Medical Asepsis - Al-Manara College of Medical Sciences PDF

‫وزارة اﻟﺘﻌﻠ ﻢ اﻟﻌﺎﻟﻲ واﻟ ﺤﺚ اﻟﻌﻠﻤﻲ‬ ‫"‬ ‫ﺗﻘﻨ ﺎت اﻻﺷﻌﺔ واﻟﺴﻮﻧﺎر‬ ‫اﻟﻤﺮﺣﻠ ـ ـ ـ ـ ـ ـ ـ ـ ـ...

‫وزارة اﻟﺘﻌﻠ ﻢ اﻟﻌﺎﻟﻲ واﻟ ﺤﺚ اﻟﻌﻠﻤﻲ‬ ‫"‬ ‫ﺗﻘﻨ ﺎت اﻻﺷﻌﺔ واﻟﺴﻮﻧﺎر‬ ‫اﻟﻤﺮﺣﻠ ـ ـ ـ ـ ـ ـ ـ ـ ـ ـﺔ اﻷوﻟﻰ ‪ :‬اﻟ ﻮرس اﻟﺜﺎﻧ ـ ـ ـ ـ ـ ـ ـﻲ‬ ‫ﺗﺮﺟﻤـ ـ ـ ـ ـ ـ ـ ــﺔ اﻟﺘﻤ ﺾ اﻟﻨﻀﺮي اﻟﻤﺤﺎﺿﺮة ‪1‬‬ ‫‪Academic Nurse Specialis‬‬ ‫ﺍﻟﺘﻘﻨــﻲ ‪ :‬ﻣﺮﺗﻀﻰ ﻧﻌﻤـــــﻪ‬ Introduction ‫ﻣﻘﺪﻣﺔ‬ Nurses are directly involved in providing a biologically safe environment..‫ﺸﺎرك اﻟﻤﻤﺮﺿﺎت ﺸ ﻞ ﻣ ﺎﺷﺮ ﻓﻲ ﺗﻮﻓﻴﺮ ﺑ ﺌﺔ آﻣﻨﺔ ﺑﻴﻮﻟﻮﺟ ﺎ‬ Microorganisms exist everywhere: in water, in soil, and on body surfaces such as the skin, intestinal tract, and other areas open to the outside (e.g., mouth, upper respiratory tract, vagina, and lower urinary tract). ،‫ واﻷﻣﻌﺎء‬،‫ وﻋﻠﻰ أﺳﻄﺢ اﻟﺠﺴﻢ ﻣﺜﻞ اﻟﺠﻠﺪ‬، ‫ ﻓﻲ اﻟﺘﺮ ﺔ‬،‫ ﻓﻲ اﻟﻤﺎء‬: ‫ﺗﻮﺟﺪ اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ ﻓﻲ ﻞ ﻣ ﺎن‬.(‫ واﻟﻤﺴﺎﻟﻚ اﻟﺒﻮﻟ ﺔ اﻟﺴﻔﻠ ﺔ‬،‫ واﻟﻤﻬ ﻞ‬،‫ واﻟﺠﻬﺎز اﻟﺘﻨﻔﺴﻲ اﻟﻌﻠﻮي‬،‫واﻟﻤﻨﺎﻃﻖ اﻷﺧﺮى اﻟﻤﻔﺘﻮﺣﺔ إﻟﻰ اﻟﺨﺎرج )ﻣﺜﻞ اﻟﻔﻢ‬ Infection : is the growth of microorganisms in body tissue where they are not usually found..‫ ﻫﻲ ﻧﻤﻮ اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ ﻓﻲ أ ﺴﺠﺔ اﻟﺠﺴﻢ ﺣ ﺚ ﻻ ﺗﻮﺟﺪ ﻋﺎدة‬: ‫اﻟﻌﺪوى‬ * Microorganism is called an infectious agent. ‫* ﺴﻤﻰ اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ ﺎﻟﻌﺎﻣﻞ اﻟﻤﻌﺪي‬ The infectious agent can be transmitted to an individual by direct or indirect contact or as an airborne infection; the resulting condition is called a communicable disease. ‫ﻤﻜﻦ أن ﻳ ﺘﻘﻞ اﻟﻌﺎﻣﻞ اﻟﻤﻌﺪي إﻟﻰ ﻓﺮد ﻋﻦ ﻃ ﻖ اﻻﺗﺼﺎل اﻟﻤ ﺎﺷﺮ أو ﻏﻴﺮ اﻟﻤ ﺎﺷﺮ أو ﻋﻦ ﻃ ﻖ اﻟﻌﺪوى اﻟﻤﺤﻤﻮﻟﺔ‬.