HAIR CARE Definition – The general health of a person affects the growth of hair. However, physical changes, emotional and physical stress, aging, infection and certain diseases or drugs can affect the characteristics of the hair. The loss of hair (alopecia) can result from improper practices of hair. Purpose – To keep the hair clean and healthy. To have a sense of wellbeing. To prevent hair loss and promote growth. To prevent accumulation of dust, dandruff and oil. To stimulate circulation of blood. To observe the scalp. To prevent and treat pediculi. To prevent itching and infection. Measures for hair care – 1. Brushing and combing – hair needs to be brushed daily in order to keep them clean and to distribute oil evenly along hair shafts. Patients who are able to perform self-care should be encouraged to maintain hair care daily. Patients who are unable to take self-care should be assisted by the nurse. Long hair requires little extra care after a patient is confined to bed even for a short period. When lacerations or incisions involve the scalp, blood and topical medications can also cause tangling. Frequent brushing and combing keeps long hair neatly groomed. Braids can help to avoid repeated tangles but braids should not be too tight. Preparation of articles Clean articles Articles Bath towel -2 A clean comb A kidney tray with carbolic lotion 1: 20 or Rationale One to protect the shoulders and garments and the other to protect bed clothes. To comb the hair of the patient. To disinfect the comb. dettol 1:40. Oil in a container. A paper bag One apron To remove the tangles. To collect the loose hair. To protect the nurses uniform. Preparation of the patient Give proper explanation to the patient. If possible, let the patient sit on a chair/stool. Place one towel over the patient’s shoulders or give fowler’s position on the bed. Place one towel over the bed linen and pillow; and the other over the shoulders of the patient to protect the bottom sheet as well as the patient’s clothes respectively. Steps of the procedure – To brush/comb properly, part the hair into two sections and then separate each section into two more sections. Parting of hair allows for easy brushing of smaller section of hair. Brushing/combing is done from the scalp towards the hair ends. If tangles are present, the nurse uses the fingers to separate a small lock of hair, grasps it firmly near the scalp and combs the loose end of the lock. This prevents painful pulling of the scalp during combing. Application of oil or moistening the hair with water or alcohol often frees tangles for easier combing. Tangles may be cut off only with the written consent of the patient. To comb curly hair, start fro the neckline and slowly lift and fluff the hair outwards until the forehead is reached. The nurse combs one side of the head at a time and then repeats on the other side. After combing the hair thoroughly, braid the hair into two-one on each side of the head behind the ear to make the patient more comfortable. Discard the loose hair into the paper bag and lice into the lotion, if any. After care of the patient and articles Remove the towels and kidney tray. Make the patient comfortable in the bed. Dismantle the articles. Wash hand. Record the observations regarding the condition of the scalp and hair on the nurses’ record with date and time. 2. Shampooing (head bath) – A person’s daily routine usually decides the frequency of shampooing. Patients staying in bed perspire in excess or any treatment that leaves blood or solution in the hair may require shampooing more frequently. How the shampoo has to be given depends on the capability of the patient to follow instructions and his/her ability to maintain a particular position without feeling discomfort. Patients who are allowed to sit in a chair can usually be shampooed in front of a sink. If the patient is not able to sit, allow the head to hang slightly over the edge of the bed by keeping a small pillow or a towel under the head and the neck. Articles required – Articles A pair of gloves Bath towel-2 RATIONALE Wash clothes and face towel To prevent cross- infection. One to protect the pillow and one to dry hair. To protect the eyes. Bath blanket-1 To cover the patient. Mackintosh-2 Cotton balls and gauze pieces in a bowl. One to make a trough and the other to protect the pillow and bed clothes. To plug the ears and to cover the eyes. oil To apply on the hair. Shampoo or liquid soap To put for shampooing. Hair comb To comb the hair. A kidney tray and a paper bag. To collect loose hair and the cotton plug. Bucket-1 To collect the dirty water. Basin-1, mug-1 To take water. Jugs-2 One foe hot water and one for cold water to maintain the temperature of the water. To make the trough. Newspepar-1 Preparation of the patient – Explain the procedure to the patient. Collect and arrange articles conveniently at bedside. Provide privacy. Close windows, put off fans to prevent draught. Remove the top linen after covering the patient with a blanket. Keep the patient diagonally and place a pillow under the shoulders to tilt the head. Cover the pillow with mackintosh and towel. Make an improvised trough with mackintosh and newspaper and place it under the head of the patient, to facilitate drainage of water into a bucket. Plug ears with cotton balls and cover the eyes with a sponge cloth. Procedures S. no Steps Rationale 1 Wash hand with soap and water. It reduces the transmission of micro-organism. 