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Jonathan Fernandez @just1doctorwala
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Fighting the flood

A handy list from Society for Emergency Medicine - India

Prepared by Dr. Danish

Your house isn't your home anymore...

But let us help each other to rebuild...
1. Enter your hiuse at moening itseld when there is daylight.
2. Do not take children and elderly when you enter your house for the first time.

3. While entering make sure to wear thick boots or shoes as most common injury is trauma from sharp objects.
4. In case of injury from sharp items wash with soap and water then apply pressure over wound with clean cloth till bleeding stops or tie a clean cloth right over the wound like a simple dressing.
5. All sounds occurring or in contact with dirty water should receive tetanus (TT) injection

6. Use emergency battery powered light while entering.
7. Do not switch on electrical appliances as it may lead to shock or short circuit. Before entering house make sure to switch off the main switch and remove the fuse. Also disconnect any inverter or solar powered devices and remove the batteries of these devices.
8. Do not enter the house with lighted candle or fire as there may be an ongoing gas leak and can lead to huge catastrophe.

9. Start cleaning your house by forst washing off the mud with water.
Next clean the affected areas with bleaching powder (6-8 tsp of 30 - 40% powder to be mixed with 100ml water then add 1 litre water and rest mix for 10 mins - next add this thick mix into 1 bucket (20 litres) water. Pour the solution on the floor wait 30 mins to disinfect area.
Then clean up with water. You may use any floor cleaning liquid to wash off any smell. Please use gloves, shoes and similar personal personal protective equipment when doing all the above. Those who have asthma and allergies should be careful doing the above.
11. Natural sun drying should be done for all items possible.

12. Items that can't be moved to be sun dried should be cleaned with bleaching powder solution.

13. In case of encounter with live wire or broken high voltage lines please contact KSEB ON 94-96-061-061
14. Food and medicine thay has come in contact with the muddy water should be discarded.

15. Clothes, sheets which are affected can be washed after being soaked in boiling water for 3 minutes.
16. For all other uses use only cooled boiled water (boil minimum 1-2 mins to completely kill any organisms)

17. Ensure proper and thorough cleaning of fruits and vegetables before consumption.

18. Clean out any utensils vessels pots etc with bleaching powder.
19. Check all corners of the house for any hiding poisonous worms or reptiles.

20. Mosquito breeding sites must be cleaned with bleaching powder to prevent expansion of breeding sites.
21. In case of multiple people of an area developing similar illness like diarrhoea, vomiting, do inform nearest public health control room.

22. Always wash hands with soap and water before handling food and after using toilet.
23. Chlorinating water tank - for every 1000L of water 4gm of 33% chlorine should be taken in a bucket and made into a paste, add water upto 3/4 capacity of the bucket and mix well. Wait for 15 mins and transfer this solution into the tank and mix well. Use water after 1 hour.
24. Make sure to clean the toilets thoroughly.

25. Dead animals or birds should be given deep burial and the area should be sprayed with bleaching powder.
26. Most common disease after a flood is diarrhoea.

In cholera there is watery diarrhoea.
Dysentery has bloody diarrhoea.
In both cases hydration is main treatment.
27. Sterilization of water can be done by:
- boil water for 1-2 minutes
- if boiling not possible use 1 chlorine tablet for 20L as it kills upto 99% organisms.

28. Keep out flies from contaminating food and drinks as they are source of diarrhoeal disease.
29. ORS should be consumed for diarrhoea or can be made at home by mixing 1L boiled water with 8 tsp sugar and tsp salt. For a child <10 years should take 50-120 ml of ORS after each diarrhoeal episode and adults should take as much as they can.
30. Person's coming into contact with dirty water should take prophylaxis of Tab doxycycline 200mg once a week for 4 weeks to prevent leptospirosis (rat fever)
31. Wet skin can quickly bring out fungal infection. This can be controlled with clotrimoxazole ointment applied twice daily on the affected skin.
32. In case of snake bite, do not tie the area off tightly but keep the bitten area lower than the level of the heart when possible. Don't panic and do not try sucking out the poison. Shift immediately to A medical centre with anti-snake venom available.
33. Jaundice caused by hepatitis A & E occurs from drinking contaminated water.
Hepatitis A vaccine is available for those who are exposed to the disease within 2 weeks of exposure. Symptoms of hepatitis are decreased appetite, nausea, vomiting, very yellow urine, yellow eyes etc
34. Those who are around malaria prone area can take chloroquine tablet as prophylaxis and can prevent malaria by using mosquito repellent creams and nets.
35. All viral fever like dengue can be controlled with adequate water consumption. Dengue is caused by mosquito bites.
36. Conjunctivitis can spread easily in relief camps and can be prevented by avoiding close contact or sharing clothing with infected persons. Those who are infected should wash eyes frequently.
37. Urinary infections can be prevented to A limit by consuming lots of water and using toilets as needed without retention.
38. Common respiratory infections like cold and cough can be prevented by using makes and if infected persona should cover their mouth and nose while coughing /sneezing.
39. Allergy prone individuals must use a make or cloth to cover nose and mouth before cleaning the house.
40. Make sure to use rubber gloves while scrubbing with bleaching solution to prevent contact skin irritation.
Stay strong!

Prevention is better than cure.

We are all with you!
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