medical office management 2 1

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Text Readings

Pearsonâ€s Comprehensive Medical Assisting, Chapters 34 and 35

Additional Readings

Supplemental Readings

  • Edward Jenner
  • Joseph Lister: Surgery Transformed
  • Bacteriology—Louis Pasteur and Robert Koch
  • How to Take a Pulse
  • Taking a Patientâ€s Temperature
  • First Aid & Safety Tips : How to Measure & Record Respiratory Rate

Lecture Notes

Infection occurs when bacteria, viruses, parasites, or other microorganisms that donâ€t normally belong in the body somehow end up in the body. Sometimes this happens when a person becomes ill. Other times, these organisms enter the body through cuts or wounds.

As early as the late 1500s, some people understood that bacteria and fungi could make people sick. Even though some of their early presumptions were incorrect, the understanding by some that microorganisms could make people sick and, in some cases, could be contagious for others, did exist during early time periods. So, even though knowledge about infections has grown and changed, people have been aware that disease can spread by biological means for a long time.

Variolation, an early type of vaccine, was developed in the eighteenth century. During this time, some believed that contagious diseases were caused by people catching them from other people. However, there were also scientists and medical people who were known as “anticontagionists” who believed that epidemics such as yellow fever were caused by environmental factors such as changes in the weather or the conditions where people lived. Today, infection control remains one of the most important processes in health care. If weâ€re unable to control infections, then theyâ€ll spread quickly, endangering other patients, healthcare workers, and even entire communities.

Important People in Infection Control

For centuries, people tried to determine the source of disease. In the eighteenth century, scientists were finally able to prove that pathogens were the cause of infectious diseases. It wasnâ€t just one person who discovered the information about infections and laid the groundwork on how to treat them. Many different scientists, doctors, and others contributed pieces of information that finally helped us understand the bigger picture of infections and how to treat them.

Hippocrates actually documented some information on infections and epidemics. However, many different scientists had a hand in providing pieces of the puzzle that eventually helped us see the big picture of pathogens, contagions, and how to treat them. Letâ€s take a closer look at some of those important people.

Edward Jenner

Edward Jenner presented his vaccination idea in 1796 when he shared his newly developed smallpox vaccination. Smallpox is an infectious disease caused by the variola virus. Itâ€s spread through saliva droplets, such as those that occur when someone sneezes or coughs.

Jenner created the smallpox vaccine after observing people infected with cowpox. During that time, it was said that people who had gotten cowpox from their cows couldnâ€t get smallpox. Dr. Jenner then experimented with using cowpox as a vaccination for smallpox. (In fact, the word vaccination comes from the Latin word vacca, which means “cow.”)

According to, during Jennerâ€s time smallpox killed around 10% of the population, and even reached 20% in cities where the population was more crowded. During this time, one in three children died from smallpox.

Because of his many discoveries regarding the immune system, Jenner is often called the Father of Immunology.

Louis Pasteur

You may be familiar with Louis Pasteur and the pasteurization process he developed around 1854 that kills bacteria by heating up liquids and then allowing them to cool. This process is still used today to sterilize a variety of foods and liquids, making them safe for human consumption. Pasteurâ€s discoveries were also integral in creating vaccinations for rabies, cholera, anthrax, and more.

Joseph Lister

In the late 1800s, Joseph Lister introduced important infection control methods for surgery. Lister, a surgeon, was particularly interested in keeping things clean during surgery. Lister introduced sterile, or aseptic, environments in surgery. He was the first to use sterilized bandages to cover wounds and then later expanded his sterilization methods to hand washing, surgical instruments, and medical environments. Before Lister developed and implemented these antiseptic techniques, it was reported that as many as half of all surgical patients died from postsurgical infections.

Lister is known as the Father of Antiseptic Surgery. The term aseptic means from contamination or infection.

Robert Koch

In the late 1800s, Robert Koch, a German physician and microbiologist, built on Pasteurâ€s germ theories and created tests that could be used to determine what specific microorganisms were the causes of specific diseases. He was known for isolating the bacteria for anthrax from a sheep and then re-creating it in a mouse. Kochâ€s discoveries made it possible to develop substances to attack and treat specific bacteria. He later discovered the pathogen that caused tuberculosis, or TB, and how it was transmitted. Koch also identified the pathogen that causes cholera. Additionally, Koch was integral in creating the process of staining bacteria so that theyâ€re more visible under a microscope.

