Dos

• Healthcare givers, medical personnel and professionals should take more precautions to reduce the risk of getting infected by Swine Flu, as these groups are in close physical proximity of the sick.
• These groups should take the following precautions:
  • Separate febrile patients from other patients, and young from the old, at the entry to the clinic.
  • To avoid crowding – entry and exit should be separate. Examine patients by appointment only and suggest follow up of improved health status on phone. Circulate printed instructions to avoid confusion, misunderstanding and to reduce patients stay in clinic.
  • Remove non essential furniture from clinic. Includes newspapers, magazines, soft toys etc.
  • Restrict use of equipments that re-circulate air. Maintain good ventilation.
  • Offer surgical masks, tissue papers, hand sanitizers and receptacles / waste bins with foot operating system for their disposal.
  • Use N95 masks or a 4 layered mask made of handkerchiefs while examining patients. Also use spectacles / goggles and knee length aprons to avoid contamination of clothing. Cotton masks should be cautioned after washing and drying.
  • Auscultate the patient from back or request him to turn his head to opposite side, hold your breath while examining throat of patient.
  • Wash hands thoroughly with soap and water for 30 seconds or use alcohol based sanitizer or disinfectant after examining each patient.
  • Equipment such as stethoscopes, BP apparatus, Tongue depressors, Thermometers, etc should be cleaned and disinfected regularly.
  • Clean clinic with detergent and warm water at least twice a day. Frequently touched surfaces like table tops, door handles, etc must be cleaned at least four times a day.
  • Bathe or shower after going home and wash/ laundry clothes separately.
  • Healthcare personnel with pre-existing medical conditions should take extra care.
  • Use of ZED Kit is compulsory. After scrubbing apron, goggles, shoe covers, caps, masks and gloves should be put on in that order
  • Medical procedures generating aerosols like Suction, Intubation, Manual ventilation, Bronchoscopy, Cardio Pulmonary resuscitation should be conducted with maximum precautions.
  • Virus excretion of Immuno-compromised patients continues up to one month, extra care at follow up checkups is required.
  • All ICU staff should take Tamiflu tablet once a day for 10 days.
• Healthcare professionals play an important part in creating awareness about any disease, more so for hitherto commonly unknown ones like Swine Flu. These professionals, apart from being medical care givers, must also carry out their social responsibilities in creating a sound and literate environment to tackle the menace of Swine Flu.

Don’ts

• Healthcare personnel with chronic health issues should not work in close proximity of Swine Flu patients.
• Healthcare personnel with chronic health issues should not work in ICUs.
• Medical staff and healthcare personnel should not work in long shifts and should not work for more than 10 days at a time.
• Healthcare personnel must not indulge in unauthorized medical advice to and activities concerning Swine Flu patients as also they should not contribute to unnecessary spread of panic or false information, especially while expressing views and opinions to the media.

Acknowledgements: WebMD.com, Data & information released by WHO / US CDC, IMA – Pune chapter, MOHFW – India website