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Occupational safety instructions for doctors and nurses when working in a first-aid post. Full document

Occupational Safety and Health / Standard instructions for labor protection

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Safe Operation

1. General requirements for labor protection

1.1. Employees who have undergone a preventive medical examination in accordance with the established procedure and instructions on labor protection are allowed to work in the first-aid post.

1.2. Employees must comply with internal labor regulations and established work and rest schedules.

1.3. When working in an office, you may be exposed to the following dangerous and harmful factors:

• electric shock due to faulty electrical equipment of the office;
• poisoning with microparticles and mercury vapor when breaking a thermometer;
• infection with infectious diseases in case of contact with sick pupils.

1.4. Pupils must:

• while in the office during class and during recess, comply with the rules of conduct provided for by the charter;
• observe fire safety rules in the office;
• be careful when using a medical thermometer;
• The victim or eyewitness to the accident must immediately report each accident to the doctor, duty administrator, and director.

1.5. Pupils are prohibited from:

• bring piercing, cutting, flammable objects into the medical office;
• touch medical devices and other items;
• run without the teacher's permission, open windows, transoms;
• push each other;
• throw things at each other.

1.6. The doctor and nurse should:

• when working in the office, follow fire safety rules, know the location of primary fire extinguishing equipment;
• ensure the stability of the furniture in the office;
• report any problems to the administration;
• to ventilate the office;
• ensure sanitization of medical equipment in accordance with the requirements of SanPin 2.4.2.1178-02 (see paragraphs 1.8 - 1.11 of these Instructions);
• exclude unsuitable equipment from use; the equipment used must have appropriate state certificates;
• organize registration and isolation of sick schoolchildren, conduct examinations of those in contact;
• use special clothing and protective equipment to prevent the possibility of infection;
• wash hands with soap before starting work;
• conduct a survey of children before professional vaccinations;
• ensure proper storage of medications: medications must be stored in a specially designated place inaccessible to children in a locked cabinet;
• in case of an accident, immediately provide first aid and report the incident to the administration; if necessary, ensure transportation of the victim to the nearest medical facility;
• know the evacuation routes for students in the event of a fire or other emergency.

1.7. Medical staff are prohibited from:

• leave students unattended in the classroom;
• leave medications unattended;
• place heavy objects on loose cabinets;
• put flowers on cabinets;
• leave electrical appliances on;
• use untested equipment;
• close the office door with a key while people are in the office.

1.8. The purpose of routine disinfection is to create a safe, clean environment for students and staff, destroy and minimize most pathogens on the surface of non-living objects, and reduce the risk of cross-contamination. For processing, it is necessary to have disinfectant/washing solutions, cleaning equipment, processing must be carried out 1-2 times a day, using disinfectants - at least 1 time a day, and it is necessary to have protective clothing for personnel.

1.9. Health care workers are required to ensure strict compliance with the following procedure for routine cleaning of premises by technical staff:

• wear protective clothing;
• With a clean rag soaked in a disinfectant chemical cleaning composition, wipe the surfaces of window sills, furniture, equipment, appliances and then the floor;
• wipe the floors using the "two buckets" method;
• moisten cleaning rags in a disinfectant solution and wash untreated floor surfaces;
• rinse the rags in water, wring out;
• moisten again in a disinfectant solution and wash the untreated floor surfaces;
• change the disinfectant solution taking into account consumption rates, and change the water as it gets dirty;
• After disinfection, disinfect cleaning equipment, rinse, dry the rags and store in a special cabinet or designated place;
• turn on bactericidal lamps;
• ventilate the room.

1.10. The purpose of general cleaning of the premises is to minimize the number of pathogenic particles after a complete cleaning of the first aid station, reducing the risk of cross-contamination. The frequency of cleaning is once a week.

1.11. Health care workers are required to ensure strict compliance with the following procedure for general cleaning of premises by technical staff:

• wear protective clothing;
• carry out preliminary cleaning of the premises using detergent solutions;
• wipe the floors using the "two buckets" method;
• carry out disinfection with a clean rag, generously moistened with a disinfectant chemical cleaning composition, wipe the surfaces of window sills, furniture, equipment, appliances and then the floor (irrigation from spray equipment is possible);
• wipe the surfaces with a sterile cloth;
• turn on bactericidal irradiators with ultraviolet light;
• ventilate the room;
• After disinfection, disinfect cleaning equipment, rinse, dry the rags and store in a special cabinet or designated place.

1.12. Health workers who fail to comply with or violate labor safety instructions are held accountable, and all medical personnel are given unscheduled instruction on labor safety.

2. General requirements for labor protection

2.1. The doctor and nurse must:

• undergo an occupational safety briefing at the medical center;
• ventilate the room before starting work;
• prepare the workplace for work;
• wear overalls, comfortable shoes;
• Turn on all the lighting in the office and make sure the lamps are working properly. The minimum illumination in the office should be at least 300 lux (20 W/sq. m) with fluorescent lamps and at least 150 lux (48 W/sq. m) with incandescent lamps;
• make sure that the electrical equipment in the office is in good working order: the lamps must be securely suspended from the ceiling and have light-diffusing fittings; switching boxes must be covered with lids; housings and covers of switches and sockets should not have cracks, chips, or exposed contacts;
• make sure that the furniture in the office is properly arranged;
• make sure that the technical means are in good working order;
• check the sanitary condition of the office, ensure the integrity of the glass in the windows and carry out through ventilation of the office;
• make sure that the air temperature in the office is between 21-23°C;
• check the stability and condition of the furniture;
• wash your hands with soap.