‫ﺟﻮا؛ و ﺴﻤﻰ اﻟﺤﺎﻟﺔ اﻟﻨﺎﺗﺠﺔ ﻤﺮض ﻣﻌﺪ‬ Pathogenicity : is the ability to produce disease; thus, a pathogen is a microorganism that causes disease..‫ ﻫﻲ اﻟﻘﺪرة ﻋﻠﻰ إﺣﺪاث اﻟﻤﺮض ؛ و ﺎﻟﺘﺎﻟﻲ ﻓﺈن اﻟﻌﺎﻣﻞ اﻟﻤﻤﺮض ﻫﻮ ﺎﺋﻦ ﺣﻲ دﻗﻴﻖ ﺴ ﺐ اﻟﻤﺮض‬: ‫اﻹﻣﺮاﺿ ﺔ‬ Asepsis : is the freedom from disease-causing microorganisms. To decrease the possibility of transferring microorganisms from one place to another. ‫ ﻟﺘﻘﻠ ﻞ إﻣ ﺎﻧ ﺔ ﻧﻘﻞ اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ ﻣﻦ‬.‫ ﻫﻮ اﻟﺘﺤﺮر ﻣﻦ اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ اﻟﻤﺴ ﺔ ﻟﻸﻣﺮاض‬: ‫اﻟﻌﻘﺎﻣﺔ‬.‫ﻣ ﺎن إﻟﻰ آﺧﺮ‬ The Spread of Infectious Disease ‫اﻧ ﺸﺎر اﻷﻣﺮاض اﻟﻤﻌﺪ ﺔ‬ An infection is defined as the successful transmission of pathogenic microorganisms, such as bacteria, viruses, parasites or fungi that are spread : ‫ ﻣﺜﻞ اﻟ ﻜﺘﻴﺮ ﺎ أو اﻟﻔﻴﺮوﺳﺎت‬،‫ﻳﺘﻢ ﺗﻌ ﻒ اﻟﻌﺪوى ﻋﻠﻰ أﻧﻬﺎ اﻟﻨﻘﻞ اﻟﻨﺎﺟﺢ ﻟﻠ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ اﻟﻤﺴ ﺔ ﻟﻸﻣﺮاض‬ : ‫أو اﻟﻄﻔ ﻠ ﺎت أو اﻟﻔﻄ ﺎت اﻟﺘﻲ ﺗﻨ ﺸﺮ‬ Directly : ‫ﻣ ﺎﺷﺮة‬  From person to person..‫ﻣﻦ ﺷﺨﺺ ﻵﺧﺮ‬  Through respiratory droplets (i.e. coughing or sneezing) or body fluids..