Jonas Salk

Jonas Salk was an American doctor and researcher. Heâ€s most well-known for his development of the polio vaccine. His research showed that there were three different types of polio viruses, and he was able to develop a vaccine that would kill all three. Because of Salkâ€s vaccine, the number of people diagnosed with polio fell from around 57,000 cases in 1952 to fewer than 1,000 in 1962.

Alexander Fleming

Alexander Fleming revolutionized medicine when he discovered penicillin in 1928. He actually discovered penicillin accidentally when he saw that petri dishes contaminated with the mold Penicillium were filled with dead bacteria. His discovery of penicillin helped move the medical field from just preventing infection to now being able to actually treat it.

Infection Control Programs

Based on the research and breakthroughs made by the physicians and scientists mentioned, as well as others, infection control became a large part of the healthcare environment. Medical professionals became aware of the importance of proper hand-washing techniques as well as the need to maintain a sterile surgical suite to prevent the spread of infection. Over the past few decades, infection control techniques have changed as new information has become available. Today, aseptic techniques include

  • Training of all staff on infection control
  • Wearing masks to prevent the spread of germs through the air
  • Appropriate wound bandaging and postoperative wound care
  • Sterilizing all equipment
  • Use of antimicrobial ointment on IV line exits

Vital Signs

Vital signs are clinical measurements of a patientâ€s

  • Pulse rate
  • Body temperature
  • Respiration rate
  • Blood pressure

The values obtained from these measurements indicate the patientâ€s health status and whether the body systems are working as they should. Vital signs are essential to patient assessment and developing a care plan to address the patientâ€s needs. Theyâ€re considered a baseline of the patientâ€s health and communicate information about the bodyâ€s physiological status.

The pulse rate, or heart rate, is used to assess the heart. It measures the number of times the heart beats per minute, or bpm. The pulse rate for a healthy adult is generally in the range of 60 to 100 beats per minute.

The pulse rate can be used to assess

  • General health and fitness
  • How well the heart is working
  • Symptoms of other issues
  • Presence of vessel blockage

Body temperature is simply the bodyâ€s way of dealing with heat. In some cases, the body will generate heat to maintain the bodyâ€s core temperature, but in other situations it will try rid the body of heat by mechanisms such as sweating. A normal temperature ranges from 98.6 to 99 degrees Fahrenheit for a healthy adult. Normal body temperature is also known as euthermia. Hypothermia is when body temperature drops below 95 degrees Fahrenheit.

Many factors can affect a personâ€s body temperature, including

  • Sex (male or female)
  • Health
  • Food and fluid consumption
  • Recent activity
  • Time of day

Body temperature can be taken in the following ways:

  • Orally
  • Rectally
  • Axillary
  • Ear
  • Forehead

Axillary temperature is taken under the arm and is generally lower than the oral temperature.

The respiration rate measures how many breaths a person takes in a minute. The normal range for a healthy adult is from 12 to 16 or 18 breaths per minute.

An increase in the respiratory rate can be caused by

  • Illness
  • Fever
  • Dehydration
  • Anxiety
  • Infection
  • Cardiac arrest
  • Asthma

A decrease in the respiratory rate can be caused by

  • Consumption of alcohol
  • Stroke
  • Head injury
  • Use of narcotics
  • Sleep apnea

Blood pressure is a measure of the force of the blood pushing against the artery walls. A blood pressure reading has two components: systolic blood pressure and diastolic blood pressure. The systolic blood pressure is the first number reported. It measures blood flow when the heart contracts. The second number, or diastolic blood pressure, measures the heart at rest as it receives blood back from the body. Normal blood pressure for a healthy adult is around 120/80 mm Hg.

High blood pressure, or hypertension, can be a risk factor for

  • Heart attack
  • Stroke
  • Kidney failure
  • Heart failure

A systolic reading of 140 or above or a diastolic reading of 90 or above is considered hypertension.

Compared to infection control and preventing the spread of disease, vital signs may seem like such a minor thing to know in health care. However, this information provides critical information about whatâ€s going on with a patientâ€s health. Vital signs can signal to healthcare providers if the patient has an acute illnesses and how rapidly the illness may be progressing. Also, theyâ€re an indicator of the potential for a chronic disease. So, even though taking vital signs will become a routine and may seem like a mundane task, itâ€s critical to take care in measuring, reporting, and verifying the signs to decrease the risk of error.

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