Author Topic: How to Isolate a Patient at Home from the 1942 Red Cross Home Nursing book  (Read 3244 times)

Offline Frugal Upstate

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Ok, so this is something that I've wanted to share for a while because I think it is really good, important information.  About a year ago I picked up two books at the library book sale--they were Red Cross Home Nursing books from 1942 and 1951.  They are EXCELLENT and I highly recommend that everyone go to Amazon or another used book source and pick them up.  Here are some links to look at them (they are my affiliate link, but buy them wherever you find them cheap) on Amazon--they run a couple of bucks, plus about $4 shipping.  Totally worth it:

The Red Cross Home Nursing -- 1942
The Red Cross Home Nursing -- 1951

The two books are different, not just regurgitation of the same exact info with some slight updates. 

Long story short--the Red Cross used to teach classes on how mother could take care of her sick family (under a doctors direction) at home.  The books contain basic info on health, children, community health & sanitation (think clean milk supply and water etc), and a lot of info on how to care for folks at home.  This was back when the doctors would recommend bed rest for folks and staying at the hospital just wasn't done much.

The 1951 book includes a lot of really neat ideas for how to improvise things at home (some of my favorites were using an umbrella and sheet to make a steam tent for a bedridden patient and putting a pitcher of hot water on a chair next to the bed, make "donuts" out of rolled socks to relieve pressure and prevent bed sores, and info on how to make bags and slippers etc out of old newspapers).    The 42 version seems heavier on the community health stuff, and includes a WONDERFUL chapter on isolating a person who is sick with a communicable disease told story style.

That's what I'm going to reproduce in sections here.  I really would like to type the whole thing out and offer it as a pdf, but quite frankly it's difficult to tell if the book is in the public domain (ie out of copyright) or not.  Maybe one of these days I'll visit my sister down by DC and go to the copyright office to check. . .but meantime I'm not paying for the info.  Instead you can all get it installment style as I have time. 

I hope you find it as informative as I do.  I'll start the first section as a new post.

Offline Frugal Upstate

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Part I
« Reply #1 on: January 28, 2018, 10:49:00 AM »
How to Isolate a Patient at home.

You have learned how to keep a patient clean and comfortable in bed, how to recognize symptoms of illness, and how to carry out the doctors instructions for giving food, medicine and treatment.  You have also learned the importance of clean hands as a protection against the spread of disease germs from one person to another.  All these principles and procedures are used in the care of a patient who is will with a communicable disease. 

In Appendix 6 on page 403 you will find a chart listing the most common communicable diseases, their source of infection, early symptoms and other facts of interest, to which you may refer when you want this information.  But what would you do if you were actually faced with the necessity of taking care of a member of your family who had developed one of these diseases?

In order that you may learn just how to mother in a home might meet such a situation we shall bring into being an imaginary family which consists of Mr. and Mrs. Keen and their three children--Julie, aged 14, Jack aged 12, and Jimmie, aged 9.  Mr Keen is a good citizen who has a small business, by means of which he provides a modest by comfortable home.  Mrs Keen is an intelligent mother who is devoted to her family and her community.  She belongs to several civic organizations, and is always on alert for opportunities to broaden her knowledge and her usefulness.  One of her most recent interests has been the American Red Cross course on home nursing that was offered by the local chapter, and which she attended faithfully.

One day in the spring, Julie came home from school with heavy eyes and a flushed face.  She said she had a headache and a sore throat, and her stomach felt sick.  She went to her room to lie down.  Mrs. Keen had heard at a parent-teachers meeting that there were a few cases of scarlet fever in town, so she was immediately suspicious.  She put away her sewing, washed her hands, and brought out the fever thermometer.  She cleaned it carefully with soap and water, as she had been taught, and took Julies Temperature.  She was a little startled to find that the thermometer registered 102.4. She knew that Julie was really sick.

"of course," she said to herself, as she cleaned the thermometer and washed her hands, "It may be nothing more than a cold, but on the other hand, it may be scarlet fever, or something else as bad."

She decided to take no chances with the matter, and went at once to call Doctor Pierce, to whom she had always gone with her worries about the children.

When Mrs. Keen told Doctor Pierce about the elevated temperature, and how Julie looked and acted, he said "Put her to bed and keep her there.  Give her nothing but fruit juice and water.  I'll come out and see her a a little later in the day.  And by the way," he added "keep the other children away from her.  No use in having them all sick."

