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1.
Sultan Qaboos Univ Med J ; 20(1): e54-e62, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32190370

RESUMO

Objectives: This study aimed to examine the proportion of needle stick and sharp injuries (NSSIs) among healthcare workers at King Hussein Medical Center (KHMC), Amman, Jordan. Methods: All NSSI reports referred from departments at KHMC to the Preventive Medicine Department between 2013-2018 were retrospectively reviewed. Proportion of NSSIs were calculated and stratified according to age, gender, job title, place and site of injury and the procedure/task during which the injury occurred. Results: There were a total of 393 NSSIs. A significant association was found between the proportion of NSSIs and all tested variables (P <0.001). The reported proportion of NSSIs was highest among nurses (39.7%) followed by cleaners (36.3%), physicians (10.4%), other workers (7.4%) and lab technicians (5.9%) during the study's six-year period. Hospital wards were the most common locations (46.1%) where injuries took place. Injuries also occurred most frequently during medical waste collection (38.2%). Conclusion: The proportion of NSSIs was highest among nurses and cleaners. Safety policies and training among high-risk groups should be reviewed to reduce the risk of NSSIs. Multicentre studies at a national level should be conducted to examine whether this study's findings reflect national trends.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Traumatismos Ocupacionais/epidemiologia , Adulto , Feminino , Serviço Hospitalar de Limpeza/estatística & dados numéricos , Humanos , Jordânia/epidemiologia , Masculino , Pessoa de Meia-Idade , Ferimentos Penetrantes Produzidos por Agulha/etiologia , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Traumatismos Ocupacionais/etiologia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
2.
Australas Emerg Care ; 23(1): 23-28, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31926959

RESUMO

BACKGROUND: Despite the introduction of a range of safety policies and sharps equipment designed to protect healthcare workers, rates of percutaneous injuries from occupational exposure to sharps remains high. This study examined the availability and use of various types of sharps devices in a tertiary hospital emergency department, to understand clinician choice between non-safety and safety devices; and to document their safe and unsafe use of sharps. METHODS: This mixed methods study consisted of areview of stock levels, a survey of staff usage, and a content analysis of semi-structured interview data to explore factors which impact on staff preferences for different sharps devices. RESULTS: Staff identified a range of sharps risks, as well as barriers and enablers to the use of safety devices. Availability of, and preference for, familiar devices influenced choice of devices used in clinical practice, despite awareness of associated risks. CONCLUSIONS: This understanding of equipment use and the factors that motivate such use have informed the first stage of the knowledge-to-action cycle. Knowledge translation, should include the development of policies to help reduce the risk of sharps injury. Culture change and ongoing skills development might help to overcome entrenched procedures and increase voluntary engagement with safer sharps.


Assuntos
Ferimentos Penetrantes Produzidos por Agulha/etiologia , Adulto , Estudos de Casos e Controles , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Vidro , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Agulhas/efeitos adversos , Agulhas/estatística & dados numéricos , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos , Pesquisa Qualitativa , Queensland/epidemiologia , Inquéritos e Questionários
9.
Surg Innov ; 25(6): 570-577, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30196768

RESUMO

INTRODUCTION: The induction of pneumoperitoneum is the first and most critical phase of laparoscopy, due to the significant risk of serious vascular and visceral complications. The closed technique for the creation of pneumoperitoneum could lead to several surgical complications. The present study aimed to overcome the complications associated with the insertion of Veress needle, improving its use, and facilitating the rapid creation of pneumoperitoneum. METHODS: Thirty large white female pigs were enrolled in our study. A common plunger was modified in order to allow the passage of a 15-cm long Veress needle. This method was applied to 26 laparoscopic procedures (26 pigs) of several specialist branches. RESULTS: OneShot-M close laparoscopy pneumoperitoneum creation device allowed us to obtain pneumoperitoneum quickly in all attempts, without any intraoperative and postoperative complications related to the use of the Veress needle. CONCLUSION: The use of the proposed device showed an induction time as quick as the standard laparoscopic closed abdominal entry. The patented device is cheap and allows a safe abdominal entry. In addition, abdominal entry is much faster than the classic open technique.


