Examination of the scalp during detection pediculosis – algorithm and time for re-examination of patients hospitals, children in school and kindergarten

Pediculosis is one of the most dangerous parasitic
invasions – lice carry pathogens, leading to
severe infectious diseases. These diseases include
tuberculosis, plague, Volyn fever, typhoid and tularemia. These
pathologies pose a threat to both children and adults.
Every year, 300,000 infections in medical
institutions. The number of patients increases by 25%
late spring and summer. To stop the rapid spread
lice, conduct regular checkups for lice.

Symptoms of Lice and Who Should Undergo Examination

The content of the article:

• Symptoms of Lice and Who Should Undergo Examination
• Identification of pediculosis and disinsection – detailed
  algorithm
• Necessary tools and means for inspection
• The term of re-examination of the patient after detection
  pediculosis

Head lice infect a healthy person for any
contact with the patient. In most cases, the transfer
The parasite occurs when hair or clothing comes into contact. More
infection through clothing and personal care products is rare:
towels, combs, brushes, bed linen. This is due to
the location of insect colonies on the scalp,
especially in the neck and temples.

If the parasites multiply rapidly, the hair begins
stick together from purulent exudate and serous fluid.
The latter come out of the sores, appearing on the place of the vinegar.
Some individuals may settle on the eyelashes and eyebrows, on the skin for
auricles, neck.

When infected with pediculosis, the following clinical
picture:

• nits (eggs), nymphs and
  adult lice;
• during the bite, the parasites inject a special enzyme into the wound,
  not allowing blood to clot and causing allergic
  reaction;
• parasitic invasion accompanied by severe itching;
• skin irritation occurs, the appearance of hematomas,
  blood crusts, development of ulcers;
• while scratching the wounds can fester, which leads to
  the appearance of pyoderma, regional lymphadenitis;
• papular erythema, erythema,
  roseola;
• with a long course of lice development is observed
  dermatitis, peeling and thickening of the skin.

When these signs appear, you must contact
medical facility for the prevention or treatment of head lice.
The diagnosis can be confirmed by a physician, infectious disease specialist, dermatologist,
paramedic The child must be taken to the pediatrician.

Mandatory inspection is carried out at the following
patients:

• orphans or children left without guardianship or
  biological parents;
• living in boarding schools, orphanages;
• students in an educational institution: schools, kindergartens,
  colleges;
• people visiting health centers, motels or
  boarding houses;
• prisoners in prisons or remand centers;
• hospitalized patients
  Patients;
• medical staff.

When lice are detected, the person is isolated to the full
recovery. The patient is regularly held sanitary
treatment with drugs to kill all lice and nits.

IMPORTANT. Children under 6 years do not carry out chemical
disinsection.

Identification of pediculosis and disinsection – detailed
algorithm

Examination for the presence of lice is carried out in the hospital reception,
clinic on the medical assistant station. Algorithm for the inspection
for pediculosis is documented in the “Patient Management Protocol”.
Such a sequence of actions must adhere to all
medical staff:

1. The doctor or nurse puts on a special dressing gown and
   gloves.
2. The patient’s hair is untied and carefully combed.
3. The survey begins with the temples and neck, where
   The probability of finding colonies of parasites is extremely high.
   The specialist examines the hair roots and scalp for the presence of eggs and
   adult insects with a magnifying glass and a special comb with frequent
   teeth.
4. In the absence of signs of parasitic invasion on the head
   inspect intimate parts of the body to identify pubic
   lice. The latter inhabit the axillary region,
   crotch
5. To identify ward lice conduct an inspection
   clothes and bed linen. Special attention is paid to
   the seams where the parasites lay their eggs.

After examining each patient, the gloves are disposed of, comb and
magnifier undergo disinfection with medical alcohol.

If a patient has lice, they isolate it from others.
people. After that, the doctor must fill out the form №058 / y and
report an outbreak of pediculosis. Acts of verification are only in
medical institutions. Schools do not register for a checkup.
lice. In schools, a nurse registers a check in
special magazine. It records the number of verified children.
and their full name, date of inspection, number of infected, class number. With
detecting a child’s lice is prevented from doing so until full
recovery.

Sanitary processing is carried out in the conditions of a hospital. The patient
It is necessary to prepare for the procedure:

1. Explain the essence of the method to the patient and get it.
   consent to conduct a pest control.
2. A doctor or nurse puts on a robe, apron,
   gloves. An oilcloth is laid on the floor, a chair is placed on top or
   couch for the location of the patient.
3. The patient is wearing a special apron, shoulders
   Cover with a hydrophobic cape. To protect the eyes
   used sterile towel that prevents hits
   on the cornea and mucous membranes
   facilities.
4. Prepare the remaining tools and
   drugs.

If these recommendations are not followed during processing
you can tolerate the risk of spreading lice inside
hospitals. In addition, chemicals can cause
harm to the patient.

After the preparation stage, start disinsection at
scalp. Elimination of parasitic invasion passes
according to the following algorithm:

1. Patient’s hair is moistened in warm water.
   which temperature does not exceed + 37 ° C, and is divided into separate
   strands.
2. Every part of the hair is evenly treated.
   with the prepared preparation against louses, put on a special top
   hat to warm the head and wait for a certain time.
   The period of achievement of the therapeutic effect of each agent
   varies.
3. After that, the hair is thoroughly washed with water.
   shampoo, then moistened in vinegar. On the patient’s head
   put the sterile cap back on and wait 15 minutes. After the lapse of
   necessary time rinse hair.
4. They are combing out every strand of dead lice,
   larvae and eggs with a comb on which a piece of cotton is fixed.
   The latter is saturated with vinegar.
5. Rinse hair again if necessary.
   the patient. Dry and inspect the hairy part
   heads.

As a final procedure, conduct
disinsection of clothes and underwear of the patient by washing in
hot water and chemicals. Re-inspection carried out
one week after treatment. After 2 weeks from
It is recommended to re-apply the procedure for disinsection.
consolidation of the result.

IMPORTANT. If the patient agrees, the hair may cut
and burn.

Necessary tools and means for inspection

For sanitization against pediculosis
prepare preparations against lice and nits, means of individual
protection and tools:

• bag or bag designed for storing clothes and
  personal hygiene of the patient, followed by transportation to
  disinfection;
• scissors, razor and hair tray needed for holding
  haircuts;
• comb with frequent long teeth;
• oilcloths for floor, stool and patient body protection;
• disposable gloves; bathrobe;
• 2-3 polyethylene hats;
• kerchief, elastic band to collect long hair in a bun;
• medical alcohol;
• cotton swabs;
• table vinegar;
• shampoo;
• warm water;
• preparation for removing lice with the attached instructions,
  appointed by the attending physician;
• means for processing bed linen and clothes
  the patient.

Pediculosis examination lamp

In some cases, when parasite colonies remain
small, inspection for suspected lice is performed under
Wood lamp or black light lamp. It radiates soft
longwave ultraviolet light, under which you can detect
eggs of insects and adults. Under the lamp Wood parasites glow
pearl white color.

The term of re-examination of the patient after detection
pediculosis

Repeated examination for the presence of lice spend after 2 weeks
after carrying out sanitary processing in stationary
conditions. During this period, the surviving eggs should
hatch out nymph first stage. They are fragile.
exoskeleton, so they are easier to destroy than adults
individuals.

REFERENCE. Eggs after chemical processing can
survive thanks to a solid dense shell of hydrophobic substances,
partially acid-tolerant or vinegar. Therefore, some individuals
may survive and hatch within 1-2 weeks.

How often is a pediculosis examination performed in various
institutions?

In each educational institution medical workers are obliged
inspect children regularly for head lice. At the same time, the planned
checks can not always fix a parasitic outbreak
invasions, so parents need to check the child at home
conditions. It is recommended to do it every 1-2 weeks, preferably in
day time

If necessary, you can use a magnifying glass for more
effective inspection. A thorough check of pediculosis
carried out in clinics, medical and obstetric point,
hospitals.

REFERENCE. You can check for the presence of lice at
family doctor, dermatologist, medical assistant and therapist.

Unscheduled inspections of the team or group closely
interacting people spend finding a patient with
parasitic infection. The periodicity of a routine check depends on
institutions.