Doctor Pierce came over a few hours later, and after looking Julie over carefully, said, "There's not much doubt that she has scarlet fever.  Can't be too sure yet, but everything points that way.

Mr Keen looked a little worried.  "Does that mean we have to be quarantined?" he asked.

"I'm afraid it does," Doctor Pierce answered, "But we can make some arrangements so you can go on about your business I think.  The health department is usually reasonable when they know they can trust a family to protect the community."

Mrs Keen asked "What about the other children going to school?"

"No," said Doctor Pierce.  "They'll have to be quarantined.  They haven't had scarlet fever, and there's no telling but they'll come down with it too."

"Oh my goodness!" Mrs. Keen exclaimed.  "I don't know whether I can keep them from it, here at home, or not."

"Sure, you can," encouraged Doctor Pierce.  "it would be nice of course," he went on, "if we could just bundle Julie up and take her to the hospital.  But the hospital is running over now, so you'll just have to the the best you can here."  He thought for a moment and said, "You know, in some of the larger cities they have visiting nurses who can go into the home and show a family how to do things, in a case like this.  Maybe some day we'll have that kind of service too."

"Well, I hope so," Mrs. Keen sighed.  But if you'll tell me what to do, we'll just prepare ourselves for the siege."

Offline Morning Sunshine

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I have the 1963 version.  I have not yet had a chance to read through it.

Offline Frugal Upstate

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Part II
« Reply #3 on: January 28, 2018, 11:05:14 AM »
Doctor Pierce stayed for an hour or more and instructed Mr and Mrs Keen how to arrange and equip Julie's room so that she would be isolated from the rest of the family, and Mrs Keen could take care of her without spreading the disease.

The arrangement of the room was not difficult since the bathroom was at the end of the hall and the family could have the use of it without going near the patient.  The pictures were taken down to simply the problem of cleaning when the illness was over.  The window curtains were plain and washable, and so were allowed to remain.  Fortunately the rugs were small, so it was no trouble to remove them and leave the floor bare and easy to care for.  Everything was removed from the dresser, but the closet was left undisterubed, because the clothes julie had taken off hung there and Doctor Pierce said it was already contaminated.  An extra table, to be used for hand washing equiment, was brought in and placed just inside the bedroom door.  Oilcloth from the kitchen table was cut up and used to cover dresser and table tops to protect them from water.  A basket for waste was lined with newspapers.  A hook was put up beside the door for the gown Mrs Keen would wear to protect her clothes when caring for Julie.

Since the bedroom was on the second floor it required carefull planning to equip it so as to save Mrs Keen from making too many trips up and down the stairs.  Doctor Pierce said that having everything conveniently arranged lesseened the danger of spreading the infection, too.  By souting around among the neighbors Mr Keen succeeded in borrowing a bedpan and a large pitcher and basin.  One basin and pticher were placed on the hand washing table by the door, together with soap and towels.  Anbother pticher and basin, to be used for Julie's bath, were placed on the dresser.  The bedpan was placed between newspapers on the lower shelf of the bedside table.  Mrs Keen said "Tomorrow, when I have a little more time I'll make a newspaper envelope for it, like the picture in the home nursing book."

The floor outside the bedroom door was protected with newspapers on which could be placed a dishpan full of soapy water to receive soiled dishes, and a wash boiler to receive soiled linen.  There, too, was kept the waste pail to receive water from the hand basin, so Mrs Keen wouldn't have to go into the bathroom so often.  Doctor Pierce expained that the bedpan might be emptied into the toilet, if she were careful to use a piece of paper to lift the seat so it would not be contaminated.  Mr Keen was a little concerned about this, because he was afraid germs might be carried to someone else through the sewer.  "No," said Doctor Pierce, "scarlet fever germs are not carried in bowel and bladder discharges, but mainly in nose and throat discharges.  Those will be burned, you see.  The few germs that go into the toilet will be taken care of at the sewage disposal plant.  Of coure," he added, "if this were a case of typhoid fever or dysentery, it would be different.  Then the bowel and bladder discharges, bath water, and everything would have to be disinfected for an hour or more before they could be put in the toilet."

