of the mildest character. In severe cases the foot of the bed can be raised and morphin (V2 gr. to Jg gr., child of four years) administered hypodermically. The physician should be immediately notified. Perforation demands absolute quiet, morphin hypodermically, and the immediate notification of the physician. Tympanitic distention may be relieved by the careful passage of the rectal tube and the pain relieved by turpen- tine stupes. One of the dangers of protracted cases is bed-sores. These can generally be averted by careful attention to cleanliness, by thoroughly drying the patient after washing, by removing all traces of urine or other discharges, and by sponging the patient daily with alcohol or whiskey. TYPHOID FEVER 255 Above all, the position in bed should be changed frequently and all inequalities in the bed-clothes should be kept smoothed out, while the bed should be kept clear of crumbs and other particles of food. Should a sore appear, anti- septic dressings should be applied and the part relieved from pressure by an air-cushion.
Convalescence. — In no disease is watchfulness during convalescence more important. Relapses and the per- foration of an ulcer may occur during this period. The ulcers are not necessarily healed when the temperature reaches the normal. Therefore, absolute rest and a liquid diet should be kept up for at least ten days after the tem- perature has reached normal. The hair is very apt to fall out and, therefore, should be cut short. By no means is it necessary to shave the head.
Prophylaxis. — Since the contagion of typhoid fever re- sides solely in the stools and vomited matter it is impor- tant that these should be thoroughly and properly dis- infected, also that the linen which has been in the least degree soiled by them should be immediately removed and sterilized. Stools may be disinfected in the following manner: Place in the bed-pan, before using, a small quantity of car- bolic-acid solution, i to 20, or chlorinated lime of the same strength. Cover the evacuation with another quantity of the disinfectant, mix thoroughly, and empty the whole into the water-closet hopper. Then thoroughly rinse out the vessel with disinfectant solution and hot water. Linen may be immersed in carbolic acid, 1 to 20, until boiled. Boiling for half an hour disinfects it. After the bowels have been moved the buttocks and anus of the patient should be thoroughly washed with 1 to 256 DISEASES OF CHILDREN FOR NURSES 40 carbolic acid or bichlorid, 1 to 2000, followed by hot water and soap. Door-knobs or parts of the door touched with the soiled hands should be washed with the same disinfectants, since drying of the fecal matter causes it to disseminate and gives rise to a source of infection. The nurse should wash her own hands with soap and water and then rinse them in a solution of bichlorid. It is by soiled hands or floating bacteria from dried feces that nurses are infected. Where tub-bathing is employed, it is possible that the water of the bath that has been used several times may be a source of infection. The nurse should, therefore, wash her hands after tubbing a patient, and watchful care should be exercised not to carry them to the mouth during the bath.
After death or discharge of the patient the mattress, which should be well protected during use by a rubber sheet, should be thoroughly aired. The rubber sheet itself should be washed in carbolic acid, rinsed in cold water, and dried in the open air.<Callout type="tip" title="Pro Technique">Regularly changing the position of the patient can prevent bedsores.</Callout><Callout type="warning" title="Safety Hazard">Do not shave the head; cutting it short is sufficient to prevent hair loss during convalescence.</Callout><Callout type="important" title="Critical Rule">Proper disinfection of linens and surfaces is crucial to preventing the spread of typhoid fever.</Callout>
Key Takeaways
- Regularly change patient's position to prevent bedsores.
- Maintain strict hygiene and disinfection of linens and surfaces.
- Keep the patient on a liquid diet during convalescence.
Practical Tips
- Regularly clean and disinfect surfaces that may come into contact with fecal matter, such as door knobs and tubs.
- Use alcohol or whiskey to sponge patients daily to prevent bedsores.
- Monitor the patient closely for signs of relapse during convalescence.
Warnings & Risks
- Do not shave the head; cutting it short is sufficient to prevent hair loss during convalescence.
- Be cautious with tub bathing, as reused bath water may contain infectious material.
- Proper disinfection of linens and surfaces is crucial to preventing the spread of typhoid fever.
Modern Application
While many of the specific chemicals and practices mentioned in this chapter are outdated, the principles of hygiene and patient care remain relevant. Modern sanitation techniques have improved significantly, but the importance of proper handwashing and surface disinfection remains critical for preventing the spread of infectious diseases like typhoid fever.
Frequently Asked Questions
Q: How can bedsores be prevented in a patient with typhoid fever?
Bedsores can be prevented by regularly changing the position of the patient and smoothing out all inequalities in the bed-clothes. Additionally, keeping the bed clear of crumbs and other particles of food is important.
Q: What should be done to disinfect linens used by a typhoid fever patient?
Linens can be disinfected by immersing them in carbolic acid (1:20) until boiled. Boiling for half an hour is sufficient to sterilize the linen.
Q: How should the anus and buttocks of a typhoid fever patient be cleaned?
After bowel movements, the buttocks and anus should be thoroughly washed with carbolic acid (1:256) or bichlorid (1:2000), followed by hot water and soap to prevent contamination.