‫ﻋﻦ ﻃ ﻖ اﻟﺮذاذ اﻟﺘﻨﻔﺴﻲ )أي اﻟﺴﻌﺎل أو اﻟﻌﻄﺲ( أو ﺳﻮاﺋﻞ اﻟﺠﺴﻢ‬  Direct exposure to infectious agent in environment ‫اﻟﺘﻌﺮض اﻟﻤ ﺎﺷﺮ ﻟﻠﻌﻮاﻣﻞ اﻟﻤﻌﺪ ﺔ ﻓﻲ اﻟﺒ ﺌﺔ‬  During childbirth from mother to foetus (transplacental/perinatal) (‫أﺛﻨﺎء اﻟﻮﻻدة ﻣﻦ اﻷم إﻟﻰ اﻟﺠﻨﻴﻦ )ﻋﺒﺮ اﻟﻤﺸ ﻤﺔ اﻟﻔﺘﺮة اﻟﻤﺤ ﻄﺔ ﺎﻟﻮﻻدة‬ Indirectly : ‫ﺸ ﻞ ﻏﻴﺮ ﻣ ﺎﺷﺮ‬  Biological - Vector or Intermediate host (eg. Zika Virus) (‫ اﻟﻨﺎﻗﻞ أو اﻟﻤﻀ ﻒ اﻟﻮﺳ ﻂ )ﻣﺜﻞ ﻓﻴﺮوس ز ﺎ‬- ‫ﺑﻴﻮﻟﻮﺟﻲ‬  Mechanical - Vector or Vehicle (eg. Plague - transmission of Yersinia pestis by fleas) (‫ اﻧﺘﻘﺎل ﻳﺮﺳ ﻨ ﺎ ﺑ ﺴﺘ ﺲ ﻋﻦ ﻃ ﻖ اﻟﺒﺮاﻏ ﺚ‬- ‫ ﻧﺎﻗﻞ أو ﻣﺮﻛ ﺔ )ﻋﻠﻰ ﺳ ﻞ اﻟﻤﺜﺎل اﻟﻄﺎﻋﻮن‬- ‫ﻣ ﺎﻧ ﻜ ﺔ‬  Airborne (eg. Tuberculosis) (‫ اﻟﻤﺤﻤﻮﻟﺔ ﺟﻮا )ﻣﺜﻞ اﻟﺴﻞ‬  The two basic types of asepsis : : ‫اﻟﻨﻮﻋﺎن اﻷﺳﺎﺳ ﺎن ﻣﻦ اﻟﻌﻘﺎﻣﺔ‬ 1 - Medical asepsis : ‫اﻟﺘﻌﻘ ﻢ اﻟﻄﺒﻲ‬ includes all practices intended to confine a specific microorganism to a specific area, limiting the number, growth, and transmission of microorganisms. ‫ ﻣﻤﺎ ﺤﺪ ﻣﻦ ﻋﺪد اﻟ ﺎﺋﻨﺎت‬،‫ﺸﻤﻞ ﺟﻤﻴﻊ اﻟﻤﻤﺎرﺳﺎت اﻟﺘﻲ ﺗﻬﺪف إﻟﻰ ﺣﺼﺮ ﺎﺋﻦ ﺣﻲ دﻗﻴﻖ ﻣﻌﻴﻦ ﻓﻲ ﻣﻨﻄﻘﺔ ﻣﻌﻴﻨﺔ‬.‫اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ وﻧﻤﻮﻫﺎ واﻧﺘﻘﺎﻟﻬﺎ‬ In medical asepsis, objects are referred to as clean, which means the absence of almost all microorganisms, or dirty (soiled, contaminated), which means likely to have microorganisms, some of which may be capable of causing infection. ،‫ ﻣﻤﺎ ﻌﻨﻲ ﻋﺪم وﺟﻮد ﺟﻤﻴﻊ اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ ﺗﻘ ﺎ‬،‫ ﺸﺎر إﻟﻰ اﻷﺷ ﺎء ﻋﻠﻰ أﻧﻬﺎ ﻧﻈ ﻔﺔ‬،‫ﻓﻲ اﻟﻌﻘ ﻢ اﻟﻄﺒﻲ‬ ‫ و ﻌﻀﻬﺎ ﻗﺪ ﻜﻮن ﻗﺎدرا‬،‫ ﻣﻤﺎ ﻌﻨﻲ أﻧﻪ ﻣﻦ اﻟﻤﺤﺘﻤﻞ أن ﺗﺤﺘﻮي ﻋﻠﻰ ﺎﺋﻨﺎت دﻗ ﻘﺔ‬،(‫ ﻣﻠﻮﺛﺔ‬،‫أو ﻣ ﺴﺨﺔ )ﻣ ﺴﺨﺔ‬.