of the virus and inactivates it. Sharp quotes a study by John Oxford’s lab using a sample of H5N1. The other thing about this machine is that you are not passing the air through the machine so the amount of virus contamination on the filter would be a lot less. I don’t know how well it works since there is no independent corroboration, but I have been using it for my study and the air quality is definitely a lot better than the other machines that I have tried. http://www.noticias.info/asp/aspcomunicados.asp?nid=72321

anon_22 – at 19:25

Good article on negative pressure room, the considerations:

http://tinyurl.com/bgoog

28 January 2006

Richard :-) – at 01:07

Re: Will’s post about UV - Hope this is of some help.

It is proven that all viruses are susceptible to germicidal UV and require relatively low UV dosages for complete eradication. The influenza virus needs a dose of 6,600µW/cm² UV for 100% kill. The bird flu virus is similar to the regular flu virus. This means that a UV dose of approximately 10,000µW/cm² will effectively eradicate the virus http://tinyurl.com/bb4gy

For water treatment http://tinyurl.com/7fft9

A good description of germicidal UV http://tinyurl.com/9p5bp

The number 1 source of information I have been able to find on the Internet for UVGI http://tinyurl.com/7auee

Corky52 – at 01:37

Beware of the UV shadow, anything that is between the UV source and the virus will shade and protect it. I’m looking into ozone as a more effective way to kill the beasties. There are several cheap way to generate ozone and being heavier than air it will penetrate things.

Alan the Pom – at 07:30

If it happens,I am going to be putting them into my carvan that is in the garden, and set up a system as per avon_22 1931. This setup could provide health care for two persons if required.

anon_22 – at 09:08

Alan, please let us know how it goes. Problems that you encounter, novel solutions etc. Or if you want post a description of your setup so that those people who are also thinking of using a caravan can learn from you and each other. Cheers.

anon_22 – at 09:09

owl,

“To seal off a room:

There is a great zipper door unit at Home Depot which contractors use to seal off rooms in houses. It is probably 8 feet long and gets taped into the center of a sheet of plastic whihc you tape to a door frame and then you slit the pastic as you unzip the zipper.”

Thanks, I ordered a couple immediately. They are great!

29 January 2006

Alan the Pom – at 09:09

Hi anon-22 and my other new friends. The caravan I am planning to use is a two berth with a bog standard UK spec : Hot/cold pumped running water (gas/mains),gas heating,fresh air ventilation, shower, flushing cassette toilet, fridge (gas/12v/mains),cooker four ring/grill/oven,plus entertainment such as TV/CD/radio. My thinking is to use this caravan as a care unit for anyone that may get sick with you know what,the internal parts are mostly plastic and smooth wood with only fabric on the seating area (which converts to two single beds),if I cover all the fabric area with plastic sheeting,I should be-able to carry out any deep cleaning that will be required from time to time. I also will be using the full size awning which will provide me with a de-contamination area, I will also install a simple battery opperated door bell from house to caravan as a ‘patient call system’. This setup, will to my way of thinking reduce the risk of passing on the bug to other people within the house. I have trained up three people to act as carers if and when this breaks, we will also have in place two quarantine areas within the house. The ‘highlevel’ area will be used by all the family,the other area (which has WC/bed/TV and direct access to the outside garden)will be used by the carer who is looking after the sick person in the canavan,(food will be provided by the family using a tray though the door system) both these quarantine areas will be separate from each other by operating a closed door system,if the carer goes down with flu, a back up carer will take over that duty.with the sick carer going into the second berth in the caravan. This is where I am now going to ask you for advice, Does anyone know when the ‘all clear’ can be given to the person who has just recovered from this bird flu, it would be crazy to put them back with the others if they could still pass on the virus. CAN ANYONE HELP.

Grace RN – at 12:00

To the best of my knowledge, and based on seasonal flu, 5–7 days after symptoms first appear, people may still be ill, but no longer shedding the virus (not contagious). However, highly immunocompromised people may shed for a longer period of time- ie

“Viral Shedding and Transmission by Persons with Symptoms

In otherwise healthy adults with influenza infection, viral shedding 24¨C48 h before illness onset has been detected but generally at much lower titers than during the symptomatic period (Appendix). Titers of infectious virus peak during the first 24¨C72 h of illness (103¨C107 50% tissue culture infective dose [TCID50]/mL nasopharyngeal wash) and decline within several days, with titers usually low or undetectable by day 5. Shedding in highly immunocompromised persons may last weeks to months. Compared with adults, children can shed virus earlier before illness begins and for longer periods once illness starts. As in adults, peak shedding in children occurs during the first 1¨C3 days of illness, but absolute levels may be higher than those in adults. In 1 report, at least 4 illnesses (8% of the total) in children were associated with presymptomatic shedding that began 6, 4, 3, and 3 days, respectively, before illness onset (5). The median duration of virus detection is typically 7¨C8 days after illness onset, but shedding for up to 21 days has been recorded. In 1 study, virus was shed by 10% of children on days 8¨C11, by 5% on days 12¨C15, and by 0% on days 16¨C19 (6). Infants with infection requiring hospitalization may shed virus longer. In both adults and children, shedding does not usually continue once illness has resolved. Serologic testing indicates that ¡Ö30%¨C50% of seasonal influenza infections may not result in illness.

Viral Shedding and Transmission by Infected Persons without Symptoms

During the incubation period, persons with presymptomatic influenza infection shed virus at lower titers than persons with symptoms (Appendix); however, the infectiousness of those with presymptomatic infection has not been studied. Apparently the only published report implicating transmission during the incubation period involves a group of adults in New Zealand in 1991. Of 26 adults who bagged fertilizer for 8 h, influenzalike illness (fever, headache, sore throat, myalgia, respiratory symptoms) developed in 16 and mild, “cold-like” illnesses developed in 3 persons within 24 to 48 h after working with the fertilizer. A person considered to be the probable index patient had felt unwell during work, although he did not have respiratory symptoms; an influenzalike illness began to develop 6 h after he finished work. Influenza A virus H1N1 was isolated from 2 symptomatic persons; whether these included the suspected index patient and whether that person transmitted infection during an incubation period or the cluster resulted from community exposure are unknown. The group shared drinking bottles and worked in a dusty environment, both of which could have facilitated transmission (7).”

link:http://www.cdc.gov/ncidod/EID/vol12no01/05-1370.htm

crfullmoon – at 12:07

Rolls of heavy plastic “carpet protector” mats are sold; they have little teeth on the other side, to not slide on carpet.

anon_22 – at 16:13

crfullmoon “Rolls of heavy plastic “carpet protector” mats are sold; they have little teeth on the other side, to not slide on carpet.” Can you tell us where?

