1.1. The teaching is intended for medical staff of medical institutions, schools, boarding schools, vocational schools, kindergartens, orphanages and other organized groups of adults and children, specialists of eligible organizations disinfection activities, employees public services (hotels, hostels, etc.).

1.2. Acute Respiratory Disease Syndrome (SARS) is a new mass contagious disease that mainly affects adults and often results in death. The source of the infection is a sick person. The disease is likely to be transmitted by airborne droplets and by means of household contact, and other means of spreading the infection are not excluded.

1.3. No etiological agent (SARS) has been definitively established. It is believed to belong to the group of coronaviruses. Regarding the resistance of human coronaviruses, the information available is limited. Coronaviruses are inactivated by agents from the group of oxidizing agents (chlorine and oxygen), alcohols, phenols and their derivatives, aldehydes, quaternary ammonium compounds. It is known that a 5% formaldehyde solution and 70% ethyl alcohol in 5 minutes inactivate the coronavirus and reduce its quantity by more than 15 thousand times.

1.4. When a case (SARS) occurs or is suspected, an anti-epidemic complex, including disinfection, and sanitary and hygienic measures are implemented, including:

1.5. Patients with atypical pneumonia of any age are subject to compulsory hospitalization in an infectious disease hospital in boxes (half-boxes) or, in exceptional cases, in separate and isolated departments.

1.6. The evacuation of patients is carried out by special medical transport, which is then subjected to compulsory disinfection in accordance with the recommendations set out in decrees N 916 of 03/04/83. "On approval of the sanitary and epidemiological regime and instructions for the protection of work the personnel of hospitals (departments) of infectious diseases" and N 100 of March 26, 1999 "On the improvement of the organization of emergency medical care for the population of the United States of America ".

2.1. In hospitals (departments) for infectious diseases, current and final disinfection is carried out in accordance with decree No. 916 of 03/04/83. "Upon approval of the instructions relating to the sanitary and epidemiological regime and to the protection of workers of infectious hospital staff (services)"

2.2. If a patient is diagnosed with "SARS" during an outpatient appointment in the office (box) and in other rooms where he was, after his isolation, a final disinfection is carried out by the staff The establishments. The means and methods of disinfection are indicated in the instructions for use of specific products recommended for disinfection in the event of viral infections (with the exception of the disinfection tools and methods used for influenza and other acute respiratory viral infections, parenteral viral hepatitis).

After admitting the patient, the staff disinfects their hands, changes their gown, hat, mask.

2.3. When a patient is identified with "SARS" in a medical establishment, he is placed in a box, a half-box or a room specially reserved for this purpose, a room in which the regime of the room infections is introduced at this time. It is strictly forbidden to place these patients in general services.

2.4. A hospital epidemiologist or an assistant chief medical officer for anti-epidemic work, or a specialist appointed on the orders of the chief medical officer, will organize disinfection measures. The doctor on duty is responsible for the correct and timely disinfection, appointed by order of the hospital's chief medical officer.

2.5. Routine disinfection is carried out by nurses under the supervision of a doctor or nurse throughout the patient's stay, final disinfection after recovery (death), as well as during reshaping of the service, service.

2.6. The patient receives individual dishes (dining room and tea), care articles, a thermometer, a container, a urinal.

2.7. To be disinfected: patient's dishes, door handles, interior surfaces, bedroom furniture, cupboards, window sills, headboards, bedside tables, toys and other objects.

2.8. The patient's dishes after each use, toys - once at the end of the day, they are immersed in a disinfectant solution (see paragraph 2.2).

2.9. Wet cleaning of rooms, cupboards and other rooms is carried out at least twice a day using disinfectants (see paragraph 2.2). The rooms are ventilated at least 4 times a day.

2.10. Medical personnel should wear 4-layer gauze respirators or masks to cover the mouth and nose. The masks change every 4 hours. To collect the masks, a bucket or tank with a lid is isolated. Disinfect them by immersion in a disinfectant solution or by boiling. Respirators and disposable masks are discarded after disinfection.

2.11. All types of patient care should be performed with disposable gloves (bedding, changing, feeding, etc.) or repeated use (for medical procedures). After each contact with the patient, the staff should wash their hands twice with warm water and soap, and if it is contaminated with sputum, saliva, etc., disinfect with a skin antiseptic in accordance with instructions.

2.12. The rooms must be well ventilated, as well as the air disinfected with bactericidal ultraviolet irradiators. They are installed in reception services and, if necessary, in hospital services, waiting rooms and medical offices, treatment rooms and polyclinic laboratories. The number of shielded bactericidal lamps required is calculated based on the volume of the room.

2.13. Indoor air disinfection is carried out in the absence of people between work or at the scheduled time.

Ultraviolet radiation created by bactericidal ultraviolet lamps acts on the mucous membrane of people's eyes, causing conjunctivitis, so when the lamps are on, they only allow a short-term presence in the room of people wearing glasses canned security.