Doctor Pierce stood looking over the room with an air of satisfaction.  "Just keep in mind that you have two responsibilities.  First you want to give Julie the best of care so she will get well as fast as possible.  And second," --he emphasized each point by smacking the forefinger of one hand on the palm of the other-- "you must keep the germs from leaving this room on hands, linen, dishes, food, body discharges or flies."

"One, tow, three, four, five, six ways for them to travel," Mrs Keen counted, watching the pointing finger.

"Good thing I go the screens put up last week to keep out the flies," Mr Keen commented.

Just before the doctor left he said, "Now doin't let this worry you Mrs Keen.  It isn't as bad as it sounds.  Just remember that eerything that goes into this room, or that comes in contact with Julie and her surroundings in any way, is a possible germ carrier.  When it leaves the room it must be disinfected or boiled before it touches anything else.  If you do that you'll be fairly safe."

"That isn't hard to remember," Mrs Keen said, looking at the notebook in which she had written down all Doctor Pierce's instructions.

"A good idea," Doctor Pierce continued, "is to draw a chalk mark on the floor across the door, so you'll always be reminded that anything that crosses that line must be disinfected when it comes out."

"I'll do that right now," and Mr Keen went to get some chalk.

"Soap and water, soap and water--they are your best friends.  You may think you've always been clean," Doctor Pierce laughed, "but you have to be cleaner than you've ever been in your life when you are dealing with disease germs."

Offline Frugal Upstate

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I have the 1963 version.  I have not yet had a chance to read through it.

I'll have to look at that!  I like these older ones because of what they don't have.  They didn't have disposable gloves, q-tips, cotton balls. . . well all sorts of things that we see as necessary now, but that might not be available in either TEOTWAWKI or even just a bad epidemic where supplies are short on the shelves.

Offline Chemsoldier

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Excellent. Timely also. Someone in the family has been sick for the last month or so.

Offline Frugal Upstate

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Part III
« Reply #6 on: January 28, 2018, 12:26:07 PM »
When Doctor Pierce had gone downstairs, Mrs Keen stood before the dresser and surveyed the trays she had fixed up.  She was rather proud of them because they were exactly as the instructor in class had taught her.

"What's the big idea of those trays?" Mr Keen asked from the doorway.

"It's just more convenient, that's all, and it keeps everything together," Mrs Keen replied.

The toilet tray, which was an oblong baking pan, held:
Soap dish
Toothbrush, in a glass
Tooth paste
Cotton swabs for the mouth, in a covered mayonnaise jar
A bottle of mouthwash
A small pan, to be used as a mouthwash basin
Cold cream for the lips
Comb, brush, nail file, orangewood stick
Bottle of rubbing alcohol
Can of talcum powder

The thermometer tray was a square cake pan.  It held
A glass filled with alcohol, in the bottom of which was a pad of cotton (a paper cap, held down by a rubber band, covered the glass to keep the alcohol from evaporating.  The end of the thermometer protruded through a hole in the paper.)
A covered jelly glass filled with dry cotton pledgets
A bottle of liquid soap, made from plain white soap melted in boiling water
A small pitcher or clear water
A newspaper bag for waste
a pencil and piece of paper

"I think I have everything there," Mrs Keen said, "and even the trays we used in class didn't look any better."  She turned to the hand-washing table.  "This is about the most important place of all, I guess, from the way the doctor talked."  She checked off the equipment:
Pitcher of water
Washbasin
Dish of soap
Some small towels.

"Oh, John, I forgot the toothpicks to clean my nails with.  Will you go get them?  And when you come up bring a pile of newspapers and a ball of cord.  I'm supposed to tie all the garbage and waste up clean newspapers before I take it down to burn."

"What about those newspaper squares the doctor said you could use to handle things with when your hands were dirty?" Mr Keen asked.

"That's right, I forgot those.  Please cut some pieces about six or eight inches square.  Our instructor showed us how to use those, but I'm going to have to practice it a lot, to be sure I get the habit." 

While Mr Keen went for the newspapers, Mrs Keen washed her hands and removed the housedress she had been wearing.  "I'll take this off and fold it inside out, just in case it might have a germ on it," she explained to Julie, who was growing a little restless with all the confusion.

"Now I'm going to put on that old blue smock that's clean, and go down and get you some fruit juice before I take your temperature and get you settled for the night.  Then I'll hang the smock up in here and use it for a gown to protect my dress.

Mrs Keen laid the carefully folded housedress on the newspaper outside the door and washed her hands again.