MaMaat 19:57

anon_22…I don’t know specifically the names of stores in your area that might sell these. The best places to try would be larger hardware and home-improvement stores. The rolls come in varying sizes and are usually used in entryways/hallways to protect carpet from wet shoes, etc. They may not be available in room widths- I’ve never seen them anyway. If you wanted to cover the whole floor in the room, you could maybe butt the width edges together and use duct tape to cover the joins. Hope that helps! …..Again, many thanks for posting this thread.

Anita – at 21:29

Very well documented thread Greetings !

Symptoms as nose bleeding, bleeding respiratory secretions, watery diarrhoea, vomiting, have been noticed in some patients affected by birdflu last months. These are a concern to think of while preparing a sick room, and the personal protective equipment.

30 January 2006

MaMaat 13:25

This might seem like a silly or obvious thing post to med. professionals, but I think it’s a good thing to point out for lay people (like me). Make sure your fingernails are trimmed short and file them smooth if you need to be wearing gloves to avoid contamination. Long nails and very rough or sharp edges on nails can tear through gloves. Having short nails also makes it easier to wash your hands properly- less area for virus to hide, easier to get underneath them…No more nail tips for me!

07 March 2006

anon_22 – at 17:31

Update:

I was looking at extractor fans and realize that the only people who consistently state the volume of air extracted per hour are the hydroponics suppliers. For example http://www.3countieshydroponics.co.uk/system/index.htm go to environments, fans.

Most bathroom fans only extracts up to 80cu.m/hr.

anon_22 – at 17:33

Also, if you are short of space, to create an isolation cubicle, just screen off the area completely, all the way up to the ceiling with clear plastic. Add an extraction system ducted outside and a zipper opening or equivalent. In this instance, because the area is small, the regular bathroom extractors will do a good enough job.

Then the rest of the room will be the semi-clean area that the carer to use. You can also use this method if you have more than one patient sharing a room and you want to reduce cross infection.

fredness – at 17:59

Actually I was thinking a remote switch for the sickroom/bathroom fan would be useful. Just turn it on before entering to create negative pressure.

fredness – at 18:32

Anyone have the part number or manufacturer for that zipper door?

anon_22 – at 19:14

It’s called Tarp Zipper Add-on and is available from Home Depot.

Owl – at 20:05

Anon, great suggestion re partitioning off a section of the patient’s room to contain shedding virus. It will also give the caregiver somewhere to be nearby but with less risk.

A chair to rest in while the patient sleeps especially if it is a child, might be a thought.

Thank you for continuing to rethink and reshape the planning process. I don’t think many of us will be thinking clearly if we need to be dealing with these issues….

Snowhound1 – at 20:11

The more we can play it out in our heads, the more likely that we won’t be making a lot of mistakes if and when we have to be doing it for real.

Carrey – at 20:51

Somewhere above, someone mentioned covering the carpet with plastic. I was under the impression that after the patient was better and out of the room, you keep the room sealed. Then after 6–10 days you could just open it up and the virus would be dead. Is that not correct?

Ceredwin – at 23:51

And…Instead of plastic sheets (like where on earth you can find a queen/king size one?) using a plastic shower curtain will do just fine, and you can put the regular sheets on top for comfort.

Also getting adult “Depends” or similar brand could be useful, not the kind that look like pants and slide up and down, but the ones that look like diapers, easier for a caregiver to remove and put on. And similar ones for kids.

And I noted somewhere that the virus can survive up to 35 days at colder temps in some environments (bird poop), and fewer days in warm climes (7 in poop.

08 March 2006

Dejan – at 09:31

Lets not forget that influenza viruses are usualy not airborne, so negative presure room will most likely not be necesery.

anon_22 – at 09:50

Ceredwin,

I am buying plastic sheets by rolls.

:-)

anon_22 – at 09:55

Dejan,

“Lets not forget that influenza viruses are usualy not airborne, so negative presure room will most likely not be necesery.”

Well, it has to do with virus concentration versus your own risk tolerance. Someone who is sick and staying in the same room day after day can cause the viral load to be very high. What I am concerned is that in any household, having one person sick with this virus is going to be so stressful and traumatic that it might be prudent to taken precautions higher than the bare minimum. It might be true that other people in the house would probably catch it anyway, but the later you can postpone this, especially for the carer, the better off everyone will be.

Plus in hospital practice with this virus, negative pressure room would be the standard to be aimed at if available.

Nothing is ever ESSENTIAL, just a good idea to keep in mind.

12 March 2006

Felicia – at 14:18

What do you think about a portable commode? I just bought a folding one from drleonards.com (think that was the site) with the thought that a sick person may not be able to make it to the toilet, but may be able to stand by the side of the bed. And for those who are worried about a sick person sharing a bathroom, this seems like a solution

crfullmoon – at 14:31

I think that’s a very good idea. Might need a bedpan, too.

People who need your assistance to get out of bed, once it becomes very difficult for them, (or if they are delirious) you or they could get hurt, and just because you’re strong enough to do something once doesn’t mean you can go it over and over without injury. Be careful.

anon_22 – at 15:26

With bedpans and commodes, the important thing to stress again is to put in 1:10 bleach. The risk of infection from body waste is very high. When disposing of waste, GENTLY pour into toilet, add in more bleach, close the lid before flushing.

DO NOT use the shower or any pressure washer to wash commodes or bedpans. Best thing is to have a huge tub of disinfectant where you can submerge the (emptied) bedpan completely.

Always wear maximum protection, including masks and goggles, for waste disposal. Long sturdy rubber gloves that go up to the elbows are good. Always follow the most stringent decontamination procedures afterwards.

17 March 2006

Urdar- NO – at 22:21

more relevant than Opera W and Where to Store Tuna, here is the Hygiene Video all should see! http://tinyurl.com/nu93n

On the use of masks, glasses, and desinfecting a room, made in relevance to the SARS epedemic, same goes for flu..

25 April 2006

nsthesia – at 11:09

After watching Dateline’s program, I started thinking more about my plans for a sickroom. I had already obtained the items I deemed necessary (utilizing many of the above suggestions). I had chosen a specific room because of it’s location, layout and bathroom access with an anteroom.