2 Brush and comb hair. Removing tangles result in more thorough cleansing. 3 Maintain water at about (43-44° C) 110° F. (Temperature can differ as per the patient’s tolerance). Prevents burns to scalp. 4 With mug, pour water slowly over hair until it is completely wet. Apply a small amount of shampoo. 5 Water aids in uniform distribution of shampoo over all parts of hair; facilitates a cleansing effect. Shampoo reduces surface tension and removes dirt. Work upward with both hands. Start at hairline To ensure thorough cleansing. and work towards the back of the neck. Lift -massage increase scalp circulation. head slightly with one hand to wash the back side of the head. Massage scalp by applying pressure with fingertips. 6 Rinse hair with water and make sure that hair is free of shampoo. Left-over shampoo gives a dull finish to hair and after drying may cause scalp irritation. 7 Wrap the head in a bath towel. Dry face with a piece of cloth used to protect the eyes. Dry off moisture along the neck or shoulders. Dry hair and scalp. Use the second towel, if required. Retained moisture may cause cooling and chills. 8 Remove the trough and place it in the basin. Discard the cotton plugs in the ears into the paper bag. -to make the unit and patient tidy. -to improve the sense of wellbeing in the patient. After care – S. no 1 Steps Rationale Spreading of hair aids in fast drying. 3 Spread the hair over the towel placed on the pillow and allow it to dry. Assist the patient in attaining a comfortable position. Change the linen, if wet. 4 Inspect the condition of hair. To note any abnormalities, if any. 5 Return all the articles to their proper place after washing and wash hands. Record the procedure in the nurses’ record and also findings related to the condition of hair or scalp. Return to the bed side. When the hair is dry, comb and arrange the hair. Remove the towel spread on the pillow and make the patient comfortable. Maintains cleanliness of the equipment and controls transmission of infections. These recording can be used to give any further treatment, if necessary. 2 6 7 This gives the patient a sense of well-being. It prevents skin irritation and bedsores. It gives the patient a sense of well-being. 3. Treatment for infestation – Due to lack of proper hygiene, parasites can infest hair. The most common infestations is pediculosis or lice. They are tiny, greyish white parasite insects that infest mammals. Types – Pediculosis capitis(head lice) Pediculosis corporis(body lice) Pediculosis pubis(crab lice) Lice can be transferred from person to person through direct or indirect contact. Effects of pediculosis – Discomfort, nervousness, restlessness Itching, scratching, infection, abscess. Anaemia, lymph node enlargement. Spreads typhus fever, relapsing fever, trench fever. Spreads on linen, blanket, bedding, towels, combs, brushes and other articles quickly. Treatment of pediculosis capitis – Purpose To destroy pediculosis and nits. To prevents its transmission to others. Articles required – Articles Bath towel-2 Mackintosh-1 Sponge clothes-1 A triangular bandage A kidney tray with disinfectant carbolic 1:40 A paper bag A hair comb Cotton swabs Rationale One to protect he pillow and the other to [protect shoulders and garments. To protect the pillow and bed clothes. To protect the eyes. To cover the head after procedure. To destroy the lice and to disinfect the comb. To collect loose hair. To remove tangles. to apply Vaseline. Vaseline A gown, a mask and gloves. A bucket with carbolic 1:40 To apply at the hair line to prevent irritation by parasiticide. To protect the nurse. To disinfect the growth and towels after treatment. Parasiticides used – Explain the procedure to the patient Provide privacy Assemble the equipment and arrange at the bedside Remove top linen and cover the patient with a bath blanket Put the patient diagonally or flat with one pillow under the head Protect the pillow and bed with mackintosh and towel. One towel is put on the shoulders to protect the garments. Protect the patient’s eyes with damp sponge cloth. Put off the fan to prevent spilling of parasiticide. Loosen the hair and remove the tangles. Procedure— S. no 1 Steps Wash hands. Put on gown and mask. 2 Rationale To prevent spread of infection. Washing technique prevents the growth of microorganism. Mask prevents inhalation of parasiticide. After parting the hair. Apply parasiticide To apply thoroughly all over the scalp and hair. (DDT powder) by gently rubbing, in order to apply to the whole length of the hair and also on scalp. Roll up the hair on top of the head and apply To prevent spread of lice to other areas. a triangular bandage. 3 After care Remove all articles, wash, disinfect and replace. Wash hands. Record the procedure with date and time, and observation made. Wash the hair the following morning and apply warm diluted vinegar (1:1) to loosen the nits. Comb the hair with a fine comb. Keep the comb and all the articles that have come in contact with the hair in a discomfectant for about 30 minutes to one hour for disinfection. Repeat the procedure after a week, if required.