"My goodness," she said, "I'm already getting self-conscious about washing my hands."

She went to the stairway and called, "There's another thing we forgot, John.  Bring up a floor mop and dustcloth, when you come.  I'll have to keep those right here in the room, of course."  Turning to Julie, she said, "I'll put them on a newspaper over here in the corner where you won't have to look at them."

Mr Keen came up with his load of newspapers and mop.  "The boys want to know if they can come up and see Julie," he said.

I should say they can't," Mrs Keen replied emphatically.  "I don't want to hear of either of them so much as putting his nose inside this door.  They are not going to have scarlet fever if I can help it."

Offline Frugal Upstate

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Part IV
« Reply #7 on: January 28, 2018, 02:24:14 PM »
Mrs Keen returned from the kitchen presently, bearing a tray on which was a covered pitcher of water, a clean galss, and a class of fruit juice on a small plate.  "Here Daddy," she said.  "You hold the tray outside the door, and I'll take the things into the room.  Then the tray will be kept clean."  She placed the dishes on the bedside table.

"Doctor wants you to drink all the water you can, Julie, so I'll put this pitcher and glass here where you can reach it.  But don't take a drink until I've taken your temperature."  Mrs Keen removed the thermometer from the alcohol, wiped it with dry cotton, and looked to see if the mercury was down.  Then she took the little pitcher of water from the tray and carreid it to the waste pail outside the door where she poured water over the thermometer to moisten it.  She put the pitcher back on the tray, and the thermometer in Julie's mouth.

"Oh, dear, I would forget something!" she exclaimed, going to the door.  "John, you'll have to leave your watch at home for the duration, I guess.  Mine has no second hand."

"Anything to oblige." Mr Keen approached, holding out the watch but looking a little apprehensive.

"Now, this is where I begin using newspaper squares."  Mrs. Keen held out a square to receive the watch.  I'll never touch it except with clean paper.  Then it won't have to be boiled when we get out,"  she assured him, laughing. 

Mrs Keen counted Julie's pulse and respiration, then laid the watch, newspaper square and all, on the table.  "I'll pick that up with clean hands when I get ready to leave the room," she reminded herself. 

Mrs Keen removed the thermometer from Julie's mouth, wiped it from the large end to the tip with dry cotton, read it, and jotted down the temperature, pulse and respirations on the piece of paper on the tray.  Then she moistened a clean piece of cotton with the soap solution and cleansed the thermometer, again wiping from the large end to the small end, and putting each pledget of cotton in the paper envelope as she finished using it.  Again she took the small pitcher of water and thermometer to the waste pail at the door and poured the water over the thermometer to rinse off the soap.  This done, she shook the mercury down and replaced the thermometer in the glass of alcohol.  When Julie had finished her glass of fruit juice, Mrs Keen put the soiled glass in the pan outside the door.  Then she carried the toilet tray to the bedside and helped Julie use her toothbrush and rinse her mouth.  She emptied the mouthwash basin into the waste pail, rinsed it with water from the large pitcher in the bath basin, and wiped it with clean toilet tissue from a fresh roll she had placed on the dresser to be used for this purpose.  The paper was dropped in the newspaper lined basket.

Next, Mrs Keen gave Julie the bedpan.  When she removed the pan she carried it to the bathroom, being careful not to touch anything in the room with her smock or hands;  with a newspaper square, she lifted the seat of the toilet and emptied the pan.  Returning to the room, she poured water from the bath pitcher into the pan, rinsed it, emptied the water in the waste pail, and returned the pan to it's place.  The square of newspaper was crumpled and tossed into the wastebasket.

"I do hope I'm doing everything right," she said to herself, "but I guess if I just remember to be extra careful not to touch anything outside of this room while I'm wearing this smock, I can't go far wrong."

Mrs Keen washed Julie's face and hands, and smoothed her bed. 

Julie said "I don't feel very sick, mother."

"No, you're not very sick, and of course we don't want you to be, so we're doing everything just as the doctor tells us an you'll be out of here before we know it."  As Mrs Keen spoke she took a square of newspaper in each hand, adjusted the window shade and raised teh window.  "It's so mild outside, I'm sure this won't be too much breeze.  But I'll put he chair here in front of the window with a sheet over the back to make a sort of screen.