2.2. Doctors and nurses are prohibited from:

• leave unattended pupils in the classroom and during breaks;
• leave medicines, medical devices, equipment unattended;
• put any items on cabinets;
• in order to ensure adequate natural light in the office, it is not allowed to place flowers on the windowsills;
• allow the operation of unstable cabinets and other equipment; immediately take corrective action.

2.3. Pupils are obliged to: comply with labor protection requirements and rules for pupils in the first-aid post.

2.4. Pupils are prohibited from:

• touch devices and medicines without the permission of a doctor;
• touch sockets and other electrical appliances;
• violate the requirements of the doctor on labor protection in the first-aid post;
• run without a doctor’s permission, open windows, transoms; push each other; throw various objects at each other;
• violate the order of placement of furniture in the office.

3. Labor protection requirements during work

3.1. Pupils are required to:

• comply with the requirements of the medical staff and the rules of conduct in the first-aid post;
• During procedures and treatment, carefully follow the requirements of the doctor and nurse.

3.2. Pupils are prohibited from:

• be in the office in the absence of a doctor;
• touch medical equipment or medications without a doctor’s permission;
• independently turn on electrical appliances;
• to avoid falling from the window, as well as injury from glass, stand on the windowsill;
• make sudden movements to avoid injury;
• open transoms, windows without the permission of a doctor.

3.3. Medical staff must:

• ensure the safe use of equipment in the office;
• ensure stable discipline of pupils in the office;
• organize registration and isolation of sick schoolchildren, conduct examinations of those in contact;
• conduct a survey of children before professional vaccinations;
• ensure proper storage of medications: medications must be stored in a specially designated place inaccessible to children in a locked cabinet;
• comply with sanitary and hygienic requirements for ventilation and temperature conditions;
• comply with office lighting standards;
• When working with technical equipment, comply with all rules of their operation and labor protection;
• keep the glass clean: the glass of windows and lamps in the office should be cleaned of dust and dirt at least twice a year. It is prohibited to involve pupils in this work;
• ensure safe operation of transoms: when opening windows, fix the frames in the open position with a special mechanism. When opening transoms, there must be limiters;
• constantly use protective clothing and protective equipment (masks, rubber gloves) in case of possible contact with blood and other biological fluids or infected surfaces and objects.

3.4. Medical personnel are prohibited from:

• leave pupils unattended;
• use faulty equipment.

4. Labor protection requirements in emergency situations

4.1. Pupils are required to:

• if you feel unwell, inform the doctor about it;
• If you receive an injury, immediately inform the doctor, who is obliged to provide first aid and report the incident to the administration.

4.2. The doctor must:

• If a student receives an injury, report the incident to the administration and, if necessary, send the victim to the nearest medical facility, accompanied by an adult;
• in case of contamination of surfaces with blood and other biological fluids, contact with the skin and mucous membranes, act in accordance with the instructions to prevent possible infection: you must immediately remove gloves, treat the skin with a swab moistened with 70% alcohol, wash with soap and water and wipe with a napkin, re-treat with 70% alcohol. If blood gets on the mucous membranes, treat them with a 0,05% solution of potassium permanganate;
• in case of injury from used instruments, it is necessary to immediately squeeze out the blood, treat the wound with iodine, undergo a timely anonymous laboratory examination, obtain advice from an infectious disease specialist and/or carry out the necessary preventive measures;
• if surfaces are contaminated with blood or other biological fluids, treat them with disinfectants;
• know the ways to evacuate students from the premises in the event of a fire danger or other natural disaster;
• if danger arises, immediately evacuate students from the office, observing the evacuation rules;
• if a fire occurs, immediately evacuate students from the building, report the fire to the administration of the institution and the nearest fire department;
• if the heating system breaks, remove students from the room, call a plumber and inform the administration about it;
• If a thermometer is broken, poisoning with mercury vapor may occur. Staying in a room where mercury is spilled is unacceptable. In this case, it is necessary to immediately remove everyone from the room, open the windows wide, close the door with a key and seal it;
• it is necessary to immediately report the incident to the administration and security personnel, and urgently call a special unit through the civil defense headquarters to collect mercury and denaturalize the premises. Mercury is collected using various devices. Its smallest particles are collected using a special film, then demercurization is carried out - chemical neutralization of microparticles. If, after demercurization, the chemical analyzer detects even slight residues of mercury vapor, it is necessary to continue ventilating the room until they completely disappear.

Poisoning with microparticles or mercury vapor is observed after 8 hours, sometimes after 24 hours and is expressed in general weakness, headache, and fever. Later, gum disease appears and abdominal pain occurs. In case of acute poisoning through the mouth, immediately rinse the stomach with a solution of activated carbon (20-30 g per glass of water), then drink milk and then a laxative.

4.3. Medical personnel are prohibited from:

• enter a room with spilled mercury without respiratory and skin protection. To do this, you can use special respirators, suits made of rubberized fabric;
• collect mercury yourself.

5. Labor protection requirements at the end of work

5.1. Pupils are obliged to calmly, without touching or pushing each other, leave the room.

5.2. Medical staff must: