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Helpful links for Avian Flu


Lois

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This is very long it includes a great many links

These are sites that you should investigate in connection with the Avian Flu.

Many of these were found by westbrook.

To keep up to date on the progression of AF

Government link

http://www.pandemicflu.gov/

 

Cidrap:

http://www.cidrap.umn.edu/index.html

World Health Organization

http://www.who.int/csr/disease/avian_influ...e/en/index.html

 

Planning for the flu

http://www.planforflu.com/

 

http://www.BirdFluPreparation.com.

 

http://www.birdflupreparation.com/presentation.html

 

http://www.arielco.us/page3.html

 

http://www.icu-usa.com/tour/equipment/stethoscope.htm

 

how to use a stethoscope (from Westbrook)

 

http://www.studentbmj.com/back_issues/0996/st09ed2.htm

 

http://www.ahc.umn.edu/rar/MNAALAS/Steth.html

 

http://www.drgascoigne.com/pacsteth.html

 

http://www.reddingmedical.com/articles/ste...tube-length.cfm

 

Using your stethoscope

 

http://scienceu.fsu.edu/guidebook/fl/pdf/module3.pd

 

How to give an enema

 

http://www.howtogiveanenema.org/

 

http://www.lifeknox.com/sample.html

 

how to give one to yourself

 

http://www.geocities.com/valerie_cct/enemas.html

 

why an enema?

 

if you can't take it orally then consider rectal

 

suggestion 5 - Use rectal injection (enemas) to administer herbs children wont swallow. It is often difficult to get children to take herbs because they do not like the taste. Even glycerine preparations, herbs mixed with honey, and other similar preparations are often too disagreeable for young taste buds. A simple solution to this problem is to make the herbs into a strong tea and inject some of the tea into the rectum using a bulb syringe. Many of the herbal constituents can be absorbed via the bowel.

http://www.webnat.com/hi/HerbsforChildren.asp

 

Enema: This is a way to administer copious amounts of liquid into the bowel itself, including infusions or decoctions, having a laxative or peristaltic action upon the bowels. It is also used as a means of conveying nutritive fluids into the system. There are anti-putrefaction enemas, diuretic enemas, emollient enemas, laxative enemas. If a hot or warm enema is given, then the anus will relax, causing the rectal area to discharge immediately, so a cool preparation is preferred as it will soak through the waste concentrations. Prepare an infusion or decoction with 1 1/2 teaspoons of herb to each cup of water. Use 1 1/2 cups to 1 pint solution for children. Use 1 to 3 quarts for adults.

http://www.healthythoughts.com/ht17/herbal.htm

 

offended by enemas?

 

how to use Suppositories

 

http://rx-pharmacy.vianet.ca/compounding_suppositories.html

 

http://www.regaininghealthnaturally.com/He...ositories.shtml

 

scroll down to almost the end;

http://earthnotes.tripod.com/basics.htm

 

Usually a person is so sick they won't resist to these two methods for administering medicines.

prepare for the flu manual

 

http://www.fluwikie.com/index.php?n=Conseq...parednessGuides

 

home alone?

 

http://www.fluwikie.com/index.php?n=Consequences.HomeAlone

 

http://www.mrssurvival.com//ubbthreads/s...=93&fpart=1

Warnings and a little common sense....

http://www.curevents.com/vb/showthread.php?t=31718

 

Potential Therapeutic Interventions for Human Avian Influenza Infection

http://www.curevents.com/vb/forumdi...40&daysprune=30

 

Master Flu Preps Thread

http://www.curevents.com/vb/showthread.php?t=17139

 

Nursing and Care giving

http://www.curevents.com/vb/showthread.php?t=27042

 

Antiviral medicines

http://www.curevents.com/vb/showthread.php?t=27149

 

Obtaining Antibiotics

http://www.curevents.com/vb/showthread.php?t=13993

 

Fever

http://www.curevents.com/vb/showthread.php?t=27028

 

Diarrhea and Dehydration

http://www.curevents.com/vb/showthread.php?t=27036

 

For general Preps

We have a room of general preps

http://www.curevents.com/vb/showthread.php?t=36219

 

Well Water

http://www.curevents.com/vb/showthread.php?t=35962

 

Kerosene stoves [cookers]

http://www.curevents.com/vb/showthread.php?t=34126

 

Potatoes Storage

http://www.curevents.com/vb/showthread.php?t=35952

 

prepping on a budget

http://www.curevents.com/vb/showthread.php?t=35984

 

Dry Mixes Online

http://www.curevents.com/vb/showthread.php?t=35886

 

Dental Emergency Kit

http://www.curevents.com/vb/showthread.php?t=35643

 

Lots of questions about stored water

http://www.curevents.com/vb/showthread.php?t=35020

 

Camp and expedition Medical kit recommendations

http://www.curevents.com/vb/showthread.php?t=35645

 

Sprouting Mung Beans At Home

http://www.curevents.com/vb/showthread.php?t=35570

 

Best prep item you may not have..

http://www.curevents.com/vb/showthread.php?t=32021

 

Heat if power is off

http://www.curevents.com/vb/showthread.php?t=33832

 

What type of stove to buy to cook indoors?

http://www.curevents.com/vb/showthread.php?t=35151

 

How little water can you get by with each day?

http://www.curevents.com/vb/showthread.php?t=32966

 

Outside solar lights inside

http://www.curevents.com/vb/showthread.php?t=35229

 

Toileting

http://www.curevents.com/vb/showthread.php?t=34555

 

Utilities

http://www.curevents.com/vb/showthread.php?t=34833

 

Indoor Camping

Set up a tent in the house as a warmth strategy?

http://www.curevents.com/vb/showthread.php?t=35144

 

Electricity Free Clothes Washing

http://www.curevents.com/vb/showthread.php?t=35084

 

Watersafe Testing Kits

http://www.curevents.com/vb/showthread.php?t=35138

 

Make your own Chlorine at home!

http://www.curevents.com/vb/showthread.php?t=34615

 

Needed: Good "survival bar" recipe

http://www.curevents.com/vb/showthread.php?t=34655

 

Home Made Stoves a firebug's garden of delights...

http://www.curevents.com/vb/showthread.php?t=34864

 

Easy homemade soap

http://www.curevents.com/vb/showthread.php?t=34174

 

Cool storage when there's no basement?

http://www.curevents.com/vb/showthread.php?t=34364

 

Prepping with Sterno Stoves, Coleman Fuel and Charcoal

http://www.curevents.com/vb/showthread.php?t=34021

 

Universal Solar Charger

http://www.curevents.com/vb/showthread.php?t=34166

 

How does one make or renew bleach?

http://www.curevents.com/vb/showthread.php?t=34118

 

Options For Staying Connected To The Internet If Utilities Are Interrupted

http://www.curevents.com/vb/showthread.php?t=31097

 

dehydrators

http://www.curevents.com/vb/showthread.php?t=31528

 

Firearms Preps

http://www.curevents.com/vb/showthread.php?t=27445

 

Materials for homemade masks

http://www.curevents.com/vb/showthread.php?t=32153

 

When do you know grain is spoiled?

http://www.curevents.com/vb/showthread.php?t=32738

 

"Help for Hard Times"

http://www.curevents.com/vb/showthread.php?t=32255

 

Micro Fuel Cells for backup power

http://www.curevents.com/vb/showthread.php?t=32615

 

Internet Resources on Pandemic Influenza

http://www.curevents.com/vb/showthread.php?t=26788

 

“Risk communication for children.”

http://www.curevents.com/vb/showthread.php?t=35725

 

What meds to stock?

http://www.curevents.com/vb/showthread.php?t=15268

 

Food and Mental Health Campaign

http://www.curevents.com/vb/showthread.php?t=35448

 

Cytokine Storm and Acute Respiratory Distress Syndrome (ARDS)

http://www.curevents.com/vb/forumdi...40&daysprune=30

 

Entertainment for the kids & psychological preparation

http://www.curevents.com/vb/showthread.php?t=34149

 

Gel hand sanitizer

http://www.curevents.com/vb/showthread.php?t=33974

 

Therapeutic Strategies for Treating Patients with H5N1

http://www.curevents.com/vb/showthread.php?t=30298

 

The thread will serve as an index and summary of discussions relating to prescription anti-viral medicines. This is a work in progress. It will cover Tamiflu, Relenza, Amantadine, Rimantadine.