2.14. To disinfect indoor air, as long as there is no one inside, you can use disinfectants designed to reduce microbial contamination suspended in aerosol cans.

3.1. Disinfection measures in the home.

3.1.1. Before the doctor arrives, the patient is isolated in a separate room (in exceptional cases, placed in a fenced part of it).

3.1.2. The local doctor, when diagnosed with SARS, will organize continuous disinfection during the epidemic before hospitalization.

3.1.3. The care of the patient is entrusted to one of the family members, preventing other people, especially children, from coming into contact with the patient and the objects intended for him (dishes, toys , new scarves, towels, etc.).d.).

The caregiver strictly follows the rules of personal hygiene and uses a four-layer gauze mask or a respirator.

3.1.4. The patient's room is ventilated at least 4 times a day and cleaned with water using a disinfectant detergent or disinfectant.

3.1.5. The patient receives separate dishes for eating, medicines, etc., an individual towel, bedding, handkerchiefs, etc.

3.1.6. The patient's dishes are cleaned of food debris, washed in hot water with a little degreaser (soda, mustard), then boiled in a 1% soda solution for 5 minutes from the time of 'boiling (with the exception of plastic utensils which do not resist boiling, which are immersed in a disinfectant solution).

Dry the dishes in an upright position, without wiping them with a towel.

3.1.7. To collect dirty laundry, a bucket, tank or other container with lid is allocated. Handkerchiefs, towels are immersed in a 1% sodium hydroxide solution or a solution of any detergent and boiled for 15 minutes from the time of boiling, then washed.

3.1.8. Patient care items and toys are thoroughly washed with a warm 1% sodium hydroxide solution or detergent solution, and then washed with warm water.

3.1.9. Used gauze masks are changed every 4 hours. The respirators change daily. They must be disinfected and disposed of in accordance with paragraph 2.9. of this manual.

3.1.10. After hospitalization, the patient undergoes a final disinfection in all the rooms where he was, using means according to the regimes recommended for the disinfection of viral infections (except the means of disinfection and diets used for influenza and other acute respiratory viral infections) parenteral viral hepatitis). Bedding, carpets, aisles, curtains, etc. are sent for disinfection of the room.

3.1.11. A person who takes care of a patient is subject to quarantine and medical supervision for at least 10 days from the date of hospitalization of the patient.

3.2. Disinfection activities at the hotel, inn and other facilities.

3.2.1. When recording a case of "SARS" in a hotel, hostel and other patient institutions, they are kept as far as possible in a separate room before the arrival of a medical worker , individual articles (eating utensils, towels, etc.), carry out the current disinfection with disinfectants. Regularly ventilate the room, disinfect the dishes and all objects with which the patient is in contact, as in paragraphs 3.1.4, 3.1.6 - 3.1.9 of this manual.

3.2.2. After hospitalization of the patient, in the premises where he was, they proceed to the final disinfection by specialists from the disinfection service. In the event of incomplete isolation of the premises, all common areas are subject to disinfection, and the premises nearby - according to epidemiological indications. Bedding: paths, carpet curtains, stuffed animals, books sent for disinfection of the room.

The personnel carry out all types of work using personal protective equipment. The respiratory organs are protected by a respirator or a 4-layer gauze mask, the hands with plastic or rubber gloves, clothes with a bathrobe, hair with a scarf or hat.

3.2.3. All people in contact with the patient are quarantined for at least 10 days. Disinfection with quarantine is carried out in volume and type of current using disinfectants.

4.1. The head of the preschool is responsible for implementing a set of hygienic and disinfection measures aimed at preventing and combating SARS in the children's team.

4.2. The doctor, the nurse gives instructions to the average medical staff, educators and other employees on the implementation of hygiene and disinfection measures, guaranteeing the completeness and appropriate quality of their conduct in the establishment.

4.3. In a children's establishment, in the group, the classroom, the office and the other rooms where the patient has been identified, a final disinfection is carried out.

4.5. In the rooms that the patient has visited, he performs preventive disinfection, which is done in the same way as continuous disinfection.

4.6. In the children's room, the thermometers are stored in a clean container with a lid completely immersed in a 0.5% solution of chloramine or other disinfectant recommended for this purpose. Before use, they are wiped with a gauze cloth. The disinfectant solution is changed daily.

4.7. The wooden spatulas after use are disinfected and eliminated; metal - disinfect.

4.8. During disinfection, special attention is paid to ventilating the rooms, preparing dishes, toys, play furniture, bedrooms, door handles, door leaves, window sills, headboards, bedside tables.

In public places (in bathrooms), water taps, buttons, keys and other flushing devices that children touch with their hands are perfectly disinfected.

4.9. Before washing dishes, staff wash their hands thoroughly with a specially designed soap and towel.

The tea utensils are washed separately from the dining room in two waters at a temperature of 50-60 ° C.