‫ﻋﻠﻰ اﻟ ﺴ ﺐ ﻓﻲ اﻟﻌﺪوى‬ 2 - Surgical asepsis, or sterile technique : ‫ أو اﻟﺘﻘﻨ ﺔ اﻟﻤﻌﻘﻤﺔ‬،‫اﻟﻌﻘﺎﻣﺔ اﻟﺠﺮاﺣ ﺔ‬ refers to those practices that keep an area or object free of all microorganisms, it includes practices that destroy all microorganisms and spores (microscopic dormant structures formed by some pathogens that are very hardy and often survive common cleaning techniques). Surgical asepsis is used for all procedures involving the sterile areas of the body. ‫ و ﺸﻤﻞ‬،‫ﺸﻴﺮ إﻟﻰ ﺗﻠﻚ اﻟﻤﻤﺎرﺳﺎت اﻟﺘﻲ ﺗﺤﺎﻓﻆ ﻋﻠﻰ ﻣﻨﻄﻘﺔ أو ﺟﺴﻢ ﺧﺎﻟﻲ ﻣﻦ ﺟﻤﻴﻊ اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ‬ ‫اﻟﻤﻤﺎرﺳﺎت اﻟﺘﻲ ﺗﺪﻣﺮ ﺟﻤﻴﻊ اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ واﻟﺠﺮاﺛ ﻢ )اﻟﻬ ﺎ ﻞ اﻟﻨﺎﺋﻤﺔ اﻟﻤﺠﻬ ﺔ اﻟﺘﻲ ﺗﺘﻜﻮن ﻣﻦ ﻌﺾ‬ ‫ ﻳﺘﻢ اﺳﺘﺨﺪام اﻟﻌﻘﺎﻣﺔ‬.(‫ﻣﺴ ﺎت اﻷﻣﺮاض اﻟﺘﻲ ﺗﻜﻮن ﺷﺪ ﺪة اﻟﺼﻼ ﺔ وﻏﺎﻟ ﺎ ﻣﺎ ﺗﻨﺠﻮ ﻣﻦ ﺗﻘﻨ ﺎت اﻟﺘﻨﻈ ﻒ اﻟﺸﺎﺋﻌﺔ‬.‫اﻟﺠﺮاﺣ ﺔ ﻟﺠﻤﻴﻊ اﻹﺟﺮاءات اﻟﺘﻲ ﺗﻨﻄﻮي ﻋﻠﻰ اﻟﻤﻨﺎﻃﻖ اﻟﻤﻌﻘﻤﺔ ﻣﻦ اﻟﺠﺴﻢ‬  Types of Microorganisms that Cause Infections : ‫أﻧﻮاع اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ اﻟﻤﺴ ﺔ ﻟﻠﻌﺪوى‬ Four major categories of microorganisms cause infection in humans : :‫أر ــﻊ ﻓﺌﺎت رﺋ ﺴ ﺔ ﻣﻦ اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ ﺴ ﺐ اﻟﻌﺪوى ﻟﺪى اﻟ ﺸﺮ‬ 1_ Bacteria : there are two types: ‫ ﻫﻨﺎك ﻧﻮﻋﺎن‬: ‫اﻟ ﻜﺘﻴﺮ ﺎ‬ A - Commensal bacteria: Found as normal flora of healthy humans. These have a significant protective role by preventing colonization of pathogenic microorganisms..