Assuntos
Laparoscopia/instrumentação , Agulhas/efeitos adversos , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Pneumoperitônio Artificial/instrumentação , Animais , Feminino , Insuflação/instrumentação , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/prevenção & controle , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Modelos Animais , Ferimentos Penetrantes Produzidos por Agulha/etiologia , Pneumoperitônio Artificial/efeitos adversos , Suínos
11.
Br Dent J ; 225(5): 391-394, 2018 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-30140045

RESUMO

All members of the clinical dental team face a daily risk of a personal sharp injury. A wide range of sharp instruments are used, some of which are specifically designed to easily pierce the skin and mucosa. The instruments are placed, moved, passed between colleagues, used for treatment, replaced and cleaned, all in relatively confined areas. The clinical dental workplace and the decontamination unit are both therefore sharp-risk environments. There is a clear risk of a sharp injury and the potential consequences of occupational exposure to blood-borne pathogens are at least inconvenient and at worst, career and even life threatening. However, good sharp safety is not universally understood and practised throughout the dental profession. This paper considers the risk of sharp injury in dentistry and discusses some of the methods used to improve sharp safety.


Assuntos
Instrumentos Odontológicos/efeitos adversos , Odontologia , Segurança de Equipamentos/estatística & dados numéricos , Local de Trabalho/normas , Patógenos Transmitidos pelo Sangue , Descontaminação , Recursos Humanos em Odontologia , Humanos , Incidência , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Ferimentos Penetrantes Produzidos por Agulha/etiologia , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Medição de Risco , Fatores de Risco , Reino Unido/epidemiologia
12.
Curr Opin Pediatr ; 30(5): 677-682, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30036203

RESUMO

PURPOSE OF REVIEW: The purpose of this article is to review clinical manifestations and management of common pediatric foreign body ingestions, with a particular focus on some of the current trends. RECENT FINDINGS: Foreign body ingestion (FBI) is a problem that is frequently encountered by pediatric providers. As new toys and products enter the marketplace, there may also be new dangers from those objects not initially recognized. Some of the recent trends and findings in pediatric FBI include an increase in adolescent injury from ingestion of laundry detergent pods because of a popular game where participants are encouraged to bite or swallow the pods, and injuries associated with ingesting parts of a popular toy known as a 'Fidget Spinner'. SUMMARY: Adverse events resulting from FBI range the entire gamut from nonexistent or minor symptoms to moderate injury and rarely may be fatal. Factors such as age, type of object ingested, anatomic location of the foreign body, and timing from ingestion to receipt of medical attention all determine the risk posed to the child and guide management decisions. Because of the constant development of products, and the potential for the emergence of new and dangerous trends among children, continued surveillance by the medical community is important in monitoring and managing injuries associated with FBI.


Assuntos
Queimaduras Químicas/diagnóstico por imagem , Qualidade de Produtos para o Consumidor/normas , Sistema Digestório/diagnóstico por imagem , Serviços Médicos de Emergência , Doenças do Esôfago/diagnóstico por imagem , Corpos Estranhos/diagnóstico por imagem , Ferimentos Penetrantes Produzidos por Agulha/diagnóstico por imagem , Queimaduras Químicas/etiologia , Queimaduras Químicas/fisiopatologia , Criança , Comportamento Infantil , Pré-Escolar , Detergentes/toxicidade , Sistema Digestório/lesões , Ingestão de Alimentos , Equipamentos e Provisões Elétricas/efeitos adversos , Endoscopia , Doenças do Esôfago/etiologia , Doenças do Esôfago/fisiopatologia , Corpos Estranhos/complicações , Corpos Estranhos/terapia , Humanos , Lactente , Lavanderia , Ferimentos Penetrantes Produzidos por Agulha/etiologia , Ferimentos Penetrantes Produzidos por Agulha/fisiopatologia , Pediatria , Jogos e Brinquedos , Embalagem de Produtos
14.
Anaesthesia ; 73(9): 1118-1122, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29858517