 

Tamiflu Availability / Unavailability - Update

http://www.curevents.com/vb/showthread.php?t=20275

 

Tamiflu question

http://www.curevents.com/vb/showthread.php?t=26583

 

Tamiflu Readministration via Imbibing Urine-packed Tamiflu

http://www.curevents.com/vb/showthread.php?t=19968

 

So Tamiflu or Relenza.....which one are you getting??

http://www.curevents.com/vb/showthread.php?t=23911

 

How oseltamivir (Tamiflu) works (and does it?)

http://www.curevents.com/vb/showthread.php?t=10525

 

Tamiflu and/or Relenza

http://www.curevents.com/vb/showthread.php?t=23699

 

Tamiflu. Will it work?

http://www.curevents.com/vb/showthread.php?t=22859

 

Tamiflu shortage: I am not worried

http://www.curevents.com/vb/showthread.php?t=22336

 

What's My Protocol for Tamiflu?

http://www.curevents.com/vb/showthread.php?t=20969

 

a little technique that may save your life..

 

http://www.merck.com/mmhe/print/sec04/ch040/ch040i.html

 

From Darlene

http://rxlist.com/

 

From Grubby

http://www.drugdigest.org/DD/Interaction/ChooseDrugs

 

From Quilty41

Here are a couple of web sites that deal with the flu and news:

 

http://crofsblogs.typepad.com/h5n1 H5N1blog

 

http://207.7.108.178/ FluWiki

 

http://news.yahoo.com/fc/Health/Bird_Flu Yahoo news page for bird flu only.

 

From Mother

I don't think this one was on the list. It seems to have quite a list also.

 

http://www.nlm.nih.gov/medlineplus/birdflu.html

 

Even some info on our soldiers and the bird flu, something from Mayo's clinic, a surevey of the American people that says they are not generally concerned about the bird flu as much as terrorism and etc. (sheeples) and lots more.

~~~~~~~~~~~~~~~~~~~~~~

Another helpful link with summeries

http://www.birdflubeacon.com/BirdFluNews.htm

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A few words about http://www.curevents.com ...

 

Their Flu forums and Prep rooms (there are two prep rooms, one for flu, plus a general purpose one) are a wealth of info.

 

 

Here's how to get the most out of them, just in case you have not BTDT. You'll love the long detailed prep threads that go all the way back to the beginning of CE. Have you seen them yet?

 

Go the the Prep Room (or whatever room), scroll to the bottom of the page. See:

 

Display Options

Sorted by: Last Post Time

From the: (pull-down menu, select "Beginning")

Sort Order: Descending

 

click on button: "Show Threads".

 

Enjoy!

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http://www.latah.id.us/disasterservices/Di...kpilingFood.pdf

 

The following is a long file with a tremendous amount of information. I couldn't figure out how to put it on here without pasting the whole document. If it takes up too much space...just let me know. I could always send the file to whoever wants it.

 

Pandemic Flu

(www.lapublichealth.org and http://pandemicflu.com)

 

“Every winter the U.S. suffers a seasonal flu that kills approximately 36,000 Americans and hospitalizes more that 200,000. Terrible as that is, health experts are now warning about a far more lethal kind of flu--a pandemic flu that could kill over half a million Americans, hospitalize more than two million.” The flu of 1918 killed 50+ million worldwide. “Health officials are particularly concerned about the H5N1 avian “bird flu” virus that could mutate to a new strain of the flu that humans would have not natural immunity against. The World Health Organization has warned that such a bird flu pandemic could infect 25-30 percent of the world’s population.(at the present time the mortality rate is 50% for those infected with the bird flu).”

In addition to this we have the possibility of biological and chemical attacks.

“If a severe Pandemic were to hit the U.S., life as we know it could be seriously disrupted. Businesses and schools might have to shut down. Travel could be restricted. Essential government services—including: sanitation, water, power and transportation and food supply. Public gatherings, including worship services, might have to be canceled. Public health officials project a cumulative absenteeism rate of 25-30 percent over three to four months during a pandemic flu outbreak.”

 

What Can You Do to Prepare?

 

Determine the possible impact of a pandemic on your family’s activities. Prepare for it.

 

Food (Red Cross-2 weeks – LDS Church 3 months supply-easy to Prepare Foods)

Water (enough to support your family if supply interrupted or polluted-Ensign)

Medical Supplies (for flu and regular prescriptions)

Supplies for Power Outages (lighting, heating, cooking, radio)

 

• Talk to family and friends about how you would handle it

• Share info about your pandemic preparedness with family, friend, co-workers.

• Establish phone/email tree to communicate to: work, family and friends

• Encourage workplace to plan for absenteeism, closings, and safe working conditions.

 

Precautions to Prevent the Spread of Flu

All flu is caused by viruses that infect the nose, throat and lungs. Passed thru cough/sneezing.

Flu shots may help lessen the effects of the flu.

Wash hands often using either soap and water or alcohol-based hand sanitizers.

Avoid touching: eyes, nose or mouth. Germs spread when touch something then eyes, etc.

Cover your mouth and nose with a tissue when coughing or sneezing. If you don’t have a tissue cough into your sleeve, not hands.

Avoid close contact with sick people. If you are sick, keep your distance from others.

Stay home when you are sick or have flu symptoms. Get plenty of rest, call your doctor.

Practice good health habits: plenty of sleep, manage stress, drink lots of water, eat nutritious foods.

Listen to Radio, TV or email to get updates.

 

What do the Lord’s Servant’s Say?

All is Safely Gathered In (Aug07 Ensign): “We encourage Church Members worldwide to prepare for adversities in life by having a supply of food and water and some money in savings”

 3 Month Supply open/eat foods, water, money, and long term FS.

 

Bishop David Burton South Jordan Stake Conference, Sept 1 2006: “Keep your eye on the Prophet. Being self-reliant has always been part of the church. Statistics show that no matter what the Church does, no higher percentage than 15% have storage. We are not going to say any more, but our people are going to need to be prepared. For example, what if somebody released a virus? What if it caused a pandemic? What if that led to quarantine? What if the quarantine was enforced? The office of the presiding bishopric has tried to come up with a plan, but we don't know what we could do. The responsibility lies with the head of each family”

 

The Church's Pandemic Education Focus

Here's something I've become aware of and wanted to be certain you, too, were informed of the Church's active attention to the issue of pandemic:

 

http://www.byucemedia.org/cw/saftey/2007/C...s-SusanPuls.pdf

 

http://streaming.byui.edu/safetyoffice/flu.wmv

 

http://www.byui.edu/safety/Pandemic_Web_Page.htm

 

~~~~~~~~~~~~~~~~

 

In light of the above pandemic preparations, the frequency and urgency of the counsel we've received to have our three-months supply of food certainly comes more sharply into focus!