Square of newspaper in hand, Mrs Keen poured water from the pitcher into the basin on the hand washing table.  "Id'd better not touch the things on this table with dirty hands, else how can I empty the basin after I'm through washing without getting my hands dirty again?" she reasoned.  She washed her hands carefully using lots of soap, then emptied the basin into the waste pail, and refilled it from the pitcher so that it would be ready the next time she washed.

After she had dried her hands she cleaned her fingernails with a toothpick.  "Now I'll see if I can wriggle out of this thing, as the book says, without touching the outside of it.  She unfastened the smock and lowered her arms, hunching her shoulders a little as she did so.  The smock was loose fitting and slid off easily.

"That wasn't as hard as I thought it would be" she said ads she hung the smock up by the shoulders, contaminated side out, still keeping her hands inside the sleeves.

"The doctor said I should have a clean gown at least once a day.  I'll cut the sleeves off another old smock tomorrow, and I'll have a fresh gown to put on after I get through cleaning up in here, in the morning.  That old hoover apron I haven't worn for years will do for a gown too.  Three ought to keep me going."  She was talking to herself more than to Julie.

She paused beside the bed.  You have a box of paper tissues there to use as handkerchiefs, dear.  Be sure to put them in the paper bag, on the bed beside you, and I'll burn the whole thing in the morning.  When I come upstairs again I'll bring the little brass bell and put it here on the table so you can call me if you want anything in the night."

She washed her hands and refilled the basin.  Then she took the watch from the paper square on the table and left the room, closing the door softly after her.  She put the watch in her own room, thinking as she did so that she must bring up some paper and start a written record for Julie, so it would be ready for the doctor in the morning.  She came out into the hall and took the waste pail to the bathroom and emptied it, drawing a sigh of relief as she put it back in its place.  Returning to the bathroom she turned on the hot water and washed her hands.  "I don't really feel as if I'd washed at all until I've done it here with plenty of running water." 

As she dried her hands and reached for the hand lotion, she thought, "I can see where I"ll have to use hand lotion by the gallon, or my hands will chap terribly.  Doctor Pierce said I mustn't allow that to happen or I might pick up an infection myself.  It would certainly be a blow to my pride to have to turn this job over to someone else on that account."  She started downstairs with the dishpan to boil the glass and plate Julie had used.

Offline mountainmoma

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Thanks !

Offline FreeThinker

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Thanks for taking the time to transcribe this, reading it had me envisioning my grandparents middle-class, blue-collar, home (2 adults, 4 kids, and a single bathroom).   Maybe because that's the last time I saw a woman (Grandma) wearing a housedress.  A bedroom with a connected bath for use solely for the sick and caregiver sanitation/hygiene would make things a lot easier.  I did have to google "orangewood stick", and while a laundry "wash boiler" is pretty self explanatory I looked it up to find the type of metal and typical size in gallons.  Copper and 12-20 gallons (household size), and a lot of fuel to bring it to a boil.  Bleach or chlorhexidine diluted with water in a plastic 5 gallon bucket is how we plan to disinfect clothing/linen prior to washing. 

*Speaking of clothing, what is everyone planning to use for caregivers in the sickroom?  I have a few tyvek suits but the wash instructions are "no bleach, cold water gentle cycle, hang dry", did some looking around online for hospital scrubs in the past but never pulled the trigger and ordered any (although they aren't expensive).  Over-sized sweat pants and pullover long sleeved shirts to go over other clothing, dedicated slippers/tennis shoes, and gloves/earloop hospital masks being the plan at the moment.  What's your plan and the reasoning behind it (especially in a grid down situation where electricity and fuel for washing may be limited)?   Thinking more in terms of flu than hemorrhagic fevers.  And if you think this is too far off topic Frugal Upstate I'll edit this out and start a new thread, don't want to mess up yours.*

Offline Frugal Upstate

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Re: How to Isolate a Patient at Home from the 1942 Red Cross Home Nursing book
« Reply #10 on: January 31, 2018, 09:13:42 AM »

*Speaking of clothing, what is everyone planning to use for caregivers in the sickroom?  I have a few tyvek suits but the wash instructions are "no bleach, cold water gentle cycle, hang dry", did some looking around online for hospital scrubs in the past but never pulled the trigger and ordered any (although they aren't expensive).  Over-sized sweat pants and pullover long sleeved shirts to go over other clothing, dedicated slippers/tennis shoes, and gloves/earloop hospital masks being the plan at the moment.  What's your plan and the reasoning behind it (especially in a grid down situation where electricity and fuel for washing may be limited)?   Thinking more in terms of flu than hemorrhagic fevers.  And if you think this is too far off topic Frugal Upstate I'll edit this out and start a new thread, don't want to mess up yours.*

No worries, I think it's great to have a conversation here as it pertains to the readings, but if it gets to be too much of a topic on it's own we can always have it moved over.

