*Isolation Rooms, Flu, Soap And Cleaners*
By: By Entropy
11 November 2007

Isolation rooms
An isolation room is going to be extremely important if someone in your household comes down with pandemic flu. These precautions could be used but not as needed for the yearly flu. The yearly flu does kill thousands of North Americans every year, but it targets the young, the old and immune compromised persons. These precautions could be used in part to protect the household from the yearly flu and to easy the pain of the flu patient.

As you know pandemic flu is much more deadly then the seasonal flu, those that get sick will need isolated from the rest of the household. If someone has symptoms of the flu they need to be isolated immediately. The whole household (who ever has had contact with the flu patient in the pervious 2-5 days) needs to be isolated from everyone out side of the home, A person should also stay in isolation for 7 days after they are “better”, (as symptom subside) that room needs to be cleaned well while the recovering person stays in it they could still be shedding (sharing) the virus. You can spread the normal flu for 2 days before you feel sick and up to 5 days after you are on the mend. Pandemic flu might be contagious for a longer period before and after symptoms start/subside.

Once one person is sick, there is a good chance that everyone has been exposed to the flu, and many will also fall ill. There is not much that can be done at that point except isolating the flu patient, and cleaning the house well. It is likely that hospitals will be filled with the sick and dying and over flow beds in school gyms and armouries will be used to house the ill. Being at home might be that best place for those who are sick, if you are able to care for them. Once a pandemic start the safest plan is to not be exposed to the virus. But short of living in a biosecure bunker with 1-2 years worth of supplies, all you can do is greatly limit your exposure with isolation from the public, PPE, and good hygiene.

An isolation room can be created in any room in the house, or heated area outside the home. There are some ideal locations/features if your house permits. Having a natural anti room off the isolation room that has a sink is ideal, but without that an artificial anteroom can be created. (More on anterooms later) An “in room” bathroom is also idea for the sick person. Other features are highly desirable: a window that opens, patio door, and negative pressure.

The flu patient should not stay in their normal bedroom, especially if it is shared with others; this should be left for the caregiver. There are more items in most bedrooms that would need cleaned afterwards if it was used for an isolation room.

To create an isolation room within a room you’ll need some common items found at any hardware store. Plastic sheets the thicker the better (enough to cover an area to isolate a number of sick patients in beds or cots), duct tape, staple gun and staples.

Take the plastic from floor to ceiling and tape or staple to the roof. You may have to staple the plastic to a light piece of wood and nail it to the ceiling to support the weight of the plastic wall. You don’t need to put plastic over the existing walls, but it would help in the clean up. You need to leave any windows or doors leading outside the house uncovered to allow intermittent airflow to the room. You do not need to seal off this room, but you do not want large gaps or holes. Taping the plastic to the ceiling and floor is a good idea, (but if you are using a negative pressure unit then you’ll need an air hole in the plastic wall).

Over lap the plastic at the exit of the isolation room by at least one foot, the door to the isolation room will lead to the anteroom, the door leaving the anteroom to the rest of the house must be over lapped the same.

The anteroom is the room you leave the isolation room too, this is where you take off your PPE (personal protection equipment), and wash before leaving. This is also where you will double bag your dirty bags of garbage or your laundry before transporting them through the house.

If you need to make an anteroom you will do so the same as the isolation room with the plastic walls, just smaller, but big enough to fit your needs inside it. If you can exit the isolation room to a bathroom or room with a sink that is ideal, but that room must be isolated from the rest of the house by a door, or plastic curtain.

Once a flu patient is in this room, nothing comes out of that room without being cleaned. Any person leaving that room must remove all isolation clothing in the anteroom, and take of their mask, wash hands, or at least use an alcohol gel sanitizer until they can go to the sink to wash.

All reusable PPE items will be sprayed and wiped down in the anteroom after leaving the isolation room; any equipment needing washed is placed in a plastic bag in the anteroom. The out side of that plastic bag should be sprayed down with a disinfectant spray before leaving the anteroom, and then put inside a clean plastic bag outside of the anteroom to be transported to the cleaning area. This is called double bagging. All items need to be washed in a 10-20% bleach solution

Dirty laundry from the isolation room needs to be placed in a plastic bag inside the anteroom, the outside of that bag sprayed down and then doubled bagged (placed in a clean bag set up outside of the anteroom). All plastic bags are dirty once they are opened and items removed, throw them out.

