Guidelines for Providing Home Care
Guidelines for Providing Home Care
Any persons suggestive of ILI or Patients in categories A, B and those who have been discharged from hospital with advise for home isolation, should be confined at home and avoid mixing with public and other members in the family that are at higher risk.
Guiding Principles for home care
Patient should:
- Be informed about the illness.
- Stay home for seven days, preferably isolate himself / herself in a well ventilated room. Avoid common areas frequented by other family members of the family. If the living space is small and more than one person need to sleep in a room, ensure that the head end of patient and others sleeping in that room are in opposite direction (head to toe).
- wear mask all the time. Three layered surgical mask should be provided by the hospital community health worker at the time of screening. If mask is not readily available, mouth and nose should be covered with a piece of cloth or handkerchief. The mask or handkerchief should be changed every six hours or earlier if it gets wet.
- Avoid both active and passive smoking.
- Avoid close contact with others.If inevitable, they should always maintain an arm’s length (at-least one metre).
- Avoid having visitors.
- Avoid hand shaking and wash hands frequently with soap and water
- Be monitored to assess worsening of symptoms.
- Take plenty of fluids.
- Follow cough etiquettes whenever mask is not worn/not available -
- Cover mouth and nose with a tissue/ handkerchief when coughing or sneezing; In case tissue/handkerchief is not available cough/ sneeze onto your upper arm or shoulder; coughing/ sneezing directly onto hands should not be done.
- Turn away from others when coughing or sneezing
- Do not spit/blow nose here and there, use a water filled receptacle for collecting sputum, thereby minimizing aerosol generation
Precautions to be taken by Care Giver:
The care provider should
- Wear disposable triple layer mask.
- Wash hands frequently using soap and water or commercially available hand rubs
Early Warning signs/ Symptoms for hospitalization
The care giver at home should be aware of the early warning signs.
The early warning signs in adults are:
- High grade fever not responding to antipyretics.
- Difficulty in breathing or shortness of breath
- Pain or pressure in the chest or abdomen
- Sudden dizziness, Confusion and
- Severe or persistent vomiting.
The early warning signs in children are:
- Fast breathing or difficult breathing
- Bluish skin/lips/nails colour
- Inability to drink enough fluids/ refusal of feeds
- Lethargy/somnolence
- Irritability/persistent crying
- High fever with rash/cold extremities
- Seizures
These signs/ symptoms needs to be identified early for immediate start of treatment and hospitalization.
Most of the adverse outcomes occur because of late reporting of the cases to hospital.
In particular, patients with co-morbid condition (hypertension, diabetes, bronchial asthma, chronic bronchitis or Obstructive airway diseases, immune-compromised status etc) need to be observed for worsening of symptoms.
Preventive care for the contacts
All the contacts need to self monitor their health.
Household contacts of the cases having co-morbid conditions shall be put on chemoprophylaxis with Oseltamivir drug. Prophylaxis should be provided till 10 days after last exposure (maximum period of 6 weeks) - Usual dosage for adults is 75 mg OD.
Dosage by Weight
- For weight < 15kg - 30 mg OD
- 15 - 23 kg - 45 mg OD
- 24 - <40 kg - 60 mg OD
- >40 kg - 75 mg OD
For infants:
- < 3 months - Not recommended
- 3 - 5 months - 20 mg OD
- 6-11 months - 25 mg OD
Infection Control
- The infection control practices listed in the guiding principles would be followed including frequent hand wash, cough etiquettes, maintaining arms length distance from others.
- The contact surfaces would be disinfected by wiping, with sodium hypochlorite solution or with household bleach (5%) solution.
- Disposable Triple layer mask should not be re-used.
- Masks used by patients / care givers/ close contacts during home care should be disinfected using ordinary bleach solution (5%) or sodium hypochlorite solution (1%) or appropriate concentration of Quaternary Ammonium household disinfectant and then disposed off either by burning or deep burial.
- Where medical waste management protocol cannot be practiced, it may be disposed off either by burning or deep burial.
- Hands should be washed after handling any infected or potentially infected material.
- Utensils used by the patient should not be used by others without washing.
Source : MoH & FW Guidelines for Providing Home Care to Influenza patients
Last Modified : 7/3/2023
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