When it comes to clothing, I think you should really avoid the use of sweats as your protective clothing--the reason that they use gowns is because it's possible to take them off and put them on without touching the contaminated side.  Here's a poster from the world health organization showing how to put on and take off:

Putting on & Taking Off Personal Protective Equipment

I'm not an expert, heck, I'm not even medical in any way shape or form, but from what I'm seeing in this Red Cross resource, they aren't really trying to provide a waterproof barrier (like Tyvek), just something that the germs will sit on that can be removed and then boiled/washed.  It's not like you are planning on having blood splashing up on  you or getting soaked in body fluids.  And it doesn't have to look awesome, it just has to cover your clothes and stand up to washing and boiling.  It may be best to actually buy some big dresses and split them up the back and add a tie at the neck or something like that.  Does anyone else have any ideas?

On the other hand, you can buy a box of 50 lightweight waterproof gowns on Amazon for less than $40 (note, that is an affiliate link for my account--but buy where ever it works for you).  Eventually you'll run out of disposable gowns though, so knowing about the cloth kind is useful.  You could probably also do the whole "fusing plastic bags together with an iron thing" and line a cloth gown with plastic--or buy oilcloth or something, but not sure how well that would hold up to washing.

Here is a medical video I found of a full on, double glove, bootie, hair cover type PPE:

PPE Donning and Doffing training (11min)

And this is from CNA training of a simpler glove and gown only situation:

Isolation Gown and Gloves Donning & Doffing, CNA Training

If you look for CNA skill training on Youtube you'll find all kinds of skills that you might need with a bedbound patient, like how to give a bedpan, or make a bed with someone in it.

Offline Frugal Upstate

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Part V
« Reply #11 on: January 31, 2018, 09:28:53 AM »
When Mrs Keen returned to the living room a half hour later, she dropped into a comfortable chair and said, "It's late, I know, John, but before we go to bed, let's go over all these instructions Doctor Pierce gave me, and see if I've missed anything.  I have to do this job exactly right.

"You mustn't forget to call the school in the morning and tell them why the children are absent," Mr Keen reminded her.

"I won't.  Now listen, and see if I've got this all right," Mrs Keen read aloud:

Care of Dishes:
1. Scrape unused food onto a newspaper, wrap it and tie with a string, and place it on a clean paper outside the door until it can be taken to the furnace and burned.
2. Place soiled dishes in a pan of soapy water, kept on newspapers outside the door.  Do not touch the outside of the pan with soiled dishes or hands.  When the hands are clean, carry the pan to the kitchen and boil the dishes for 15 minutes before they are used again.  Be sure they are covered with water when boiling.

Care of Bedding and Clothes:
1.  Keep the wash boiler, filled with washing soda and water, on clean newspaper outside the door.
2.  Remove bedding, carefully, to prevent getting it near the face or touching the gown.
3.  Place soiled bedding, towels, washcloths, and patients gown in the wash boiler as soon as removed.
4.  Be careful not to touch the outside of the boiler with soiled linen or hands.
5.  Once a day, or oftener, place the boiler on the stove and boil the clothes for 15 minutes before putting them in the regular laundry."

Mrs Keen broke off.  "John, you'll have to help me carry the boiler down to the basement each evening so I can boil the clothes and take the boiler back upstairs to be ready for the next day."

"O.K." Mr Keen agreed.

"I forgot to put down how much washing soda to put in.  Did Doctor Pierce say?"

"He said 1 tablespoon of washing soda to 1 gallon of water, I'm sure."

"Fine.  I'll write it down so I don't forget it."