When going into the isolation room, you will put on PPE (person protection equipment) in the anteroom. This at minimum should be an eye protection, N95 mask (N100 or P100 are better), gown and gloves. Disposable is best, but more expensive. Head cover, face shield, and shoe covers are ideal. You’ll only wear these once before they are washed or thrown out. If using reusable glasses, face shield, or mask they need to be washed (not the mask) after each use. The mask, if taken off and placed on a clean surface, face side up, can be reused if needed, but don’t touch the outside or inside of the mask. The surface needs to be clean before the mask is placed on it and after it is removed. The outside of a mask is always considered dirty. Only every touch the outside of the mask with one hand and place the straps over your head with the other hand. Wash your hands with at least alcohol after touching the outside of the mask.

Take everything you’ll need with you when going in, because to exit you need to take everything off and wash, then start all over again. Once inside the isolation room get as much done as possible for the patient, you don’t want to be going in and out too often. Gather all things going out, and keep them in a manageable size to carry out and be bagged for exit from the anteroom


Example of isolation room and anteroom use:

After completely tasks inside the isolation room, dressed in a gown, mask, hair cover, eye cover, face shield, foot cover and gloves. I would use an alcohol gel on hands inside the isolation room; I would have all the items ready to be taken out of the isolation room waiting at the exit. I would exit carefully as to not contaminate the anteroom more then necessary. I would drop all items into a plastic bag. If space and equipment were readily available, I would have one hamper for clothing, one for equipment to be washed (both lined with a clean plastic bag), and one for garbage.

Soiled laundry in one bag, it is not full so I would leave it for now. But the equipment like water jug for the humidifier needs washed, along with my bottle of re-hydration drink mix, some other equipment. They go into another plastic bag.

I would alcohol gel my gloves after touching the dirty equipment and the laundry is put in bag. Then I would remove my face shield and spray and wipe it down before placing it on table. Without touching my face I would remove the glasses and spray/wipe them down with 50/50 mix. I would remove my foot cover, my hair cover and then gown.

With gloves and mask on, I would take the bags ready to leave the anteroom, spray them off with either 50/50 mix, or Clorox aerosol spray. I would then drop the dirty/sprayed bag into a clean bag outside the anteroom, if you do not have that bag in a hamper/box a persons with gloves on, waiting outside the anteroom could be holding a clean bag to catch the dirty one.

I would then remove gloves then mask, alcohol my hands and leave. Carrying the clean bag to the room with a sink where that equipment would be cleansed.

Start by carefully open bags and placing the equipment in a 10-20% bleach solution for 5 minutes, and dispose of bags. Wash hands after touching dirty equipment/bags, then use alcohol gel. You do not want to place dirty equipment under running water until after they have soaked. Any virons on the equipment could become airborne with spray from the faucet. (Virons became airborne from a hose being used to clean out monkey cages contaminated with Ebola at a USAMRRID LEVEL 4 lab, spreading the virons to another room killing the controlled group of monkeys) kills the ‘bugs’ by soaking them in a solution then rinse with running water.


Negative pressure is when the air in the isolation room is being pulled out, filtered and blown outside (or into another room, only if it cannot be filtered outside and the filter is of high enough quality.)

A negative pressure filter system makes it so that every “bug” floating around and every inch of air in that isolation room is circulated and removed. This can be done with a little time and preparation, if you have neither of those; there are simpler but less effective substitutes. With negative pressure, you do not need to seal the room; the roof and floor gaps should be very minimal and can be sealed with tape. If you have a tight fit at the ceiling and floor, you will need a small ½ inch hole in one of the walls. (As per hospital negative pressure rooms) to pull air through the room and filtered it.

Fan in a can see This Article for a positive pressure/negative pressure home made unit

A standard room air cleaner unit that uses a HEPA filter (get a TRUE HEPA, not a “HEPA like” filter) can be used to clean/circulate the air in the isolation room. These units will remove some of the virons in the air. This may also keep a fresher smelling room. The room system requires the plastic walls to be sealed at the ceiling and floors and to existing walls for this and all following methods to work.

Fan blowing out a window is another option, but this requires an open window or at least a cracked one. A rectangular fan the fits into a partly open window would work well or a normal fan blowing towards the cracked window. This will circulate the air and keep room a little fresher.

Cracked window for at least part of the day is the minimal step that should be taken.


A HOT air Humidifier in the isolation room is important, it eases symptoms, and the hot air will kill some of the virons in the air. When refilling the unit, use a jug or bucket and bring the water into the room, don’t take the humidifier out. That jug will need to be sprayed down, double bagged and washed.

Vicks medication can be added to water if desired.


