Alcohol-based Information and Courses from MediaLab, Inc.

Procedural Step Comment Caution Greet and positively identify patient Always use at least two patient identifiers to ensure positive patient identification. Never rely on name placards that are placed on or near the patient's bed or crib to identify the patient. If there is a discrepancy in identification, do not proceed until the discrepancy is resolved. Explain the procedure If the patient is a small child, be at eye level when explaining the procedure. Also explain the procedure to the parent(s). If the patient is aware of what will be happening there is less chance of the patient suddenly jerking away his/her hand when the puncture occurs. Position patient appropriately An outpatient who is a small child should sit on the parent's lap. If necessary, seek assistance for finger puncture if the patient is a small child. Cleanse hands and put on gloves Use soap and water or alcohol-based gel to cleanse hands. Cleanse hands before donning gloves and after removing gloves. Warm puncture site if needed Use the method that is approved by the laboratory for prewarming the puncture site. Never use a moist cloth that has been heated in a microwave as this may cause injury to the patient. Gather appropriate equipment Only have needed equipment at hand. Keep track of ALL equipment to prevent patient injury. Cleanse the puncture site Use 70% isopropanol unless the patient is sensitive to alcohol. Allow the site to air dry. Performing the puncture before the alcohol has dried may hemolyze the blood specimen. Securely grasp and puncture finger Puncture the side edge of the fleshy pad of fingertip. Avoid extreme side and tip of finger. Discard puncture device into appropriate container Puncture device should be discarded into a sharps container that is puncture-proof, has rigid sides, and has a lid Do not discard puncture devices into regular trash or biohazard bags. Injury to personnel who handle these bags may occur. Wipe away the first drop of blood Use slight pressure to facilitate blood flow. The first drop of blood contains tissure fluid that may contaminate or dilute the blood specimen and affect test results. Collect blood into container Allow blood to flow freely into the collection device. Tap the container gently on a hard surface to move blood further down into the tube if necessary. Do not "milk" the finger or scrape the collection device across the finger to obtain specimen; both actions may cause the specimen to hemolyze. Mix specimen immediately upon completion of the collection. Apply pressure to the puncture site to stop the bleeding. Use gauze to apply pressure to the puncture site. It is not advisable to apply an adhesive bandage over the skin puncture site if the child is less than two years old as the child may place the bandage in his/her mouth. Label specimen Specimen must be labeled in the presence of the patient. Unlabeled specimens will be rejected by the laboratory.

C. difficile spores resist dessication for months and are known to persist on hard surfaces for up to five months. Spores persist even after exposure to air. Epidemic strain B1/NAP1/027 is known to hyper-sporulate, a virulence-associated characteristic of outbreak strains. Health care workers are important vectors for transmission, as they may carry the spores on their hands or clothing. Alcohol-based hand sanitizers are very effective against non-sporulating organisms but do not kill C. difficile spores or remove the organism from the hands. The CDC recommends thorough hand washing using soap and water for caregivers and family members alike.Patients with C. difficile infection (CDI) should be isolated to a single room with a bathroom or cohorted (roomed) together. Staff treating infected patients should use personal protective equipment (PPE), including at least gowns and gloves, and must wash hands after removing gloves. The use of gowns helps to prevent contamination of clothing. Surfaces should be decontaminated using a solution of 10% sodium hypochlorite (bleach), this is effective in reducing environmental contamination in hospital rooms. The CDC recommends the use of bleach for cleaning patient and staff rooms during outbreaks. Control strategies involving reinforcement of Infection control practices rather than drug restriction are more effective. These practices include:Proper education of staff members involved in care of CDI patientsBetter isolation compliance Use of glovesFrequent and thorough hand washingEnvironmental decontamination

In addition to vaccination against the influenza A 2009 H1N1 virus, the CDC recommends the following preventive measures to prevent person-to-person spread of infection during the influenza season. Wash hands often with soap and water for 15-20 seconds or cleanse hands with an alcohol-based hand sanitizer.Avoid touching mucous membranes such as the nose, mouth, and eyes.Stay home if you have a fever and flu-like illness until 24 hours after the fever has resolved.Avoid close contact with sick individuals.Avoid large crowds during an epidemic.

Eosin is a rose-colored fluorescent dye that is created through the action of bromine on fluorescein. Although it is not the only dye used to stain the cytoplasm of cells, it is the most common. It can be used in either an aqueous or alcoholic solution. The strength of the solution varies, but generally a 0.5% to 2% solution is used. Some advantages of using alcohol-based eosin formulations over aqueous are that they: React in a more stable manner chemically. Minimize, if not eliminate entirely, the unpredictable effects of various impurities such as water-soluble salts that, in water, may interfere with dye uptake. Tend to stain more slowly than water-based formulations, resulting in a wider range of shades.