RESUMO

Injection pressure monitoring provides valuable information to prevent intraneural injections and possibly consequent nerve damage during peripheral nerve block. However, the measurement of injection pressure along the injection line is inaccurate as it is influenced by several variables. The aim of this study was to test a new system for precise injection pressure monitoring at the needle tip in a cadaveric model. The system consists of a miniaturised pressure sensor embedded within the needle shaft that is connected via an optical fibre to an external control unit. In order to test the capacity of the system to discriminate between perineural and intraneural injections, a total of 24 ultrasound-guided injections at various locations of the sciatic nerve (12 perineural and 12 intraneural) were performed in fresh cadavers. The injections were delivered at a constant rate by an electronic pump (5 ml saline at 10 ml.min-1 ). Two perineural and two intraneural injections were excluded from analysis, since the operator could not confirm the exact needle-tip location. Mean (SD) peak injection pressure was significantly lower for perineural compared with intraneural injections (14 (6) kPa vs. 131 (56) kPa; p < 0.001). This study shows that this system is a reliable method to accurately monitor injection pressure at the needle tip, allowing for discrimination between perineural and intraneural injections of the sciatic nerve in fresh cadavers.


Assuntos
Ferimentos Penetrantes Produzidos por Agulha/diagnóstico , Bloqueio Nervoso/métodos , Nervo Isquiático/lesões , Anestésicos Locais/administração & dosagem , Cadáver , Sistemas Computacionais , Desenho de Equipamento , Humanos , Injeções/efeitos adversos , Injeções/métodos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/métodos , Agulhas , Ferimentos Penetrantes Produzidos por Agulha/etiologia , Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle , Bloqueio Nervoso/efeitos adversos , Bloqueio Nervoso/instrumentação , Traumatismos dos Nervos Periféricos/diagnóstico , Traumatismos dos Nervos Periféricos/etiologia , Traumatismos dos Nervos Periféricos/prevenção & controle , Pressão , Nervo Isquiático/diagnóstico por imagem , Método Simples-Cego , Ultrassonografia de Intervenção/métodos
16.
Environ Health Prev Med ; 23(1): 2, 2018 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-29316884

RESUMO

BACKGROUND: The objectives of this study are to investigate the incidence and reporting behavior of sharp injuries among healthcare workers (HCWs) and identify the risk factors associated with these injuries. METHODS: A cross-sectional survey was conducted in February 2017 in a provincial teaching hospital in China. Data were collected from 901 HCWs using a self-administered questionnaire which included demographic information, experience, and reporting behavior of sharp injuries. Stepwise logistical regression was used to analyze the risk factors. RESULTS: HCWs (248 [27.5%]) had sustained a sharp injury in the previous year. Factors including seniority, job category, title, education, department, and training programs were associated with the occurrence of sharp injuries. According to the stepwise logistical regression, seniority, and training programs were the risk factors associated with the occurrence of sharp injuries. Of 248 sharp injuries, 130 HCWs were exposed to blood. Only 44 (33.9%) HCWs reported their injuries to the concerned body. The main reasons for not reporting the sharp injuries were as follows: perception that the extent of the injury was light (30.2%), having antibodies (27.9%), and unaware of injury (16.3%). CONCLUSIONS: Sharp injuries in the studied hospital were common and were likely to be underreported. Therefore, an effective reporting system and sufficient education on occupational safety should be implemented by the relevant institutions. Moreover, it is important to take effective measures to manage sharp injuries in HCWs and provide guidance for their prevention.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Hospitais de Ensino , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Ferimentos Penetrantes Produzidos por Agulha/etiologia , Ferimentos Penetrantes Produzidos por Agulha/psicologia , Fatores de Risco
17.
Reg Anesth Pain Med ; 43(1): 92-96, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29189495