Washing:
After exiting the isolation room you must wash hands with soap and water if able in the anteroom, or use alcohol gel until you leave to wash hands in a sink. Anything skin that was exposed to the air. This includes hair if not covered

Before cooking or even touching the refrigerator door you must wash your hands. Wash before going to bed, a complete shower making sure to wash your neck, behind ears, hair and then the rest of your body. Using rubbing alcohol on your face and around mouth and nose is extreme, but may be somethihng to consider. The use of mouthwash with chlorhexidine or alcohol is a good idea

Chlorhexidine mouthwash info
http://www.pharmacy-online.ca/quick_search.jsp?criteria=CHLORHEXIDINE

COMMON BRAND NAMES: Oro-Clense, Peridex, Periogard, Perioselect

Using the soap (mentioned below) on a bath SCRUNCHY (ask your wife she’ll know what that is) works best, suds it up and clean. You can use this mix on your face, hair and body. I have had no skin problems, rashes etc from the use of this formula.

The alcohol may dry your skin, using skin moisturizing lotion throughout the day and before bed is a good idea. Also keeping well hydrated will help keep skin healthier.


Soap for the body – I have been using a home mixed soap for cleaning, I’ve tested this soap while at work, and at home to make sure the mix keeps well over time, so far no problems at all.

I take body wash gel soap; lever 2000 or dial gel, remove ¼ of the soap from the bottle and save for later use. Add part chlorhexidine 2% or 4%, and part 70% rubbing alcohol. Shake the mixture well now and before use.

Chlorhexidine can be found in drug stores as face soap, surgeon scrub, mouthwash, skin cleaner. It kills bugs and helps prevent their growth. It only works on non-soiled areas, so two washes with it works best.

Buy chlorhexidine here (one source, look for better deals!)
http://www.amazon.com/Chlorhexidine-Solution-gallon/dp/B00061MU9W

Hand washing using liquid soap; wash with cool to warm water, start by wetting hands and then applying soap. Rub it on hands using friction for at least 20 seconds after touching known contaminated areas, before food preparation, and anytime after touching your face, blowing nose or coughing. Make sure you wash between your fingers, fingertips and the edge and back of hands. Using a fingernail brush is not a bad idea. (This needs to be cleansed after each use) then rinse using the same rubbing motion under the water, keeping hands below your wrists/elbows so that water/soap dose not run down your arms. Do not put the water on high, you only need enough water to wash off the soap, you do not need a lot of splash. When rinsed, dry hands with disposable paper towel and use that paper towel to turn off faucet. After washing hands, alcohol gel is a good idea.

Alcohol gel of 70% or more is ideal, but at least 60% alcohol is needed in the gel cleanser. You’ll need a bottle inside the isolation room, in the anteroom, at the equipment-cleaning sink, and as many spots in your house as you can afford. When using the alcohol gel you need 1-2 pumps of it. Rubbing it over your hands making sure to get in between your fingers, your fingertips, and the sides and backs of your hands. Do not touch anything until the alcohol is dry on your hands. Rub continuously with friction until hands are dry.


Environmental cleaning—I’ve been using a mixture for cleaning I call 50/50 mix. It’s 50% Lysol solution, the common stuff you by in stores will be fine. I am aware that the concentration has extra ingredients for germ destructions but this mix is very effective. The other part of the mix is a 20% bleach solution. (To make 1 liter (4 cups) of 50/50 mix. 500 ml (2 cups) of Lysol. 400 ml of water, and 100 ml of bleach.)
This can be used on any hard surface for cleaning, keep that surface wet for at least 1 minute, 5 minutes would be ideal! It must be kept in a spray bottle, or in a sealed bottle to make sure the bleach does not evaporate and weaken the solution.
Use only bleach that is from an unopened bottle less then a year old or a bottle less then 6 months old and only if that bottle is kept with the lid on it while stored.

Bleach solutions for cleaning in an open sink or bucket are only good for a couple of hours, after that the bleach will evaporate and weaken the solution.

Lysol or Clorox wipes would be handy for quick cleans of door knobs and light switches through out the day, but again those surfaces need to be wet after the wipe down. Using 50/50 mix with a wipe is a good idea. Lysol or Clorox aerosol sprays are for easy spray downs and air freshening.

Virox 5 wipes or 1:16 solution is also a powerful cleaner. 2 cleanings of an area is a guaranteed “clean”. The concentrate 2 oz of Virox to 4 cups or 1 liter of water is the 1:16 concentrate.
By Entropy



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