I had thought of the logistics of the care. And of course prayed that NONE of this preparation to utilize a sickroom would ever happen. It is one thing to “hunker down” for the duration of a panflu and have adequate food/water, etc. It is another nightmare altogether to envision having to care for a friend/family member infected with this lethal virus within your own home. Especially in the event that there is no functioning healthcare system.

I have the supplies. I have the knowledge. I have the skills to provide for a critically ill patient.

And then I realized…when we shelter in place, there will be three of us here. My spouse, his young son and me. We plan on sheltering in place (SIP) if it all falls apart. I’ll work as long as it is feasible.

But I realized if my stepson, whom I love like I made him myself…(his mom died at his birth) became ill, that I would be the likely person to care for him. I makes no sense to have both his dad and I exposed. But I know that any parent would want to be with their child. His dad has NO concept of asceptic technique and IMHO would be contaminated within 10 minutes. In all likelihood, we would all die. And his dad is NOT trainable…I’ve been trying for years! :0

That is when I started thinking that I had read about one person being the one to go outside if necessary and that they would isolate themselves from the rest of the family until the contamination phase was over. But, when we speak of being caregivers to a sick family member, we speak of decontaminating ourselves and then reentering the family unit. IMHO, it is much more likely that a direct caregiver would be contaminated than someone just going outside among the unknown.

All I could think of, was that we would become our own cluster. And that there would be many others found dead inside their homes if someone got sick. Even with all of my education/training, I don’t believe I would be safe reentering our home. And I definitely would not feel safe if my spouse did the caregiving and reentered the environment. Not if the virus maintained the current lethality.

I now realize that the key to our sheltering in place is to do so early enough to prevent infection. And in the event that somehow, one of us does become infected while SIP, that the caregiver would also have to stay isolated. With only three of us, and one of us being a child, that is a nightmare scenario. What do we do if both adults are isolated?

Bottom line, we have to prevent getting infected in the first place. Or perhaps add people to our shelter scenario. sigh… Just as I do not believe that healthcare workers will be going home to their families on a daily basis, I also do not believe that it would be a good idea for caregivers of a panflu victim to mingle with the well members of the household.

I plan on moving the room I would use as a sickroom to an area with an adjoining room/bath. And will pray none of this is ever needed.

NJ. Preppie – at 11:36

nstesia- Gee, I was hoping you would give me more tips not more hopelessness. If I was nursing my son, and using all the isolation, extra hygiene techniques, it would mainly be to try to prevent the spread to my other son. See- you only have one to worry about. I am more worried about teenagers than myself, because who wants to have to outlive their child? I would have a horrible life under those circumstances. You say you know about critical nursing care, will you have IV supplies? I was concerned about that and found someone who could do that for me. People should try to make local contacts like that.

anon_22 – at 12:02

It is more difficult if there are only 2–3 people. It works a little better with a bigger group of people. In addition to caring for anyone who gets sick, there are many different types of chores needed to sustain a prolonged quarantine. It works a little better if resources/skills are pooled. For example, just this exercise of setting a sick room shows how much work is needed, and its almost the same amoung whether you are planning for 3 people or 8. Let’s say 3 families of with a total of 4 working adults and 1 homemaker and 5 kids getting together might decide only 2 of the adults are essential workers. The 3 adults can split their energy and resources into caring both for the kids and maybe supplying essentials to the 2 who go to work who will lodge in separately accommodation in a nearby location.

NJ. Preppie – at 12:13

We all work at home here. If I had best friends, who had not prepped, and were in dire circumstances- one or more sick, and I went over there, as a good Samaritan, to bring supplies, gatoraid; when I return home, should my quarantine from my family last about 7 days? I wonder when I would be safe from getting ill.

nsthesia – at 12:30

Sorry, NJP,

Not meaning to sound negative, it was just that I had not thought about it. And when I did, I went to my husband and asked him what he thought. He does not have a healthcare background. He said it would be his responsibility to care for his son. I said, you don’t know how. I would be more than willing to do so, but both of us couldn’t be exposed. Of course, that didn’t work. That was when I realized what a mess that would be. We would all be exposed.

I don’t know if you would also be three alone in a house, but it does create a problem. I suppose you/I would have to look at it as making a choice between the ideal (isolating the caregiver) and the “acceptable” alternative (trying to maintain as clean a technique as possible and reentering the household). I just hate the thought of the last situation. Especially if we had a lack of water or utilities.

Yes, I do have supplies to cover hydration, etc. My ID name is also my profession.

As for any helpful hints, I do believe most of them have been covered. Having worked in hospitals for years now, all I can think of is all of the TRASH that is created when caring for a patient. I know we won’t have all of that in our homes, but even what we do produce must be disposed of to reduce the risk of infection. That is why you must have covered containers, lots of soap/water, keep the horizontal surfaces disinfected.

I’m saving some of my plastic grocery bags to use for sickroom use (tissues, barf bag). Check for holes and double bag just in case. Obtaining a metal garbage can to use to burn trash if needed.

Someone mentioned keeping your nails short and clean if you are doing patient care and wearing gloves. Short nails are also easier to clean. Also take off your rings if you are going to care for a panflu patient. Less chance of them tearing thru your gloves. And it is easier to ensure that your hands are clean. I would also remove my watch for the same reason.

Those with long hair should keep their hair restrained. The last thing you want is to be trying to get your hair out of your face. Of course a cap is recommended for direct care, but it is much easier to control if it is first tied back. When you take off your goggles, mask and cap, you do not want to be brushing your hair out of your eyes. Practice keeping your hands away from your face. Contact lenses are probably not a good idea. Also, good mask fit requires that facial hair like beards be removed.

When I looked at MY sickroom set-up, all I could see was a panflu situation. Of course, we may well use it for other illnesses with minimal consequences. However, it would still be a good idea to keep the sick person away from the others as it is anticipated that our healthcare system will be stretched to the max and a routine doctor’s visit won’t be routine…

And I apologize if I increased your anxiety. Altho I do appreciate the opportunity to express MINE! This was a scenario I had not thought out completely. And I realized I had only implemented the first step - obtaining supplies and a plan. Just like any bureaucracy, ya gotta IMPLEMENT the plan. I forgot that part!

But now that I have another piece of the puzzle, I will problem solve. Just like in anesthesia, you have to have plan A, B and C. Always expect the unexpected.

NJP, you’re already thinking and planning. You’re ahead of 95% of the rest of the public. We still have time to work out solutions. We will continue to do so even if this virus does become the next pandemic. Just like a virus, “Those that adapt, survive.”