RESUMO

BACKGROUND AND OBJECTIVES: Unintentional dural puncture is one of the most frequent complications of the epidural technique. One previous study suggested that atypical sonoanatomy of the ligamentum flavum/dura mater unit may be a risk factor for this complication. In this study, we describe the anatomy of the lumbar spine, assessed by magnetic resonance imaging (MRI) and ultrasound, in women sustaining unintentional dural puncture during epidural catheter placement for labor analgesia. METHODS: We approached women who sustained a recognized unintentional dural puncture. Following consent, technical aspects of the epidural catheter placement were documented. Postpartum MRI of the lumbar spine and bedside spinal ultrasound were performed. Ultrasound images of the ligamentum flavum/dura mater unit in the transverse view were classified as typical, atypical, or inconclusive. Magnetic resonance imaging images were reviewed by a neuroradiologist, who was blinded to the level of the puncture. RESULTS: We included 10 women with unintentional dural punctures in the study. In 5 of the 10 women, these dural punctures occurred despite epidural catheter insertion by experienced practitioners. These women had a mean body mass index of 28.5 kg/m (range, 24-38 kg/m). Two women suffered dural punctures twice. Ultrasound imaging in the paramedian view produced typical images in all patients. In the transverse view, 7 of 10 women showed atypical or inconclusive images, with atypical images seen at either L4/5 or L5/S1. Magnetic resonance imaging results revealed no anatomical abnormalities, with the exception of 1 woman who showed a ligamentum flavum gap away from the puncture site. CONCLUSIONS: Our results suggest that unintentional dural punctures occur in likely anatomically normal women. Furthermore, the transverse ultrasound views may fail to demonstrate typical ligamentum flavum/dura mater unit at the lower lumbar levels despite its confirmed presence by MRI.


Assuntos
Analgesia Epidural/efeitos adversos , Analgesia Obstétrica/efeitos adversos , Dura-Máter/lesões , Vértebras Lombares/diagnóstico por imagem , Imagem por Ressonância Magnética , Ferimentos Penetrantes Produzidos por Agulha/etiologia , Ultrassonografia , Adulto , Dura-Máter/diagnóstico por imagem , Feminino , Humanos , Ligamento Amarelo/diagnóstico por imagem , Ferimentos Penetrantes Produzidos por Agulha/diagnóstico por imagem , Valor Preditivo dos Testes , Gravidez , Estudos Prospectivos , Punções , Fatores de Risco
19.
Biomed Res Int ; 2017: 5094509, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29214171

RESUMO

Intensification of modern swine production has led to many new technologies, including needleless injectors. Although needleless injectors may increase productivity (by reducing injection time) and reduce needlestick injuries, the effect on risk for musculoskeletal disorders is not clear. This project will compare conventional needles with needleless injectors in terms of cost, productivity, injury rates, biomechanical exposures, and worker preference. Muscle activity (EMG) and hand/wrist posture will be measured on swine workers performing injection tasks with both injection methods. Video recordings during the exposure assessments will compare the duration and productivity for each injection method using time-and-motion methods. Injury claim data from up to 60 pig barns will be analyzed for needlestick and musculoskeletal injuries before/after needleless injector adoption. Workers and managers will be asked about what they like and dislike about each method and what helps and hinders successful implementation. The information above will be input into a cost-benefit model to determine the incremental effects of needleless injectors in terms of occupational health, worker preference, and the financial "bottom line" of the farm. Findings will be relevant to the swine industry and are intended to be transferable to other new technologies in animal production.


Assuntos
Injeções/efeitos adversos , Doenças Musculoesqueléticas/etiologia , Agulhas/efeitos adversos , Ferimentos Penetrantes Produzidos por Agulha/etiologia , Animais , Análise Custo-Benefício , Feminino , Humanos , Masculino , Saúde do Trabalhador , Fatores de Risco , Suínos , Local de Trabalho
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