"General Instructions," Mrs Keen read on

1.  You are clean when you go into the room, but as soon as you touch anything that has been in contact with teh patient, you are contaminated.
2.  Your hands must not touch your face or clothing while you are in the room.
3. After your hands are contaminated you must not touch the window shade, or lamp, or anything you want to keep clean, unless you use a piece of newspaper and discard it after using it once.
4.  Your gown is to be kept clean on the inside, but is always contaminated on the outside where ever it touches the patient or bed.
5.  It is not necessary to put on the gown when you go into the room to take fresh water or do anything that does not require touching contaminated articles.
6.  If necessary to disinfect anything that cannot be boiled, soak it in a solution of chlorinated lime and water, mixing 1/2 pound of lime to 1 gallon of water.
7.  Dust the floor and furniture only with damp or oiled mop and dust cloth, and do not remove them from the room.
8.  Open door with newspaper squares in the hand so as to keep doorknobs clean."

"Looks to me as if you are getting a liberal education," Mr Keen commented.

"Oh yes, I suppose so, but I'll never free as if this house is clean again." Mrs Keen sighed deeply.  How in the world will we ever get the place cleaned after we get out of quarantine?"

"Don't cross that bridge until you get to it," Mr Keen warned.  "Doctor Pierce said if you were careful enough while Julie is sick, cleaning up afterward wouldn't be any worse than ordinary housecleaning."

"Well, perhaps not.  But look, it's nearly midnight; and I don't mind admitting I"m tired."  Mrs Keen rose and started for the stairway.

Offline Frugal Upstate

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Part VI (Final)
« Reply #12 on: February 01, 2018, 07:07:32 AM »
Julie had a light run of scarlet fever, with no complications.  Doctor Pierce said it was because she had such good care.  He praised Mrs Keen often for her good work, and said he hoped the time would come when every mother had the knowledge and good judgement she had.

Jack and Jimmie found plenty to amuse themselves with in the yard and basement and rather enjoyed the experience of staying at home and managing themselves.  They were never allowed near Julie's room, and the germs, apparently, never reached them.

With the permission of the health department, Mr Keen came and went to his business every day, and, of course, he stayed away from Julie at night, because that was a part of the agreement. 

By the time three weeks had passed, Julie was feeling as good as new and was impatient to get out of isolation and back to school.  Doctor Pierce came out one day and examined her carefully.  He asked for a specimen of urine to examine, because he said the kidneys were frequently affected by scarlet fever, and he wanted to be sure there was nothing wrong before she was released.  He also took cultures of her nose and throat to send to the laboratory to find out whether it was safe to release her.  He took cultures from the boys too, just to be on the safe side, he said.  A few days later he returned and said the cultures were negative, which meant the family could be released from quarantine.  There was great rejoicing from the children.

"Now, listen, and I'll tell you what you must do," he said.

"Wait until I get my notebook and write it down, so I'll be sure not to forget anything," Mrs Keen exclaimed.  She returned in a few minutes with her book and pencil.

"This is what we call TERMINAL DISINFECTION," Doctor Pierce explained.  "It simply means getting rid of all the germs at the end of an illness so there's no danger of anyone else picking them up."

"First, give Julie a thorough soap and water bath in her room, shampoo her hair, and clean her fingernails and toenails. Don't take her clean clothes into the room, though."

"May I take a tub bath?" Julie asked eagerly.

"Yes, but take the sponge bath in your room first.  Then you can step on clean newspapers and go to the bathroom for a shower or tub if you want to." 

"Second, after Julie is out of the room, it's just a question of soap and water, sunshine and fresh air," Doctor Pierce continued.  "Burn all the papers and trash.  Boil all the clothes and dishes, wash the furniture and floor with soap and water.  Put the mattress out in the sunshine and air for a few days, turn it so that the sun reaches all sides, and brush it well with a whisk broom before you bring it in."

"What about the blankets?" Mrs Keen asked.

"They should be washed in warm soapsuds, rinsed well, and dried in the sun."  Doctor Pierce stood up as if to go.

"Is that all there is to it?" Mrs Keen asked in surprise.

"That's all, except to open the windows and let the room air out for a couple of days."  Take the clothes out of the closet; wash waht you can and hang the others on the clothesline for a few days."

"Don't we have to fumigate with something?"

"No, that's a thing of the past.  Scientific study has proved that soap and water, sunshine and fresh air are more effective in killing germs than fumigation.  And they're much simpler."

"Well, that's a great relief," replied Mrs Keen, "but what shall we do about the books and magazines that Julie has had in her room?"

"Stand the books on end, open, so the leaves are spread apart, and allow them to air for several days, in the sun if possible.  It's less trouble to burn the magazines."