NJ. Preppie – at 12:52

If you are going out to work, esp. that you go to a hospital, wouldn’t you need to live, with different space, from your son? Are you going to prepare and eat different meals? If your husband goes to work too, shouldn’t he keep separated from your son? Are you going to have your son know how to prepare his own meals? (This is assuming there is a bad fatality rate for young people)I got all the sick room stuff, UV airfilter, the director of the hospital intensive care unit as a neighbor, but that’s not that helpful if your kid gets the cytokine storm. That will be my priority, but I wonder if I could help a friend by wearing the mask, gloves, gown, cleaning up with disinfectant, then living in the basement till I’m sure I’m not getting sick. I feel like the odds of getting sick, with careful effort, would be low enough, to try to bring important aid to someone. I just know how I will feel, when someone who is like family, is dying.

anon_22 – at 12:55

nsthesia,

“And I apologize if I increased your anxiety. Altho I do appreciate the opportunity to express MINE! This was a scenario I had not thought out completely.”

That’s what the wiki is for. Folks helping each other by exchanging ideas/

“ya gotta IMPLEMENT the plan.”

yep, that’s important for sure.

anon_22 – at 12:56

Comments on Replikins Inc here

nsthesia – at 13:04

NJ,

Think about it. If your neighbors were sick and dying, the odds of your gatorade saving them is zero. Tamiflu, oxygen, IVs, suction maybe slightly better odds. With 24 hour care. So, would you jeopardize infecting your family? I wouldn’t. It is not being cruel, it is necessary for survival. I am sure many will not understand, but if 2 will die and 3 live, that is better odds than 2 dying and you getting infected, infecting your sons, and then you have 3 more deaths, 5 vs 3. Even worse, your sons seem to have a greater risk of dying from this than you or I. The risk of my infecting them and their dying would keep me home.

It is like the thread about the sick child. Would I take in a sick child? If I knew there were no adults using the child as bait. Yes. But I would not take the little waif into my home immediately. I’d have to isolate the kidlet until I could determine that they were healthy. I’d provide shelter, water, food and explain what I was doing. But I would not just take them into my home.

We have to make impossible decisions in healthcare every day. Remember…first, do no harm. Bringing a potentially lethal virus into my home wrapped in the body of a child is a decision I never want to have to make. Because I would not do it. One may die. Three may live. This same scenario will happen all over the world. It is happening today in Darfur. They must choose who gets hydration/food/meds. When there is a crisis, you must do the best for the common good.

These same decisions will be made in the hospital setting. Who gets the meds. Who gets the ventilator. Who will even be allowed to ENTER the hospital? If this gets pandemic, I am sure these facilities will turn into armed fortresses.

Come to think about it, my little sickroom is looking better all the time…

nsthesia – at 13:19

NJ,

Maybe your neighbor would SIP with you. That would be another adult.

And you’re right. I will work until it gets too critical. And I will isolate then. Our home is large enough to have separate areas to isolate. My husband has decided to be the one to leave the house as needed once we make the decision to SIP. Hopefully, he really won’t need to. But he is double my size and can protect himself. I do not trust the social unrest aspect.

I have also invited family members to come stay with us. But they live 2 states away and may never make it. That would be my heartache. I lived without knowledge of their welfare during Katrina for over a week. I’ve already felt that panic and emptiness.

NJ. Preppie – at 13:20

Thank you for the answers. When do you stop going to work, as soon as the illness is in our country? Are you both able to quit working? How many healthcare workers will not go to the hospital anymore? Was there a poll that had about 40% say they won’t go? Of course it all depends on how bad the news is, if it’s a 1%, 2%, 3% fatality rate. I think it’s about a one/third chance of being at least a 1% or worse rate. I’m figuring two/thirds of pandemics are mild to moderate and 1/3 of pandemics are bad enough to prepare for. I think a one/third chance of a dangerous pandemic, eventually, is very serious, and can’t believe the way experts will make it sound like a rare, far fetched, possibility. Hearing the ideas of other people help a lot to prepare psychologically, as well as physically. It’s reinforcing, thanks!

NJ. Preppie – at 13:31

So, you beat me to the questions. My neighbor of the intensive care unit, has a family too, young adult sons. But we would make a good security team if need be. Their property connects to ours, although woods have grown up between what used to be farms. Her husband and sons are police officers. Our sons have shared the woods for forts and target practice. There are a lot of nurses around, I know of three others myself. I also made friends with parents who are both pharmacists. I’m not lining them up yet, but I just thought I’d reccommend to people to find out where are your resources nearby, in case things shut down or become too crowded.

anon_22 – at 14:51

nsthesia & NJ, you might want to read through the Disaster Survival thread. There’s some overlap discussion about whether to take people in and teaming up with others.

bird watcher – at 17:42

I plan on have a room set up that is very isolated. Plastic on the mattress. Throwing out any soiled linen or trash out the window in plastic bags. Never bringing them in the other rooms. Around the patients bed I plan on putting plastic Shower curtains to contain cough from splattering in the room . Keeps it easy to keep the room clean. Sort of like hospitals have. Room needs proper cleaning daily with bleach I considered disposable thermometers Plenty of hand sanitizer in the room. Patient needs to clean hands regularly. Never handle the tissues let the patient put them in a covered container near bed. Trying to keep everything disposalble may stop the spread of the virus to other parts of the house. Portable potty in the room for patient with bleach in it. Entrance to the room may have a safe area to change before entering and leaving room. This is my first time so if some of this stuff sounds silly excuse me. I am just adding to the dicussion so we can refine what we need to do. I read that the patient needs to wear a mask when people enter the room so that they don’t spread the germs. Patient will have disposalble dinnerware etc.

lauraB – at 17:47

Someone brought up a good point in another thread: make sure the room has windows and plenty of sunlight. Sunlight and fresh air can help reduce the risk of pneumonia. Getting a patient upright and moving a bit can help as well. In 1918 they would darken rooms, keep them still and laying down.

bird watcher – at 17:53

Now for the sick rooms supplies: Baby Wipes for washing if no water is available Disposable themometers Tissues Waste basket with lid lined with plastic bags. Laundry basket for patients items. Cough syrup anti diaharel meds tylenol asidomedifine ( i know i spelled this one wrong) asprin benadryl Plenty of gatorade hydration solution (water,salt,sugar) this is like iv fluid read it on this site from Dr. Ostherholm Plenty of face clothes and water basin Portable potty Bleach bleach bleach…. (Lysol sanitizing wipes) kills salmonella choleracsius , influenza az japan personal hygiene items for patients in room. Alcohol towels mask for patient ( Keep our mask separate )

bird watcher – at 17:54

thankyou lauraB good idea

nsthesia – at 21:39

NJ 13:20,

Yes, both myself and my husband can stop working as needed. I am working independently, contracting to facilities, mostly on an outpatient basis. If TSHTF, I don’t expect much need for outpatient surgery and the in-house stuff will surely be emergent only.