The dishes after mechanical removal of food residues, as well as spoons, forks, are washed at a temperature of 60 ° C with a little degreasing agent (mustard, baking soda, etc.), washed with water in a second container (sink) at a temperature of 60-70 ° C.

Washed dishes, forks, spoons are boiled for 5 minutes from the time of boiling. In the absence of boiling conditions, the dishes after washing are immersed in a disinfectant solution, so that the assembly is covered with a solution. In the presence of a disinfectant with detergent properties, dishes free of food debris are disinfected by immersing them completely in a disinfectant solution, then they are washed in this solution. After that, the dishes are washed with lukewarm water and dried in an upright position on special drying facilities, without wiping with a towel.

To disinfect dishes, tea utensils, spoons, forks and other items, an air sterilizer is also used in the following mode: temperature 160 ° C and exposure for 30 minutes. The washed dishes are placed in an upright position.

4.10. Tables, oilcloths for dining tables, plastic tablecloths are washed with a hot soapy solution or 2% soda after each meal with a clean boiled cloth.

In institutions for children, quarantine is introduced for a period equal to the incubation period from the moment of isolation of the patient (at least 10 days). Disinfection in quarantine is carried out according to the type and volume of disinfection in progress. The rooms are ventilated at least 4 times a day. To be disinfected: tea and kitchen utensils, cloths for washing it, tables, household linen, interior surfaces (floor, door leaves, door handles, window sills, headboards, bedside tables, etc.) , toys, playpens, sanitary equipment, sanitary, cleaning equipment.

4.11. For preventive disinfection, the toys (plastic, rubber) are washed with hot water and soap or in a 2% soda solution in special jars marked with a cloth or a clean brush: in a nursery group - 2 times a day (in the afternoon and at the end of the day) and in kindergarten groups - once at the end of the day.

During the current or final disinfection, they are irrigated from all sides from the control panel, or immersed in disinfectant solutions so that the toys do not float, for this they are crushed with something heavy.

After disinfecting each toy, the rags are rinsed in a disinfectant and the toys are washed under running water. Lint is excluded from use, disinfected (disinfection of the room) or destroyed (incineration).

4.12. Floors, walls and furniture are cleaned with rags and upholstered furniture is cleaned with brushes soaked in a disinfectant solution.

4.13. The attendants carefully monitor the cleanliness of their hands and the hands of children. Each time the hands are washed twice with warm water and soap. To wash your hands, soap is allocated to the staff (caregiver, nanny) and especially to children, each uses individual towels.

4.14. The nurse, the group nanny must wear two white coats a day, one of which is only worn to feed the children.

4.15. In the quarantined group (or filter-isolator), carpets, paths, plush are excluded from use. Children use individual dishes.

4.16. To disinfect the air during disinfection in the absence of children in the rooms, ultraviolet irradiators and means designed to reduce microbial contamination of the air can be used, packed in aerosol cans.

4.17. Staff must wear 4-layer gauze masks or respirators. The masks change after 4 hours, respirators - every day, after use, they are disinfected and eliminated. The masks and respirators are disinfected by immersion in a solution of one of the disinfectants.

5.1. Preventive disinfection is carried out in the absence of an identified source of infection. It is carried out as a planned event or according to sanitary-hygienic and epidemiological indications.

5.2. A programmed preventive disinfection is systematically carried out in order to maintain a minimum level of contamination by microorganisms of environmental objects in institutions, organizations, companies and installations in order to prevent the appearance of outbreaks of infectious diseases and to create favorable living conditions for the population.

5.3. Preventive disinfection of sanitary and hygienic indications is carried out in institutions, organizations, companies and installations under unsatisfactory sanitary and hygienic conditions, which are determined by specialists in sanitary and epidemiological surveillance of the State.

5.4. Preventive disinfection according to epidemiological indications is carried out to prevent the penetration and spread of SARS in groups of people in establishments, institutions, territories, etc., where this disease is not present, but there are a risk of introduction from the outside.

The need for preventive disinfection according to epidemiological indications is determined by the competent health inspection specialists (epidemiologists).

5.5. To carry out preventive disinfection, it is allowed to use only disinfectants that have succeeded in the prescribed manner: state registration in the United States of America and certification with a certificate of conformity in the GOST R. system Certificates on state registration, guidelines or labels for their use and guidelines for methods of controlling disinfectants for the content of active substances, approved held by the Ministry of Health of USA.

5.6. Preventive disinfection measures are implemented by organizations authorized to undertake disinfection activities, specially trained staff from day-care centers, service vehicles, etc.

The population can carry out this work in their apartments or houses without sanitary and epidemiological conclusions, but only with disinfectants approved for domestic use.

5.7. For prophylactic disinfection of objects, disinfectants with a virucidal effect must be used, as well as physical methods: ultraviolet radiation and high temperature (boiling, dry hot air, saturated water vapor).

Disinfectants are stored closed in a dry, cool and dark place, out of the reach of children.

The precautions for disinfection measures and first aid in case of accidental poisoning are defined for each specific disinfectant in the instructions for use.