"I was afraid the books would have to be burned, too," Mrs Keen said.

"No, you see most disease germs soon dry out and die in fresh air and sunshine.  If some other person doesn't pick them up soon after they are discharged from the patient, they don't last long;  which is lucky for everybody."  Doctor pierce was in a harry to get away, but he turned at the door to say, "You've done a fine job with this Mrs Keen, I'm proud of you."

"Well, I must admit it hasn't been as hard as I thought ti would be, and I don't think I'll ever be afraid of isolation again," Mrs Keen replied.


PROBLEMS FOR ACTION (this was like the little homework section at the end of each chapter in the book)

1.  Outline a plan for taking care of a patient who has diphtheria in your home, including all the necessary family adjustments, available equipment, and arrangement of the room.

2.  Practice putting on and taking off a gown, used as a protection for your clothes in caring for a patient with communicable disease.

3.  Practice using squares of newspaper as a protection against contamination in handling articles in the sickroom.

4.  Ask your health department for local rules and regulations on the control of communicable diseases.

Offline Frugal Upstate

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Photos from the Book
« Reply #13 on: February 01, 2018, 07:52:46 AM »
Here is the little picture tutorial on how to put on a gown from the book:



The setup with the different buckets/wash boiler etc outside the sickroom door to receive the various contaminated items:



The sickroom set up (sorry, it's dark)--shows the various surfaces covered with oilcloth.  If you look, you can see the bedpan is on the bottom shelf of the bedside table, inside of a newspaper cover. 



A photo showing the "newspaper envelope" for the bedpan:



An example from earlier in the book on how to keep a record of care for the doctor:


Offline Frugal Upstate

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Re: How to Isolate a Patient at Home from the 1942 Red Cross Home Nursing book
« Reply #14 on: February 02, 2018, 06:23:43 AM »
I’ve got to say, I thought more folks on here would find this info interesting.

Offline mountainmoma

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Re: How to Isolate a Patient at Home from the 1942 Red Cross Home Nursing book
« Reply #15 on: February 02, 2018, 11:09:21 AM »
I’ve got to say, I thought more folks on here would find this info interesting.

I find it invaluable, so much so I ordered a copy for myself, and one sent directly to my eldest dd. I think that your transcribing here is fantastic, as it allows the information to get to people without having to order a copy, as copies are limited supply. I think that people dont comment so to not interrupt the flow of posts from you, we see it as an informational resource rather than a discussion thread. I also think that these type of threads are good for the "long haul", in other words may not be read my all now, but when they get scared and wonder, will go to the health part of the forum and then read it. 

Offline mountainmoma

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Re: How to Isolate a Patient at Home from the 1942 Red Cross Home Nursing book
« Reply #16 on: February 02, 2018, 01:09:21 PM »
Eldest dd just called, she got her surprise copy of the book and is enjoying looking at it. She sees it has good info, and we both remarked that Doctoring is sure different now then it used to be, they used to spend more time with patients and would actually give intructions for diet and care

Offline Hurricane

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Re: How to Isolate a Patient at Home from the 1942 Red Cross Home Nursing book
« Reply #17 on: February 03, 2018, 02:13:35 PM »
 :popcorn:

Offline Frugal Upstate

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Re: How to Isolate a Patient at Home from the 1942 Red Cross Home Nursing book
« Reply #18 on: February 04, 2018, 02:47:26 PM »
I find it invaluable, so much so I ordered a copy for myself, and one sent directly to my eldest dd. I think that your transcribing here is fantastic, as it allows the information to get to people without having to order a copy, as copies are limited supply. I think that people dont comment so to not interrupt the flow of posts from you, we see it as an informational resource rather than a discussion thread. I also think that these type of threads are good for the "long haul", in other words may not be read my all now, but when they get scared and wonder, will go to the health part of the forum and then read it.

Thanks Mountain Moma.  I'm glad you and your daughter are enjoying it--I just found it so interesting to see the different way things used to be done.  They didn't HAVE a lot of the things we are worried about running out of in a long term event (one that jumped out at me were gloves) so seeing how they did things without them was both interesting and useful.  I mean I never would have thought of using newspaper squares if I didn't have gloves! 

Offline Frugal Upstate

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I actually think that a lot of folks haven't seen this information and it's so useful, so I'm hoping by commenting on it, it pops up in people's "unread posts" feed.