I have signed on to our state’s disaster list for healthcare workers, so they will be able to find me. But once the situation has reached a level 5(.5) and it is confirmed that there will be no vaccine or definitive treatment, then I will SIP.

I have inquired as to what possible use the outpatient surgery facilities might be put to and no one seems to have an answer (or maybe they don’t want to answer). They seem like they would be great places to use as additional places for panflu patients. They are small, usually less than 30 beds. They have oxygen, suction, monitoring, IV, staff capabilities. They are usually located closer to neighborhoods than hospitals.

The down side is they do not have all the testing facilities as a hospital, nor all of the support staff or equipment (like ventilators, altho our anesthesia machines would work as a substitute). I would see them more like an intermediate care facility, but I read where hotels might be utilized and I could see these also being utilized.

An additional comment about the sick room…have you ever read the label on the Clorox Bleach wipes? There is NO bleach in them. Same for the Lysol ones. If I remember, they contain a relatively weak agent. IMO, I might use it today just to wipe down surfaces, but not in a panflu sickroom. I will be using bleach as my gold standard where I can. My sickroom also has two walls of glass, one that opens onto a lanai and the other onto a lake (with BIRDS). Lots of sun and ventilation.

bird watcher – at 21:49

Just for your info:

Lysol Sanitizing Wipes Contain: Active ingredients Alkyl 50% C14, 40 % C12 , 10% C16 , Dimethyl Benzzl Ammonium Chlorides 28% Inert Ingredients 99,72%

Not a rocket sciencetest here but isn’t chlorides bleach????

This isn’t a subsitute for bleach…I did mention bleach bleach bleach to clean the sick room. The wipes are for quick cleanups…like the patient spilled something.

Jane – at 23:02

bird watcher at 17:53-Patient’s dirty laundry should go into a laundry tub with bleach and water so it soaks immediately, if I understood the earlier posts. (Do we wash sheets in the washing machine? Save them for later decontamination? We don’t want to wash healthy people’s clothes in the same machine… right?)

Birdie – at 23:07

Do you think an air purifier will be of any use in the sick room? I am not sure about how they work with germs.

08 May 2006

Rock – at 18:42

I recommend double wrapping your mattress in plastic. In case you have a second person that has to use your sick room (hopefully the first one has survived), you can change the top plastic sheet and not contaminate the bed.

Rock – at 18:44

I was wondering if granular pool chlorine can be used in a pinch to create a disinfection solution for clothing. I was thinking I could use my pool chlorine to fill buckets for contaminated clothing and keep the bleach for true disinfecting. Any ideas.

Melanie – at 18:46

Rock,

Ask your manufacturer. There should be an 800 number on the containers.

Rock – at 18:55

Oops, found the CDC link for making bleach solution from pool chlorine . Thanks Melanie.

I’m-workin’-on-it – at 21:03

I have a Gaterade/Pedialyte type question…..if someone is dehydrated, how much do you think they need to drink beyond the usual 8 glasses a day (I know that’s in debate too)? In other words how do I know I have enough? I don’t have kids so can someone tell me if Pedialyte tastes OK on it’s own?

09 May 2006

anon_22 – at 19:55

The best guide to rehydration beyond 8 glasses a day is uring output. A previously healthy person who is passing moderate amounts of urine (and not in dark colors) every 5–6 hours should be adequately rehydrated.

Melanie – at 20:01

To add to anon_22′s comment, a previously healthy person who has diarrhea or been throwing up for a couple of days is going to need to force fluids and will need electrolytes. A healthy person who is exercising/exerting hard and losing fluids in sweat and exhalations will need an additional couple of glasses a day.

I’m-workin’-on-it – at 20:24

Thanks to both of you….my husband & I are rarely sick other than sinus issues. And I’ve never had flu of any kind, so this stuff is really worrisome to me not to know when one of us is really really really sick that it’s just the regular flu & not the bird flu. And not knowing the subtlties of dehydration, when someone doesn’t want to drink anything anyway, just seems impossible.

Rock – at 21:07

Birdie - I am not sure recycling air purifers would be a good idea in a sick room. You would be stirring up virus in the air until it gets sucked into the filter. More chance of getting into mucas membranes of the carer through eyes and around mask. I think if you could vent the exhaust, then you’d be OK. However, why not just get an exhaust fan as long as the exhaust air goes out to an unpopulated area and not your neighbor’s window. The best bet is to create a negative airflow from other parts of the house to the sickroom and then outside. If the exhaust is in the proximity of other entrances or windows of your home or a neighbors, it would be better to treat the exhaust with a hepa filter so reduce the spread of infection. I have alsoread somewhere on this site that the HEPA filter in the sickroom would have a significant viral load and become dangerous to handle correctly. SO only do so if necessary. I know that some hospital rooms have a in ceiling HEPA air filter and UV system to prevent the risk of spread of pathegens, but I think the air is vented to the outside. I do think that a good hepa filter may be what you need in the comman areas of the home so that any unwanted viruses, molds and other allegens (e.g. shedding human skin from not bathing as often and being indoors a lot) would be reduced.

10 May 2006

PFWAG – at 02:05

More sickroom items:

Sharp’s Plasmacluster Ions Effectively Deactivates H5N1 Avian Influenza Virus http://tinyurl.com/phvb6 http://tinyurl.com/pyhno

and a nebulizer to use with sub-nano particle size colloidal silver.

31 May 2006

adoor – at 01:29

I thought I saw a sick room prep illustration somewhere on fluwikie, but for life of me, I can not find it now. Any links? Also, does anyone have any idea where to buy iv starter kits and fluids, etc for sick room?

lauraB – at 06:43

If you are buying oral rehydrators, only buy a small bit first and do a taste test for your family. My kids HATE Pedialyte but will drink Gerbers. Gerbers now has a non-flavored one as well which would be easy to mix into a favorite beverage to encourage drinking. But a few toddler sippie cups that can be kept in bed without making a mess and make it easier for a very ill person to drink. Also, medicine droppers for meds and larger ones for liquids.