‫ ﺗﻮﺟﺪ ﻋﻠﻰ ﺷ ﻞ ﻧ ﺎﺗﺎت ﻃﺒ ﻌ ﺔ ﻟﺪى اﻟ ﺸﺮ اﻷﺻﺤﺎء‬: ‫اﻟ ﻜﺘﻴﺮ ﺎ اﻟﻤﺘﻌﺎ ﺸﺔ‬.‫ﻫﺬە ﻟﻬﺎ دور وﻗﺎﺋﻲ ﻛﺒﻴﺮ ﻋﻦ ﻃ ﻖ ﻣﻨﻊ اﺳﺘﻌﻤﺎر اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ اﻟﻤﺴ ﺔ ﻟﻸﻣﺮاض‬ B- Pathogenic bacteria : have greater virulence, and cause infections. ،‫ ﻟﻬﺎ ﻓﻮﻋﺔ أ ﺒﺮ‬:‫ اﻟ ﻜﺘﻴﺮ ﺎ اﻟﻤﺴ ﺔ ﻟﻸﻣﺮاض‬.‫ و ﺴ ﺐ اﻻﻟﺘﻬﺎ ﺎت‬،‫ ﻟﻬﺎ ﻓﻮﻋﺔ أ ﺒﺮ‬: ‫اﻟ ﻜﺘﻴﺮ ﺎ اﻟﻤﺴ ﺔ ﻟﻸﻣﺮاض‬.‫و ﺴ ﺐ اﻻﻟﺘﻬﺎ ﺎت‬ 2- Viruses : such as hepatitis B, C viruses and HIV, influenza viruses..‫ وﻓﻴﺮوﺳﺎت اﻷﻧﻔﻠﻮﻧﺰا‬،‫ وﻓﻴﺮوس ﻧﻘﺺ اﻟﻤﻨﺎﻋﺔ اﻟ ﺸﺮ ﺔ‬،C‫ و‬،B ‫ ﻣﺜﻞ ﻓﻴﺮوﺳﺎت اﻟﺘﻬﺎب اﻟ ﺪ‬: ‫اﻟﻔﻴﺮوﺳﺎت‬ 3- Fungi: include yeasts and molds. ‫ و ﺸﻤﻞ اﻟﺨﻤﺎﺋﺮ واﻟﻌﻔﻦ‬: ‫اﻟﻔﻄ ﺎت‬ 4- Parasites: include protozoa. ‫ و ﺸﻤﻞ اﻷوﻟ ﺎت‬: ‫اﻟﻄﻔ ﻠ ﺎت‬ Types of Infections : ‫أﻧﻮاع اﻟﻌﺪوى‬ 1- Local infection : It is limited to the specific part of the body where the microorganisms remain..‫ و ﻘﺘﺼﺮ ﻋﻠﻰ اﻟﺠﺰء اﻟﻤﺤﺪد ﻣﻦ اﻟﺠﺴﻢ ﺣ ﺚ ﺗ ﻘﻰ اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ‬: ‫اﻟﻌﺪوى اﻟﻤﺤﻠ ﺔ‬ 2- Systemic infection : The microorganisms spread and damage different parts of the body ‫ ﺗﻨ ﺸﺮ اﻟ ﺎﺋﻨﺎت اﻟﺤ ﺔ اﻟﺪﻗ ﻘﺔ وﺗﻠﺤﻖ اﻟﻀﺮر ﺄﺟﺰاء ﻣﺨﺘﻠﻔﺔ ﻣﻦ اﻟﺠﺴﻢ‬: ‫اﻟﻌﺪوى اﻟﺠﻬﺎز ﺔ‬ 3- Acute and chronic infections ‫اﻻﻟﺘﻬﺎ ﺎت اﻟﺤﺎدة واﻟﻤﺰﻣﻨﺔ‬ Acute infections generally appear suddenly or last a short time. A chronic infection may occur slowly, over a very long period, and last months or years.‫ﺗﻈﻬﺮ اﻻﻟﺘﻬﺎ ﺎت اﻟﺤﺎدة ﺸ ﻞ ﻋﺎم ﻓﺠﺄة أو ﺴﺘﻤﺮ ﻟﻔﺘﺮة ﻗﺼﻴﺮة‬ ‫ و ﺴﺘﻤﺮ ﻷﺷﻬﺮ أو ﺳﻨﻮات‬،‫ ﻋﻠﻰ ﻣﺪى ﻓﺘﺮة ﻃ ﻠﺔ ﺟﺪا‬،‫ﻗﺪ ﺗﺤﺪث اﻟﻌﺪوى اﻟﻤﺰﻣﻨﺔ ﺑ ﻂء‬