 

 

Electrolyte drink (for dehydration)

1 quart water

1/2 t. baking soda

1/2 t. table salt

3-4 T. sugar

1/4 t. salt substitute

Mix well and flavor with lemon juice or sugar-free Kool-Aid.

 

 

Additional Websites with Pandemic Information

 

http://lapublichealth.org/acd/PandemicFlu.htm

www.lapublichealth.org

www.dhs.ca.gov

www.cdc.gov

www.pandemicflu.gov

Stages of a Pandemic

The World Health Organization (WHO) has developed a global influenza preparedness plan, which defines the stages of a pandemic, outlines the role of WHO, and makes recommendations for national measures before and during a pandemic. We are currently in Phase 4.The phases are:

Interpandemic period

Phase 1 : No new influenza virus subtypes have been detected in humans. An influenza virus subtype that has caused human infection may be present in animals. If present in animals, the risk of human infection or disease is considered to be low.

Phase 2: No new influenza virus subtypes have been detected in humans. However, a circulating animal influenza virus subtype poses a substantial risk of human disease.

Pandemic alert period

Phase 3: Human infection(s) with a new subtype but no human-to-human spread, or at most rare instances of spread to a close contact.

Phase 4: Small cluster(s) with limited human-to-human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans.

Phase 5: Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans but may not yet be fully transmissible (substantial pandemic risk).

Pandemic period

Phase 6: Pandemic: increased and sustained transmission in general population.

Notes: The distinction between phases 1 and 2 is based on the risk of human infection or disease resulting from circulating strains in animals. The distinction is based on various factors and their relative importance according to current scientific knowledge. Factors may include pathogenicity in animals and humans, occurrence in domesticated animals and livestock or only in wildlife, whether the virus is enzootic or epizootic, geographically localized or widespread, and other scientific parameters.

The distinction among phases 3, 4, and 5 is based on an assessment of the risk of a pandemic. Various factors and their relative importance according to current scientific knowledge may be considered. Factors may include rate of transmission, geographical location and spread, severity of illness, presence of genes from human strains (if derived from an animal strain), and other scientific parameters.

 

 

Symptoms associated with Avian Flu

The patient will not necessarily Exhibit all these symptoms

 

* Fever

103º-105º for adult

101º-103º for child

 

Sore Throat

Cough

Headache

Aching Muscles

Diarrhea and Abdominal Pain:

Vomiting: Nausea and vomiting has been a symptom in some patients.

Bleeding of nose and gums: A symptom reported in some patients

Conjunctivitis (Eye infections)

 

Causes of Death in Avian Flu

 

Dehydration: From fever, vomiting, diarrhea

Pneumonia

Acute Respiratory Distress

Inflammation of the Brain and Heart

Stroke or Heart Attack

 

 

More Than General Preparedness

Taken from fluwiki.com

Where to Stay

Questions to answer:

Do I plan to ride out the pandemic with my immediate family? Extended family? Friends? Other like-minded people? Some combination?

What is the potential of the current location for civil unrest that may jeopardize my (family’s) safety? What is the potential for household, neighborhood, community, and town/city protective measures?

What is the potential for food and water storage in the residence? What is the potential for food and water resupply?

 

Distancing vs. Stay-in-Place (SIP)

At some point, you will have to determine the approach you will take to isolate yourself from others during the pandemic. The major choices are;

• No isolation; continue as normal

• “Distancing” (keeping at least 3 feet from anyone in public)

• Staying home when sick or to care for children when schools are closed

• Staying home altogether when a pandemic wave is in your region

There is no one approach that will fit everyone’s family and work situation. This something you MUST determine now.

State and Local Government Preparation

Each State has been working on a pandemic program with the aid of the Federal Government. To see what your State is doing, Google your State name and “Pandemic Preparations”.

Your local government may be putting together or already has a program. The two best sources are the local Health Department or your local emergency management group. It’s best to have the phone number and local radio program station by your phone for emergencies in your area at any given time.

The primary criteria you can use to gauge the local government’s current response status are:

• Does the municipality have a local health official tasked as the designated health advisor for a pandemic?

• Does the municipality have an Emergency Operations Center? This operations center will be the fulcrum for command and control of health, security, transportation, utility coordination, and local public information dissemination. (There can be backup sites and/or distributed operations as well.)

• Have critical government functions been identified, and has training been established to shift staff around in case of high absenteeism

• Has the local municipal critical infrastructure (i.e., electricity, water, sewage) been evaluated for sufficient capacity and operational mitigations to the risk of a pandemic event? How long could the water supply continue if the electrical grid were inoperable for an extended time?

• Have alternative treatment and triage sites been established to handle a pandemic treatment surge?

• Has there been coordination with grocery stores and pharmacies to ensure that citizens will be able to resupply without fear of infection?

• Are policies established to identify which public areas will be closed and the specific criteria for closing? Have policies and criteria been established for reopening?

• Are plans and detailed procedures established for the mass distribution and administration of vaccinations (if and when a vaccine is developed and produced for the pandemic strain)?

• Has there been coordination with private, volunteer, and neighborhood organizations to develop and synchronize local response?

• Has a plan been established to account for surge operations at the mortuary and related services?

• Has the local government coordinated completely with State/Province/Regional authorities and satisfied their requirements?

• Is there a public health education campaign underway that addresses the local government’s response, as well as recommended citizen responses?

• Are there mutual aid agreements with neighboring localities?

• Are there any considerations for controlling the movement of people and commodities or out of the community?

• Have the health, social service agencies, and fire departments created a registry of former and retired personnel and suitable volunteers?

• Has the law enforcement agency created a registry of former and retired law enforcement personnel and suitable volunteers who could provide continued civil order, traffic control/restrictions, security at clinics, etc.?

• Has a public communications medium been established that will reach people during power outages? Do citizens know what communications devices they need (e.g., solar/crank powered radios)?

The Department of Homeland Security’s Pandemic Influenza Preparedness, Response, and Recovery Guide for Critical Infrastructure may help to understand the protocol being implemented.

If local preparations appear to be slow, stalled, or too narrowly focused (i.e., predominantly medical), then seek to improve the chances of you, your family, and your community by contacting local officials and advocating timely and sufficient pandemic preparedness measures.

Consideration of Other Locations Regardless of the type of disaster, you should always have another location identified and confirmed in case the situation at your home or primary site becomes unsafe for any reason. If you decide to consider riding out the next pandemic at a site other than your home, reflect first on the benefits you and your family can bring to that site. Are you going to bring extra food for your hosts and pre-position it so that you can leave for the site without extensive preparation time and the potential for an overloaded vehicle? Do you bring a special skill to the group (i.e., medical, electrical, mechanical, security, food preparation, gardener, etc.)?

There are three important measures to take when traveling during an elevated pandemic state:

1. Take an emergency supply kit with at least 3 days worth of supplies

2. Take spare vehicle fuel (or if biking, spare tires, patch kit)

3. Have an extensive map of the areas you will travel through. Plan at least 2 alternate routes.

Questions that must be answered when meeting up with others at another site include:

1. What is the specific trigger point/event at which you leave?

2. Will you impose restrictions on when members of your Support Group are allowed into the refuge due to possible contagion

3. How might these trigger points align with possible quarantining of the local metropolitan area?

4. What supplies do you promise to pre-position?

5. When are they to be in place?

6. What skills do you bring, and what tools are required for you to exercise your skills?

7. What contingency plans will the group at the refuge execute? Are you expected to be a part of the site’s security arrangements?

 

 

 

 

 

 

 

 

 

 

 

See chart below in helping to determine how you will ride out the pandemic.

 

 

 

Setting Up and Using Sick Room

 

Since most of us don’t live in a hospital or healthcare clinic, we’ll have to turn our house into a medical clinic, or at least in part.