Ocean2 – at 06:58

Anon 22 Thanks hugely for the disinfection schedule and all other contributions from everyone else. One question arises based on what I read in CanandaSue’s scenario. Is it really necessary to inhale a weak bleach solution as part of disinfection routine when one comes in from outside? Could the other mentioned alternatives to bleach, Virkon or citric acid, be a better alternative? Inhaling bleach seems so extreme. We (2 people) live in a small flat so separation of carer/sick one is not possible. Since many in our city are friends or relatives of people in Indonesia we expect panflu to hit hard here. At the first suspiction of flu we will go SIP because our options are limited. But we have practiced many times as if it (TSHTF) really has hit so we are learning what to do and what not to do. I realize how important it is to practice again and again and to check and re-check everything. My brand new water containers leaked- every one of them!

Kim – at 07:20

Ocean2 at 06:58, INHALING a bleach solution?!?!?!? No, no, no, NO!!! Unless you’d like to burn your throat and lungs… NO WAY should you do this!

Ocean2 – at 07:56

Kim, my thought also! I just haven’t read anything here to the contrary so I wondered… Thankfully, from anon_22 and others I’ve now learned much more. I’m a newbie and non-medical, the fluwiki got me started with prepping. Thank goodness I don’t have a job because prepping and planning for even 2 people is time consuming. I try to read as many threads as I can plus other items on the sidebar but it’s a lot! Thany you all and may you all be well!

anon_22 – at 07:59

“it really necessary to inhale a weak bleach solution as part of disinfection routine when one comes in from outside?”

No, and it is actually dangerous. Nor do you need to inhale virkon, or anything else.

If you have virus anywhere on your mucous membrane (nose, pharynx, lungs) then the virus is IN your body already. You will need to depend on you immune responses to get rid of them.

Kim – at 08:48

If worried about “disinfecting” (which is not really possible, but this MAY help), you can buy sterile saline nasal spray for a couple bucks at any drugstore and snuff some of that up your nose. The saline will help to wash out any “bugs” lurking there. It really helps for any nasal stuffiness too. Be sure to buy a separate bottle for each family member and write their name on it with a Sharpie marker, so you’re not cross-contaminating everybody.

lauraB – at 16:02

I was just at Wallyworld and their brand (President’s Choice?) has a non-flavored oral-rehydrator. You can find it in the baby section.

01 June 2006

Rock – at 00:36

I had always heard that dry mucus membranes are an easier place for viruses to attach to. This would mean that the care giver should stay hydrated while caring for sick. Kim, it seems to me that you may actually be washing the virus further up the nasal passage, are you sure this works?

Adoor – at 01:15

Does anyone know where the illusrated sick room info is located on this site? Also, where is everyone getting IV fluids and kits?

I’m-workin’-on-it – at 07:37

Adoor, you might check some of the pet/veteraniarian sites, but you might have to have a prescription for that stuff, I just really don’t know — I’d assume though that you couldn’t just stroll into Wallgreen’s & order some up from behind the counter….let us know when you find out.

SCW AZ – at 11:45

anon_22 – at 09:55 08 March 2006

I agree 100% on negative pressure, if at all possible. You need nothing more than a box fan in a window, with the air being forced OUT of the sick room.

PFWAG – at 02:05 10 May 2006 Nebulizer’s are a spread virus. . . Thinking of SARS in Toronto

corrientempe – at 12:02

As far as nasal protection goes, I and my family swear by the Zicam nasal swabs. Its an homeopathic remedy, but using the swabs right when first feeling sick really DOES shorten normal colds and flus. I use them myself when one of the kids come down ill, just as a prophylactic (sp?). I have several packages of Zicam swabs and nasal spray as part of my medical prep kit.

Any thoughts on this?

Np1 – at 12:08

corrientempe – at 12:02 Yes, do you have any real evidence that it is effective? Double blind studies, controlled, ect? I have no doubt that you believe it works for you. I also doubt that it has been tested with H5N1. Kelly

corrientempe – at 12:20

I’m not a medical professional, and Zicam is a zinc-based homeopathic remedy - in other words, not considered any better than taking vitamins if you know what I mean. But, IMHO I and my family will never get access to vacines or tamiflu, and by the time TSHTF there will not be a doctor or hospital to go to. Therefore, based on my own experience and results within my family (BTW my dad who is a retired MD recommended the Zicam to us, he and mom use it religiously to reduce the effects of colds and flu.)

I agree with you, I doubt anyone has thought to do controlled testing with H5N1, much less studies required by the FDA, again, this product is in a non-prescription category.

corrientempe – at 12:32

Also, I apologize if I’ve done something wrong here on the forum by mentioning a product by name, but I don’t know of any other maker of the zinc-based gel. I’m in no way connected to the brand or company that makes Zicam.

04 June 2006

I’m-workin’-on-it – at 10:38

That’s good info corrientempe, I’m gonna get me some! ANYthing that can help reduce symptoms or even shorten the time spent sick will be a wonderful thing to have.

Watch Dog – at 11:14

I bought one of there air filters. It runs on 150 watts at its highest setting and I will have enough energy to run it if there is no power.

Will this help me? Was it a good purchase? How can I best use it?

AllerAir 4000 Exec UV Air Purifier Air Purifier Type: Air Purifier - Filtering Technology: UVThe AllerAir 4000 Exec UV Air Purifier adds special UV filtration to its filter functioning to sterilize air-borne antigens and pathogens. The AllerAir 4000 Exec UV Air Purifier covers 1200 square feet and features anti-microbial, HEPA and MAC-B filtration. Extra protection with UV filtration means much cleaner air. For those with the most severe sensitivities in a medium-sized room, the AllerAir 4000 Exec UV Air Purifier is a great choice. The AllerAir 4000 Exec UV Air Purifier has a 1200 square foot coverage area and acts to eliminate large and microscopic particles, gases, odors, anti-microbial, antigens and pathogens. The filter compound is anti-microbial, UV lamp, HEPA, MAC-B mass activated carbon filter and the 4000 Exec UV offers multi-stage filtration. With a CFM (cubic feet per minute) rate of 400, the AllerAir 4000 Exec UV Air Purifier is a floor model. The AllerAir 4000 Exec UV Air Purifier features 2 air changes per hour, a cleanable prefilter and an anti-microbial filter for disease carrying micro-bacteria. The MAC-B filter provides military-strength protection. Choose from 4 attractive color options. The 4000 Exec UV’s UV lamp sterilizes bacteria and viruses for extra protection.

anon_22 – at 11:29

Watch Dog,

why don’t you re-write your post and ask specifc questions? eg which one did you buy? How do you intend to use it, in what size room etc?

:-)

CAVU – at 11:38

Along those same lines, can anyone recommend a good UVC light sterilizer for physical objects like mail and packages? I see lots of UVC air purifiers but haven’t had much luck locating a sterilizer. Thanks

Urdar-Norge – at 11:47

for UV-C to be strong enough to purify, it will also be harmfull for eyes and skin. Care must be taken to avoid this. Look in akvarium /waterfilters resellers for UV-C bulbs and equpment. Wath out for hoax products and disco type blacklight/ bill fraude UV-checkers like pruducts that is claiming to kill viruses, they dont.. UV_ need special glass, buildin your own system you may ude the bulb alone, or with those special glass tubes used in wet sytems.

It there is a shadow, the virus will survive, so packages etc will only be desinfected on the visible surface..

Urdar-Norge – at 11:53

Hot fan ovens is claimed to be used as air purifiers in a rom (not like a filter, but to constantly sirculating air, and then kill virues with heat. in a sick room) I read this in a guide made by an Australian., the link is somehere in the wiki.. cant find it anymore.. care must be taken to not overheat the pasient, and it is dependent of el..

LMWatBullRunat 12:01

As someone who has dedalt with particulate contamination in semiconductor facilities and infectious organisms in healthcare environments, I have a couple of points to make-

- Postive pressurization in the clean area and negative pressue in the “hot area” are essential. This means that the sick room shoudl have an exhaust fan direct to the outdoors, preferably through a HEPA filter to strip out contaminants. The clean area should have a fan pushing clean outside air into the room. It’s common sense, but be careful the exhaust and the incoming air streams do not cross.

-If the power is off, positive air flow can be maintained relatively easily with the Kearney Air Pump; there are directions on the OISM website. link here http://www.oism.org/

LMWatBullRunat 12:04

It’s in the book “nuclear war survival skills” Ch 6. KAPs are easy to build.

anonymous – at 12:47

LMWatBullRun at 12:01

Your link above goes to the home page of an organization that calls itself “the Oregon Institute of Science and Medicine” not to any air pump directions. This organization is also engaged in denying that increased atmospheric concentrations have anything to do with global warming.

Quoting them: (“A review of the research literature concerning the environmental consequences of increased levels of atmospheric carbon dioxide leads to the conclusion that increases during the 20th Century have produced no deleterious effects upon global weather, climate, or temperature.”)

I don’t want to get into politics here but that position is pure poppycock and I would be extremely skeptical about any purportedly scientific explanation.

anon_22 – at 12:55

LMWatBullRun

“the sick room shoudl have an exhaust fan direct to the outdoors, preferably through a HEPA filter to strip out contaminants. The clean area should have a fan pushing clean outside air into the room.”

It is my understanding that you only need one (very powerful) fan to extract air outwards, as long as you carefully seal the room so that the opening available for air to enter eg under the door, is on the other side of the patient from the exhaust fan, and significantly smaller than the volume of airflow.

To test this, make sure your door has a spring mechanism which is just strong enough to close it automatically if you leave it ajar, then turning the fan on should keep the door slightly open unless someone goes to close it.

It works even better if you have 2 such sets of doors, which would reduce the risk of air outflow through them as people enter or leave. You must make sure that one door is properly shut before opening the other.

This is of course a very crude way of doing it, so please correct me if this is going to cause major problems or if it can be improved.

05 June 2006

Ceredwin – at 04:55

Here is a link to a CDC site on dealing with SARS at home, thought it pretty good summary: http://tinyurl.com/pz6ja

And from CDC, here is a good illustration of a sick room originally for hemorraghic fevers: http://tinyurl.com/qsvts

In fact their whole download on this topic, infection control, isolation, supply checklists, protective clothing and so forth is excellent. It’s on the above link.

I’m-workin’-on-it – at 07:38

Ceredwin,

Thanks for the great downloads!

Watch Dog – at 10:29

anon_22 – at 11:29

“why don’t you re-write your post and ask specifc questions?”

I thought I did ask specific questions:

Will this help me? Was it a good purchase? How can I best use it?

Anon_22, would you own one of these? and if so, how would you use it during a pandemic or sick room situation?

08 July 2006

anon_22 – at 13:23

Watch Dog,

Sorry, this thread kinda disappeared down the list of threads so I didn’t see it till now!

Yes, it looks good. The most important component is the HEPA filter. I don’t know how much more useful is the addition of UV.

But, in case of H5N1 infections, anyone changing filters are at high risk so use maximum infection control for that!

Could the risk be reduced? Maybe. If you have a humidifier of bleach solution, and run it in a small room/cupboard with this on at the same time, there may be some virucidal effect, although I don’t know whether that would damage the machine in any way. In any case, even if you do this, just assume the material may still be contaminated or the function of the remaining filters may be affected, so it may be a good idea to replace ALL the filters in one go.

09 July 2006

fredness – at 02:42

In May Adoor asked for an illustrated example. I posted a link to one earlier in the thread.

http://www.cdc.gov/ncidod/dvrd/spb/mnpages/vhfmanual.htm I have found this “Infection Control for Viral Haemorrhagic Fevers” manual to be a great help in setting up a sick room. Download the chapters you like. Section 3 and annex 3 are essential.

I also did make the the first part of this thread into a wiki page http://www.fluwikie.com/pmwiki.php?n=Consequences.SickRoom

prepmaniac – at 07:42

I am planning to use a room with a door to the balconey -upstairs- and a fire escape. I am going to put all soiled items in plastic garbage bags -black- while in room and leave on the balcony in the sun. I am hoping that the heat of the sun and time spent on balcony would make it safer to handle. I don’t know how long the bag would have to sit to render it safe. I will wait at least a week, then put it in water with bleach to keep any live virus from becoming airborn before I bring it into the house through the garage, into the laundry room.

anon_22 – at 07:48

fredness,

Thank you for posting the “Infection Control for Viral Haemorrhagic Fevers” manual. It is very useful as you say and a lot of my posts were ideas taken from that.

prepmaniac,

May I suggest that you keep a covered bucket of bleach on the balcony and dump everything in that straight away. Then you can fish the stuff out whenever you want and they will be safe for handling.

anonymous – at 14:19
Orlandopreppie – at 14:37

I have two plans in mind. For a sickroom I think the master bedroom with it’s owm bathroom. Bathroom does have a door to back yard, and two indows in an east facing wall. I will exhaust air out one window and use bathroom door for entry, exit through “airlock” system.

For entrance into house I plan on using garage. I am still planning. Looking to make three different staged room for entry from outside world (if that happens). First room, remove first layer of gloves, shoe covers and mask, apply lotion to outside of second gloves. Second room remove second gloves and clothing. Third room, put on bathrobe and enter house. To exit house, will go into bathrobe room, and prepare to leave with clean supplies, exit through side garage door.

Does that sound okay? Want to use 1×2′s screwed to ceiling, and plastic sheeting for walls. Will use overlapping plastic for doors, and offset them from room to room.

anonymous – at 15:58

once in the house→ → straight to showers

prepmaniac – at 16:15

anon_22-at 07:48

I just got back. I left as soon as I made my last post. I thought about my plan the whole time I was gone. You are right. That makes a lot more sense. The virus might like a nice dark, moist place to live. The bucket with bleach on the balcony sounds like the way to go to me.

Anita RN pulm nurse – at 18:08

Orlandoprepie Looking to make three different staged room for entry from outside world (if that happens). First room, remove first layer of gloves, shoe covers and mask, apply lotion to outside of second gloves. Second room remove second gloves and clothing. Third room, put on bathrobe and enter house. To exit house, will go into bathrobe room, and prepare to leave with clean supplies, exit through side garage door.

Does that sound okay? Want to use 1×2′s screwed to ceiling, and plastic sheeting for walls. Will use overlapping plastic for doors, and offset them from room to room.

A few thoughts - eye protection ? - mask must be removed last in order Shall upload some protocols from Sars times, soon Regards Anita http://avianflu-personal-protection.blogspot.com/

Orlandopreppie – at 18:50

Thank you Anita, it would be greatly appreciated.

Grandma – at 18:52

Finally got a paper from our county health department today in our newspaper. It is yellow with black lettering. They say to wear surgical masks and disposable gloves when coming in contact with or cleaning up body fluids. Also give plenty of liquids to prevent dehydration and reduce fever. In large letters DO NOT GIVE ASPIRIN TO ANYONE YOUNGER THAN 20. Also What you can do to prepare Does not give a time frame to prepare for. They also explain what Bird Flu is On the back of the paper it tells you wash hands cover mouth keep social distance and work from home if you can. Last but not least All the websites health department in our area, red cross , pandemicflu.gov and state of Illinois website. I am very happey that this was in the paper.

11 July 2006

CAMikeat 01:11

bump for BB.

Hurricane Alley RN – at 02:13

bump

lauraB – at 06:13

Question for you all - either dh or I may have to go out at some point, either for supplies, or dh may have to work, etc. He/me would then have to isolate for seeral days to make sure we’re not infected. We have an isolated guest room (top floor or house with no other rooms on same floor) with it’s own bathroom which we plan to make the sick/isolation room. The only problem is that to get to it you have to walk through the house and go up the one and only stair case. I was thinking that if the person stripped down outside, washed as best possible (winter in NE could make this tough) and donned a mask while walking upstairs, then waited a long time (but how long???) this would be okay? I remember in Barry’s books that one of the ships they tried to seperate the men, but they’d walk through the same hallways going for chow and they all got infected anyway.

Thoughts?

prepmaniac – at 06:31

I would rather enter the window from a sturdy ladder than try to shower outside. brrrrr

lauraB – at 19:20

prep - like I said, a shower may not be manageable. But a ladder isn’t an option either - 3rd floor! plus if it’s winter then there is likely ice and snow on the ground making a ladder even more dangerous. Wish we had a beter handle on just how contagious this thing will be.

anon_22 – at 19:35

lauraB,

What you are describing is what a lot of HCW went through during SARS in Hong Kong. Since they all lived in apartments, some of them got really creative, pretty much just short of stripping in the public foyer!

Generally, if you make sure that the hallway and staircase are well ventilated, and everyone else is behind closed doors in their rooms, the risk of transmission from someone just walking through the area is not high. If you add all that stripping/washing and wearing a mask, that’s probably going to be pretty good prevention. It is definitely safer than trying to use a ladder to a 3rd floor window!

No matter what you do, there’s always going to be some risk. So its always a matter of balancing risk of transmission vs risk of some other catastrophe!

lauraB – at 19:42

Thanks anon-22. I was thinking that whowever was in the house would have to go to the furthest point away for a few hours. It’s the main staircase (okay only - we don’t have a mansion or anything) but it’s wide open and plenty of ventilation. SIP is our plan of choice but clearly we needs Plans B, C D and E as well.

BTW - I appreciated your post (yesterday?) to someone about what really happened in Hong Kong with SARS. I knew it was a mess there, but I din’t realize how bad it was realtive to the number of infections and deaths. Rather sobering given what could happen with H5N1.

MAV in Colorado – at 22:22

climb inside a very large clear bag, seal it up, poke your feet out and off you go…..up the stairs

Dude – at 22:43

Have an outdoor camping shower with bleach solution in it for when you come back. Wear plastic rain gear, swimmers goggles, mask, double gloves, rubber boots and have a brush handy for reaching your back. I will have three setup with varying strength of solutions…one shower remove, second shower, remove, towel and in the house.

12 July 2006

lauraB – at 06:19

Thnaks Dude - forgot about the bleach part. My only problem is winter! The garage is “warmer” than outside but still very, very cold plus the water is well water so it will be freezing cold too, if it’s even running through the garden hose. The other adult in teh house could warm water up, but then you risk getting that person exposed while getting the water to the possibly sick one.

We need those giant film wrappers they use at the airport to just shrink wrap a person!

prepmaniac – at 07:27

Would it do any good for the person reentering the house to have a large can of Lysol or maybe even alcohol to “cover his or her tracks” —spray stairs, banisters, even into the air behind them as they go upthe stairs.

13 July 2006

Hurricane Alley RN – at 00:30

bump

CAMikeat 01:32

bump

Hurricane Alley RN – at 01:34

bump

16 July 2006

Dr. C – at 06:38

Important to remember, if a someone you’ve been living with gets sick with BF, you will have been exposed for days already when they were shedding virus and asymptomatic.

katherine – at 13:58

MAV in Colorado – at 22:22

“climb inside a very large clear bag, seal it up, poke your feet out and off you go…..up the stairs”

If this isn’t the funniest image ever. oh my god, can this be put on the fluwikie t-shirt. I will be thinking of this image and chuckleing all day while I pack to move.

18 July 2006

QekLMhSUKgat 13:08

18 September 2006

Closed - Bronco Bill – at 00:06

Closed to maintain Forum speed.

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