 

Start collecting what you can now. Don’t wait until the last minute. Medical clinics and hospitals are already way ahead of you!

 

Location of the sick room

Ideally, a room away from the main living quarters would be a guesthouse, a room over the garage, and a workroom like a hobby area in the garage - assuming there is a way to keep the area warm in winter or cool in summer. If need be, set up a tent or other portable shelter for keeping the patient in. The main idea is to keep the infected person as far away from the rest of the family as possible, and yet as comfortable as possible.

 

Having the sickroom near a bathroom is also a good idea. A master bedroom with a bathroom is ideal inside the house. Putting liquid waste down the toilet is the best source for getting rid of it. If need be, the well family members can use a portable toilet which can then be emptied in the toilet located in the sickroom area. A portable shower can be set up outside for washing. It’s for only six weeks or so. Pretend like you’re a pioneer!

 

Another main concern would be the location of the room to be far away from the intake vent to the heating/cooling system. You don’t want to draw the virus into the rest of the house through the vents! You’ll also be covering the vents in the sick room and using portable heating and cooling systems if possible..

 

If the sickroom is to be located in a bedroom, try to make it in an area down at the end of a hallway. You will be setting up an isolation system and will need room for this.

 

Having this area set up in advance allows you an area to quarantine any family members that may have been exposed. Anything that you can do or plan ahead of time will reduce pressure and stress and will allow you to concentrate on helping your family stay or get well.

 

Where to Start

Discuss ahead of time the caretaker arrangement. Since you won’t know who will be ill and who won’t, different scenarios should be played out. Allow only the minimum number of caretakers. No children allowed in the area!

 

Learn first aid and CPR, how to use a stethoscope and how to use a blood pressure cuff.

 

Preparing the Sickroom

You will be disinfecting EVE\RTHING in the room once the patient is well. The least amount of items in the room at the time of cleanup is best.

Take all clothing and shoes out of the closets and dressers.

Depending on how much cleaning you want to do, I would take everything stored on the room that will not be needed for yourself or the patient.

If curtains or drapes are machine washable, leave them. If not, dry-cleaning services will most likely be shut down, so remove the drapes and cover the windows with plastic shades or aluminum foil for privacy and diffusion of light for the patient.

 

Wood furniture will be easy enough to disinfect, but cover any fabric chairs and cushions with plastic – 4mm is best.

 

Cover the mattress with 4mm plastic. Since a fever is part of the illness, place a quilt or blanket.

 

Pillows can be replaced. Having a few extra pillows to replace those used during the illness is best. If they can’t be replaced, wash them in the hottest water available with a disinfectant.

 

Some have suggested covering the carpet with plastic. If the patient is vomiting or has uncontrolled diarrhea, perhaps covering the area around the bed is best. The carpet can be cleaned and disinfected, but how deep is a question you have to consider. Use a disinfectant after cleaning any spills on the carpet or floor.

 

With any use of plastic, duct tape it into place to secure it.

 

Use a piece of cardboard, a rubber strip or a weather strip under the bedroom door to contain germs.

 

Having a fan in a bedroom window with the flow going out is also a good way to keep the germs flowing away from the room and adjoining areas. But, make sure you don’t have it pointing to a neighbor’s window or area where children might be playing outside

 

Cover the heating and cooling vent in the bedroom. Use a portable heater, swamp cooler, vaporizer or humidifier to set the room to a comfortable temperature. Again, you will have to research and decide what you can afford and which system is best for your needs and the area you live in. The question has been raised concerning a filtering system in the room. The best I have read about are the Ozone UV systems. But HEPA, Ozone and UV systems all claim to kill and or contain the virus. I suggest you do some research on each to decide if you want or can afford a system and which is best for your needs

 

In the sickroom you will need a bedside table with ample room for items you and the patient will need. Clock, box of tissues, monitor, books, etc.

 

On the opposite side of the room you will need a large table for sickroom supplies

 

If possible, setting up some kind of a curtain between the bed and the rest of the bedroom would be ideal, especially if you have to spend a long time in the sickroom.

 

Make sure you set up a monitor system next too the bed so the patient can call for you when you’re out of the room. A baby monitor would be fine; a two way radio is better given the patient is coherent enough to use it.

 

In the sick room you will have a pad and paper to record all the information regarding care of patients, times, temperatures, blood pressure, etc. Think hospital procedures..

 

 

 

Three Areas of Isolation and Quarantine

Hospitals have a quarantined area between the well area and the sick room; you will be providing the same. The best is to put a thick shower curtain as the beginning entryway to the sick area. You may have to make sure you have a curtain rod narrow enough for the hallway width.

Another alternative to plastic curtains: A contractor curtain allows you to zip and unzip door for entrance and exit.

 

Area 1

Now you will set upon a table with all your needs. Fresh gowns, masks, gloves, hair covers, shoe covers. If you are not using shoe covers, make sure you have a pair of shoes just outside the sickroom. (When leaving the sickroom, spray shoes Lysol or other spray disinfectant, or using a bleach solution: 100 parts bleach to 1 part water, dip shoed feet into a small bucket with disinfectant before removing shoes).

On this table will also be all the medications, both prescription and over-the-counter medications. If need be, have a small plastic bucket to carry everything. Don’t forget anything, you will not want to go in and our of the sickroom more than is needed.

Nothing should be allowed in this area if it has been near or in the sickroom unless it has been disinfected or is in disinfectant water.

 

 

In order to remember everything when the time comes, do as hospitals do - make and posts lists. For example, in the first area of isolation, have a chart that shows items that are to be there and also how to don protective clothing.. The area outside the sickroom door should include how to take off protective equipment and how to disinfect the area and use of the biohazard bin and disinfectant water.

Area 2

Just outside the sickroom

Bucket with disinfectant water

Biohazard waste bin. A covered bin

 

Sickroom

 

The items that will be located in the sickroom are:

Choux

Thermometer

Vaporizer and/or Humidifier

Blood pressure monitor

Stethoscope

Soda straws for helping to administer fluids

 

Biohazard wastebasket for used Chux, tissue, etc. used by patient. A biohazard wastebasket is anything that is closed between uses.

Disinfecting wipes for all surfaces. Use these on a continual basis for keeping contamination down. Disinfect the doorknobs and light switches, etc when leaving the room.

Small container with alcohol on the table for disinfecting the thermometer

Hand sanitizer. Use this occasionally on gloved hands and when readily to leave the room.

 

 

Keep the door to the sickroom closed at all times. Keep all doors and curtains in this area closed as mocha possible.

 

Just outside the bedroom door or in the bathroom (assuming no on else will be using the bathroom, will be the board bin for the caretakers protective equipment and anything else that leave the room.

 

Disinfecting bucket

Fabric gowns

Soiled clothing of caretaker

Have a small disinfecting container for

Plastic head coverings

Eye protection

 

 

Biohazard Bin is for ALL items that will be disposed of. DON”T carry any of these items outside the isolation area

Gloves

Paper gowns

Masks

Any disposable protective equipment

All dishes and eating utensils the patient has used (Make sure you have plenty of disposable products for this purpose.

 

If you have a window close enough to the ground, you may want to have a set up where everything goes out the window and into the designated buckets or trash.

 

Make sure you change the disinfecting bucket every 12 hrs. and each time the laundry is done.

 

Procedure

Entering the first curtain:

Put on head covering, gown, mask, eye protection, gloves

Gather all needed items

Make sure first curia in completely closed

 

Enter second curtain

Close completely behind you

Enter bedroom

 

Make sure you have something to keep you busy, book, etc, in the event you have to spend time with a child or spouse for any amount of time.

 

Getting ready to leave\

Make sure all solid items are in the proper bins.

Close tightly

Decide how you will take biohazard bin and disinfect water out of the room. Otherwise every 12 hrs is required. Close bio bin bag slowly and away from your face. Secure.

Make sure you have disinfected any surfaces you or patient has touched with disinfecting cloths. Make sure monitor is on. Close door completely behind you.

 

Wash your gloved hands medially y on leaving the room and between taking off each piece of protective equipment. I know they don’t do this in hospitals, buy we are all amateurs and safety comes first.

 

Make sure each piece of protective equipment goes into the proper container. Do not set anything down on any other surface. Again, disposal of water and biotins are every 12 hrs.

Wipe down the area with disinfecting wipes, leave fiat curtain and close completely behind you.

Check table to see if anything needs to be replaced. Leave area closing curtain behind you. If possible, take a shower before interacting with other family members.

 

This is by no means a perfect setup for everyone. You will have to take time now to decide where the isolation area will be, who the main caretaker will; where well children will be kept and how to kept them entertained; etc. We will be isolated from society to a large extent, and knowing now what to do will minimize panic when the time comes.

 

 

Toilets

Depending on how your system is plumbed, it might be better to assume that the system is contaminated if someone in the house is sick. If you live in an apartment so that your plumbing is connected to others’ then just assume that it is contaminated. Again the best thing to use is bleach. Remember in this instance you are not worried about the water in the tank but rather the stuff in the toilet bowl so make sure that you put some in there.

If you have to use a portable toilet in the sickroom and have to bury the water, dig a hole 8-12 inches, pour in waste, add lime or diluted bleach, bury it with loose soil, top with sod and pack it down with your foot. Organisms in the soil will decompose the material within a few days. If you dispose of waste in the family toilet, be sure and try to reduce splashes and clean the area with bleach or other disinfectant immediately afterward.

In addition, to reduce splashing, always close the lid before flushing. During SARS when people were actually infected by such routes in Hong Kong, gentlemen were advised to use the facilities sitting down!

 

 

 

 

Masks

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Inovel’s respirators are different by design. They’re more comfortable and they’re easier

to put on and fit. And, because they’re more durable, they can be worn longer. All of

which facilitates compliance — and

decreases overall cost

 

 

 

 

 

 

 

 

 

 

 

 

 

Definition: The National Institute of Occupational Safety and Health (NIOSH) of the Centers for Disease Control certifies respirators. The number (95, 99, 100) refers to the particulate filtering efficiency level of the mask. So:

• An N95 mask filters out 95% of the particles that attempt to flow through the mask.

• An N99 mask filters out 99% of the particles that attempt to flow through the mask

• and an N100 mask filters out 100% of the particles that attempt to enter the mask.

• N means not resistant to oil.

• R means resistant to oil (there are also R95 masks available)

• and P means oil proof.

Please note that influenza viruses themselves are 0.08- 0.12 micrometers in diameter, smaller than what an N95 filter is capable of filtering.

• However, influenza viruses are often carried in aerosols of respiratory secretions, emitted from sneezing for example, that are up to 10 micrometers in diameter, large enough to be filtered out by an N95 mask.

Also note that not all N95 masks are NIOSH and FDA certified. Non-medical N95 masks may only be certified by NIOSH and not the FDA. Masks that are respirators and surgical masks are recommended since they meet standards of both NIOSH and the FDA..

 

What is the Difference Between a Mask, Respirator and Face Shield?: The terms are often used interchangeably, but there is a difference. Air must pass through respirators such as N95, N99 and N100 masks, whereas when using a simple mask, such as a procedural mask or a surgical mask, that is not also a respirator, air may also be breathed in from the leaky sides. See the definition of N95, N99 and N100.

What Do Masks Filter Out?: Masks provide a physical barrier between common entry paths of viruses and bacteria, your mouth and nose, and the germ. Germs, or particle the germs are riding on, become trapped in the mask. N95 masks are 95 per cent efficient at filtering out particles that are greater than 3 micrometers in diameter. N99 masks are 99 per cent efficient and N100, 100 per cent efficient. Droplets emitted by sneezing, coughing or talking are 5 micrometers or bigger, so these masks will work well for influenza or tuberculosis infection control.

Masks Do Not Provide Total Protection: Masks provide some protection if used properly. Masks must be fit properly each time they are used. Masks can give people a false sense of confidence. This confidence may lead to participating in high risk activities to contract bird flu unnecessarily during an outbreak or pandemic or in the event of close contact with tuberculosis. Goggles, gloves, aprons and boots are other personal protection equipment items people in close contact with deadly germs may need. Remember that another entry way for germ laden droplets are the eyes.

Who Should Wear a Mask: At this time, H5N1 bird flu is not very transmissible among humans, so it is not necessary to wear a mask unless you find yourself in an area where highly pathogenic bird flu has been confirmed or you research avian influenza and have contact with samples that may contain highly pathogenic avian influenza. The most common mode of transmission of bird flu is from direct contact with birds. If there is an outbreak of highly pathogenic avian influenza or pandemic flu or you believe there is a reason to wear a mask due to a risk of tuberculosis, please refer to Who Should Wear a Mask.

Kind of Mask You Need: The types of masks that will help protect you from H5N1 bird flu and other types of influenza and tuberculosis if used properly are:

• N95 masks that are both NIOSH certified and FDA approved or the European equivalent, FFP2. These are respirators AND surgical masks.

• N99 or N100 standard mask.

• Surgical masks, that are not respirators, and procedural masks are much cheaper than the above masks, but they will not efficiently protect you from getting influenza because they have leaky sides. It is recommended that patients wear surgical masks, however, to reduce the spread of the virus from coughing and sneezing.

Masks for Children: In general, masks are made for workers, not for children. Some masks may fit small faces better than others, but at least in the US there are no child specific N95 masks. Children should avoid participating in high bird flu risk activities and should not be in close contact with patients with tuberculosis. For bird flu prevention, please see Children and Bird Flu Prevention.

What if I Cannot Afford to Buy Masks or They are Not Available: In fact, you can make your own mask that would be better than no mask in case of an outbreak. (See the article "Simple Respiratory Mask" in the CDC's free online journal, Emerging Infectious Diseases.)

 

For material, we choose heavyweight T-shirts similar to the 2-ply battle dress uniform T-shirts

A Hanes Heavyweight 100% preshrunk cotton T-shirt (made in Honduras) (http://www.hanesprintables.com/Globals/Faq.aspx) was boiled for 10 minutes and air-dried to maximize shrinkage and sterilize the material in a manner available in developing countries. A scissor, marker, and ruler were used to cut out 1 outer layer (≈37 × 72 cm) and 8 inner layers (

 

 

 

 

 

 

Beware: Wearing a mask can boost a user's confidence and encourage him or her to participate in activities he or she would avoid under no mask circumstances.

 

How Many Masks You Need: The number of masks needed to prevent tuberculosis depends on the duration of the disease and level of exposure. In the case of bird flu or a pandemic, for most people, 90 masks of N95 efficiency or higher should be enough for a 6 week period, but before you buy masks, see the pros and cons of pandemic stockpiling.

If you plan to buy masks, the quantity you buy will depend upon your exposure. See how many masks you need for a list of how many masks are needed for different people.

Where to Buy Bird Flu Masks: Once you have decided to buy a mask, you may want to look over this list of N95 NIOSH certified and FDA approved Masks to find manufacturers and models that comply to these norms. Then proceed to buy masks from an authorized vendor such as:

• Hospital Supply Stores.

• Hospital Supply Catalogs.

• N95 Masks and Simple Surgical Masks Online (3M Respirators, Dynarex and CVS surgical masks).

About.com Updated: May 9, 2007

Goggles

One of the protection kits used to prevent the infection of avian flu is the bird flu goggle. The pandemic flu generally infects human beings with avian influenza virus only when it comes in direct contact of infected or sick or dead infected birds.

In response to the escalating risk of an avian bird flu pandemic, personal protective equipment for individuals and families and organizations has been sought who deal in poultry or ornithology. Thus, 'necessity is the mother of invention', is aptly suited to the situation and the danger of spreading of the disease has led to manufacture of safety kits and one of them is the bird flu goggles.

Bird flu goggles were made keeping in mind the infection control guidelines from the Center for Disease Control & Prevention (CDC), World Health Organization (WHO), and National Institute of Occupational Safety & Health (NIOSH).

Bird Flu epidemic can occur during any season. Therefore, the handy preventive measures are more important at the time of the bird flu spread than the vaccines. Bird flu goggles reduce the risk of airborne contaminants entering the body through the eyes. They should be considered a necessary piece of personal protection when protecting oneself from the avian bird flu.

Wearing the goggles can prevent bird flu virus from getting in via the moisture around your eyes since goggles stop the cough and sneeze droplets and also prevent your hand from inattentively rubbing your eyes. The bird flu shields mucous membranes of the eyes and the H5N1 virus cannot enter the eyes.

 

 

 

 

 

 

Items Needed for Patient Care

 

o Several rolls plastic –4 milm if possible

o Duct tape

o Fan

o Large bucket for disinfecting

o Trashcan with lid

o Heavy-duty trash bags

o Bleach or disinfectant - Anything guaranteed to kill Influenza Type A

o Spray Lysol

o Walkie-talkies or baby monitor

o Air filter – HEPA, OZONE, UV. Ozone UV is the best.

o Fan for reverse air flow (to be put into window of sick room facing out)

o Masks

o Gowns

o Gloves

o Eye protectors

o Hair protectors

o Chux (can use puppy training pads)

o Two thermometers

o Vaporizer and/or Humidifier

o Blood pressure monitor

o Stethoscope

o Table Salt and Sugar or large quantity of Gatorade or other rehydrator

o Disposable eating utensils

o Soda straws for helping to administer fluids

o Coca butter for dry skin from dehydration

o OTC

o Herbal teas for symptoms

o Theraflu

o Hemorrhoid Medications

o Tucks

o Ibuprophen

o Tylenol

o Benadryl

o Robitussen - Expectorant only

o Anti diarrhea Medication

o Meclazine for nausea & dizziness

o Ocean drops for sinuses

o Epsom Salts

o Petroleum jelly

o Migraine Cooling Headache Pads

o Aromatic Cooling Patches

o Fever cooling patches

o Gel Cooling Sheets

o Gel sheet for children,

o Thermal Therapy Patch

RX if possible to get

Tami Flu

Probenecid

Phenergan

Hydrocodone

Valium

 

 

 

 

Quarantine vs. Isolation

 

QUARANTINE separates people who have been exposed to a specific illness but they have not yet come down with the symptoms.

The incubation period for H5N1 bird flu may be longer than that for normal seasonal influenza, which is around two to three days. Current data for H5N1 infection indicate an incubation period ranging from two to eight days and possibly as long as 17 days.

 

ISOLATION separates those who are already ill or infected from those who are not.

 

The patient must remain in isolation for a period of 14 days after all symptoms have disappeared.

 

 

At the time of the pandemic outbreak, public officials will determine the length of both quarantine and isolation.

 

Sanitation

Use of Bleach

Bleach needs to be made up each day, otherwise it degrades very quickly. Now that can add up to a lot of bleach over a few months. Instead of buying bottles, you can buy bleach tablets. These come in packets of 10 where each one makes 1L of bleach, which can then be diluted as above.

Bleach can be corrosive to both skin and clothing and the fumes are toxic if breathed too long. Have the area ventilated when using bleach. Consider other disinfecting alternatives if possible.

Bleach: for normal household bleach, which is approx 5%, use 1:100 (10ml in 1L of water) for general cleaning and disinfection.

For body fluids, waste, and spillages, use 1:10 (10ml in 100 ml of water).

Toilets:

Depending on how your system is plumbed, it might be better to assume that the system is contaminated if someone in the house is sick. If you live in an apartment so that your plumbing is connected to others’ then just assume that it is contaminated. Again the best thing to use is bleach. Remember in this instance you are not worried about the water in the tank but rather the stuff in the toilet bowl so make sure that you put some in there. In addition, to reduce splashing, always close the lid before flushing. During SARS when people were actually infected by such routes in Hong Kong, gentlemen were advised to use the facilities sitting down!

You will want to continually disinfect the home. Door knobs/window handles/ buttons/switches • Sofa • Telephones/intercom/computer keyboards and mouses Dining Area • Tables/chairs • Floors • Eating utensils Kitchen and Toilet • Water taps/shower heads

Cleaning and Disinfection Procedures (Also applies to general workplaces) Furniture Step 1 • Wipe thoroughly with a 1:99 solution of diluted household bleach (mix 1 part household bleach with 99 parts water). • For areas that are dirty, use a stronger solution of bleach at the ratio of 1:49. Step 2 Wipe dry. Walls Step 1 • Wipe thoroughly with a 1:99 diluted household bleach solution. • For dirty areas, use a stronger 1:49 bleach solution. Step 2 Wipe dry. • Carpet • Surfaces (e.g. tables) • Children’s toys • Floors • Bath-tubs and wash-basins • Drain outlets Mopping floors Step 1 • Sweep litter before mopping. Step 2 • Mop thoroughly with a 1:99 diluted household bleach solution. • For areas that are dirty, use a stronger 1:49 bleach solution. Step 3 • Clean and mop dry. Toilet bowls Step 1 • Clean with a toilet brush and a 1:99 diluted household bleach solution. Step 2 • Flush. Bath-tub and basins Step 1 • Clean with an ordinary brush and a 1:99 diluted household bleach solution. Step 2 • Rinse with water. Drain outlets • Pour a teaspoonful of 1:99 diluted household bleach solution down the drain outlet. • After 5 minutes, pour clean water down the drain outlet. General Cleaning and Disinfection Tools • Broom • Bleach • Mop • Appropriate protective clothing • Brush • Face mask • Bucket • Rubber gloves • Towel Points to Note • Clean and disinfect your home at least once a day. • Pay attention when cleaning electrical switches or computer equipment. Inspection Tips Pay special attention to the following: • Ensure soil and waste pipes function properly. Repair any defects or leaks immediately. • Look for signs of pest infestation (e.g. rodent droppings, cockroaches, stagnant water) and if present, clean immediately. If necessary, seek help from the management company. • Keep carpets clean by vacuuming daily and regular dry cleaning. • Ensure ventilation systems are clean and well maintained. Clean air filters regularly. For any enquiries, please contact the Food and Environmental Hygiene Department Hotline on 2868 0000. Health Advice • Maintain good body immunity. Eat a proper diet, exercise regularly, get adequate rest, reduce stress. Don’t smoke. • Maintain good personal hygiene. Wash hands frequently using liquid soap. Use disposable towels or a hand dryer to dry-hands. • Cover the nose and mouth when sneezing or coughing. • Wash hands after coughing, sneezing or wiping the nose. • Wash hands before touching the eyes, nose and mouth. • Do not share towels. • Do not share eating utensils – use serving spoons and chopsticks. • Maintain good indoor ventilation.”

 

 

Replacing Work and School

 

Staying on a schedule of some sort is best when isolated from society. Thinking in terms of what to do with all those hours in a day can bring on panic alone, so think in terms of projects around the house that need to be done.

 

Now that you’re not at work…

Purchase painting, plumbing and home repair supplies and do those projects that you have been putting off. Put up wallpaper; replace the contact paper in the kitchen cabinets; practice faux wall finishes; replumb those leaking sinks; rewire old lights and fixtures; reorganize the garage and/or the attic; landscape; plant a vegetable garden; learn a new skill.

 

If the kids can’t go to school…

There are many websites that provide free worksheets and schooling ideas. Keeping your kids busy doing what they would normally be doing will help in with the boredom.

It would also be a great time to teach homemaking and home maintenance skills.

Cooking

Cleaning

Sewing

Gardening

Plumbing

Home repairs

Car Maintenance

 

Have in your preparedness supplies:

Paper

Pens and Pencils

Paints

Markers

Craft Items

Hand–powered woodworking tools

Fabric, thread, needles

Books

Games

Purchase a portable DVD player and portable tape player for times you may not have electricity. A portable DVD player can be recharged in the car if electricity in unavailable. Make sure you have batteries and tapes for the tape player.

 

Other Ideas:

Writing a story; as a family or individually.

Make sure you have a decent sized religious library and learn the more about the scriptures.

Have a set of encyclopedias (not internet – that may not be available) Learn tons of new information.

 

Make a list of interest of each family member and have the supplies needed each person.

 

 

 

 

Preparing for Death

Patient Prognosis During Pandemic Influenza

As a general rule, all patients should receive the same level of care since it will be impossible to determine who will live and who will die.

 

Type 1

These patients have the poorest prognosis and almost all will die with in 2-3 days of the development of their first symptoms. The causes of death will most likely be from massive respiratory failure. Patients that already have a compromised respiratory system or heart problems will most likely be in this category. At the time the pandemic hits, there will probably still not be an effective treatment.

Signs ands symptoms:

Rapid onset of severe shortness of breath; cyanosis (bluish discoloration of the skin of the hands, feet and around the mouth) or bleeding from the lungs, stomach and rectum.

Type 2

Similar to type 1, except they may live one week to 10 days. These individuals may survive of they had access to ICU equipment and professional medical care, but since those resources will be limited during a pandemic, there will be no hope, no matter how much care they receive.

 

Type 3

These individuals will survive in either medical units or home care. These patients WILL BE COMPLETELTY DEPENDENT ON OTHERS FOR CARE. Death is possible if secondary infections such as pneumonia, stroke, or heart attack occur.

 

 

Signs of Impending Death

Increased sleeping

Less interest in eating and drinking.

By this time, the patient will be dehydrated. Keep them comfortable by moistening the mouth moist with a damp cloth, ‘toothettes’ (a small sponge on a stick),

or eyedropper. Keep the lips moist with lip balm.

Changes in speech and hearing.

Speech may become slurred and there may be indications they can’t hear you. Stay calm, talk normal and carry on conversations as normal. Talk about religious beliefs concerning death; express your feelings of love and concern. It’s best to keep all other well family members in another room, especially children. If you have been using an electronic system for communications, other family members can use this to communicate to the dying person. Say the things that have not been said and encourage others to do the same. Your loved one may be able to understand what you are saying even if he or she cannot respond.

 

 

Confusion, visions,

As the oxygen supply to the brain is depleted, they may become more confused about time, where they are and the identity of others. There may also be visual and auditory dreams or visions

Restlessness.

He or she may also become restless, pulling at bed linens, trying to remove clothing, or even trying to get out of bed. One of the causes of death may be a buildup of fluid in the lungs. This will most likely cause panic.

Anticipate any of these symptoms

What you can do: Reorient your loved one by gently reminding him or her of the time and day, and by identifying yourself and others in the room. Keep favorite and familiar objects in the room. Provide physical reassurance by touching, holding hands, or gently massaging the back, hands, or feet. If your loved one is experiencing hallucinations, simply be present to what is happening; it may be appropriate to just listen. Provide a safe environment; bedrails may be needed to keep your loved one from injuring herself

Shortness of breath; feeling of being drowned

Heavy coughing and choking on secretions

Cyanosis: Blue tint to skin, beginning with the lips

Heart rate over 150 with sweating

Indications of shock: cold extremities and rapid weak pulse

 

Breathing may be checked by watching the person’s chest, or by putting a mirror in front of their mouth and nose.

If the person stops breathing for more than 10 minutes the heart and brain usually will die.

Checking the pulse can check heart activity. An inexperienced person should practice taking their own pulse at the corner of the jaw and neck. The carotid artery is located here and is usually easy to check. Pulses may also be checked at the groin and wrist. Having a stethoscope and will aid in checking the heartbeat or lack thereof.

 

 

Memorial Service

The death of a loved one is an intense experience for everyone involved. The time immediately following death is very special and should not be rushed. There is no need to hurry with the removal of the body.

Once a family member has died, it would be best for the family to have some kind of memorial service, even if it is family only and in the home. A memorial service is a way for family members to experience closure to the death of the loved one.

Play the deceased favorite hymns and/or music, have an opening and closing prayer. Anyone interested should say a few words about the deceased and their relationship with them.

Read scriptures and passages from religious material that can bring comfort to living family members.

Bodies that have been temporarily buried will later be exhumed for proper burial. A graveside memorial with friends and family at this time would be appropriate.

 

 

Coping with Death, Grief and Loss

Grief is the body and minds response to the loss of someone or something. Do not think you are so strong that you cannot experience grief. The best response to any of these reactions is to allow time to for healing.

How each person copes with death and loss will be dependant on the person’s experience with death of others and their personal and religious beliefs. It’s best to understand that all survivors will experience some kind of grief response. There is no right or wrong way to grieve; just your way. Below is a list of grief responses that we may or may not experience. It’s best to read and understand these in the event you will experience them and how you may feel.

Denial, numbness, and shock

This serves to protect the individual from experiencing the intensity of the loss.

Numbness is a normal reaction to an immediate loss and should not be confused with "lack of caring".

Denial and disbelief will diminish as the individual slowly acknowledges the impact of this loss and accompanying feelings.

Bargaining

There may be preoccupation about what could have been done to prevent the loss and about ways that things could have been better, imagining all the things that will never be.

Depression

Loss of appetite

Loss of interest in normal daily activities.

Feeling helpless or hopeless, and may have crying spells.

Sleep disturbances. Both insomnia and sleeping too much.

Impaired thinking or concentration.

Trouble concentrating or making decisions and have problems with memory.

Changes in weight.

Agitation, restlessness, irritable, easily annoyed.

Fatigue or slowing of body movements. Feel weariness and lack of energy nearly every day seeming like everything is in slow motion; speaking in a slow, monotonous tones.

Low self-esteem. Feelings of worthlessness and excessive guilt.

Less interest in sex.

 

Thoughts of death, dying and suicide.

Gastrointestinal problems (indigestion, constipation or diarrhea),

 

Headache and backache; general unexplained aches and pains.

 

Anxiety.

 

Children may perform poorly in school, refuse to go to school, or exhibit behavioral problems.

Anger

This reaction usually occurs when an individual feels helpless and powerless.

Acceptance

Healing occurs when the loss becomes integrated into the individual’s set of life experiences Time allows the individual an opportunity to resolve the range of feelings that surface.

Factors that may hinder the healing process:

Avoiding or minimizing emotions.

Use of alcohol or drugs to self-medicate.

Use of work (over function at workplace) to avoid feelings

Guidelines that may help resolve grief

Allow time to heal.

Acknowledge and accept all feelings, both positive and negative.

Journal

Confide in friends, family and religious leaders

Express feelings openly.

Identify any unfinished business and try to come to a resolution.

Attend Bereavement Group. Once the pandemic has passed, there will most likely be a number of support groups cropping up. Join one if possible.

If the healing process becomes too overwhelming, seek professional help.

 

 

Caring for the Dead

State Plans

(Most States)

 

What are the States planning for mass casualties during a pandemic? Have these plans included resources out state; i.e. crematories, mass storage of bodies, what about religious and cultural issues on disposal of the dead?

Most States have applied for and received federal funding to hire one full time person whose responsibility is to plan for "care of the deceased" during a pandemic influenza. Planning will include all of these issues.

 

Who is responsible for payment of the site and final disposition?

At this time, this question has not been answered. Both the local government and the state will probably be involved. There may be federal money to help offset some of the costs involved. We just do not know at this time.

 

Can the county take state land under imminent domain law?

This is highly unlikely. If a city or a county has to implement a temporary cemetery site, the key word is "temporary." We do not intend to bury bodies and have that be their "final resting place." Once mortuary services are able to recover from the surge of deaths that have overwhelmed their local resources, the bodies would be disinterred and returned to the funeral home of the family's choice for burial or cremation.

 

Who would the funeral directors report to?

Funeral homes don't really need to "report" to anyone. They will go about their business in a usual manner and once they are unable to keep pace with the surge of deaths in their area, the state plan for assistance (temporary morgue/processing center) would kick in. The state will work with funeral homes and local governments to help them in their planning.

 

How will the Mortuary providers handle such an influx in bodies?

Mortuaries, hospitals, nursing homes and other care facilities in some areas of the state will be overwhelmed by a surge in death tolls should pandemic influenza strike. In those areas, planning will be required so that an effective response is coordinated.

 

Who will be trained for the care of the deceased?

Funeral homes, medical examiners/coroners, health care facilities, National Guard, state and local governments.

 

What is a temporary morgue?

A temporary morgue is a location that will be used to process dead human bodies when mortuaries have been overwhelmed in certain geographic areas of the state. Once local mortuaries are able to return to normal business operations, they would come to the temporary morgue on behalf of the family contracting with them for the funeral arrangements.

 

If someone dies as a result of pandemic influenza, is the body still infectious?

Influenza is spread by inhalation of respiratory aerosols, by deposition of respiratory aerosols on the mucous membranes of the eyes, nose, or mouth, and by inoculation of the eyes, nose or mouth by hands contaminated with respiratory secretions. Once an infected person dies they will no longer be expelling aerosols, however the airspace of a recently deceased patient may contain respiratory aerosols for a short period of time after death and the respiratory secretions of the patient could also be infectious for a period of time after death.

 

Therefore, the following recommendations are for family members of the deceased:

Respiratory protection should continue to be worn by family members in the airspace of the patient immediately after the patient's death. Contact with the respiratory secretions of the deceased should be avoided. If the family of the deceased patient wishes to touch the body, they may do so. If the patient died in the infectious period, the family should wear gloves and gowns and follow with hand hygiene (washing hands with soap and water or using an alcohol-based hand rub). If family members want to kiss the body (hands, face) these body parts should be disinfected, using a common antiseptic (e.g., 70% alcohol). If the family wants to view the body and the face of the deceased, but not touch it, there is no need to wear gowns or gloves.

 

If my family member dies in our home, is there anything I need to do to preserve the body until someone (funeral home, etc.) is able to collect it?

The WHO (World Health Organization) recommends that the bodies of persons who have died from pandemic influenza be wrapped in a thick plastic sheet or plastic body bag for transport. Prior to removal from the home, family members could cover the body with a sheet or a blanket. Other than that, the best thing that could be hoped for is to keep the body in a cool place. The state will be working on a way to notify authorities of deaths that take place in homes when local mortuaries are no longer able to conduct business as usual. Handle the deceased in the same way as a sick person. Full body protection.

 

Will cremation be mandatory during a pandemic?

No.

 

* Will families be able to hold traditional funeral services during a pandemic?

Probably not. More than likely, public gatherings will not be allowed, and that would include funerals. Private family funerals will be allowed and everything possible will be done to allow for normal, religious and cultural ceremonies.

 

With so many deaths, how will people be able to keep track of deceased family members?

The state is working on a web-based computerized system that will address this issue.

How will death certificates be handled?

Most death certificates are already done electronically by funeral homes and doctors/M.E.'s /Coroners. Once funeral homes are overwhelmed by a surge in deaths, the temporary morgues would take over and process the death certificates. Copies of the certificates are available at local county offices. Have the following information available.

If having to temporarily bury a body, make sure to include a copy of the death certificate info with the body. Seal in a plastic bag and place on the body before wrapping it.

 

Will bodies be collected and disposed of in mass graves?

If temporary morgues are required in certain areas of the state, bodies would be collected in non-traditional methods. For instance, the National Guard may be used to collect the dead. If the surge is so great that refrigeration of the dead is not possible, then "temporary" burial may be required. Again, religious and cultural issues will be a factor in this decision. There may be no need for temporary burial if a pandemic strikes during the winter. If that is the case, natural refrigeration would be possible until mortuaries are able to recover and return to normal business.

 

Is there any planning going on to address the psychological impact on families who may have witnessed the death of (a) loved one(s)?

At this time, the Mortuary Science Section within the Minnesota Department of Health has only considered the impact on the death care industry workers. There may be other state agencies that are working on this.

.

Who will be trained for the care of the deceased?

Funeral homes, medical examiners/coroners, health care facilities, National Guard, state and local governments.

 

What if the next of kin doesn’t want their relatives buried at the site; what authority is there on this issue?

Every accommodation will be made to honor the cultural and religious customs of individuals. However, if temporary burial is necessary, family wishes can be honored during the recovery stage of a pandemic.

 

Will funeral homes be embalming bodies?

As long as funeral homes have the time to do embalming, they may do so.

 

Mass burial sites: a. who has the authority to pick a location; b. who will pay for this?

Local government.

 

 

 

 

What to do when a family member dies and local officials cannot arrive quickly.

 

Treat the body with the same precautions as if caring for a patient with the flu.

Finger print the deceased and fill out the Death Certificate Information.

Wrap them first in a sheet

Make sure death certificate information and fingerprints are placed in a plastic bag (sealed) and laid on the body, but over the sheet. Make sure you have kept another copy for yourself.

Wrap in thick plastic or several layers of any other thinner plastic.

Put the body in a cool room, or if it’s hot and needs to go outside, make sure it can’t be bothered by rodents or other animals. DO NOT bury it unless instructed to do so. This can contaminate the soil. A simple wooden box will suffice for the time being.

 

*

Once a family member has died, it would be best for the family to have some kind of memorial service, even if it is family only and in the home. A memorial service is a way for family members to experience closure to the death of the loved one.

Play the deceased favorite hymns and/or music, have an opening and closing prayer. Anyone interested should say a few words about the deceased and their relationship with them.

Read scriptures and passages from religious material that can bring comfort to living family members.

Bodies that have been temporarily buried will later be exhumed for proper burial. A graveside memorial with friends and family at this time would be appropriate.

 

Information needed for the Death Certificate

 

Deceased Name: First _________ Middle ______________ Last ________________

 

Date of Birth _______ Age _____ Sex _____ SS # ___________________________

 

State/Country of Birth ____________________ City __________________________

 

Military Service Y/N Branch __________ From ___________ To ________________

 

Marital Status _________ If Married – Yrs __________ Yrs Educated ____________

 

Race _____________________________

 

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