Sharp Instruments Research Articles

XRF identification of sharp-force trauma in fresh and dry human bone under varied experimental heat conditions

Heat-induced fractures can be hard to distinguish from sharp force traumas. This challenge can negatively impact medico-legal analysis. The present study aimed to experimentally assess if X-ray fluorescence (XRF) can be used to detect chemical traces transferred from the blade of a sharp instrument onto both fresh and dry human bones. This was performed by inducing sharp force traumas with five different instruments on 20 fresh and 20 dry human clavicles. All bone samples were probed before and after experimental burning (at 500 °C, 700 °C, 900 °C and 1100 °C). Our results show that XRF is potentially useful for detecting iron traces in fresh human bone, both unburned and burned. However, we were not able to clearly detect iron traces from the blades in bones that have been previously inhumed, since exogenous iron acquired during diagenesis masks the iron traces originating from the blade.

Trividha Anushastra Karma in Netraroga

Shalakya tantra, also known as Uttamanga Chikitsa, focuses on the vital sense organs situated above the Jatru-clavicle, addressing diseases of the head (Shiras), ear (Karna), eye (Netra), throat (Kanta), and nose (Nasa). The eye is considered as very important part of the body which performs the work of vision and due to its sensitive nature, it needs great care. Acharya Sushrutha outlines four treatment methods like Bheshaja, Shastra, Kshara and Agni karma as important treatment modalities. Anushastra karma are the para-surgical procedures, entail performing surgical interventions without the use of Shastras - sharp surgical instruments. Acharya Sushrutha has mentioned 14 types of Anushastras among which Jalaukavacharana, Agnikarma and Ksharakarma are given more importance and described in detail. Due to the pradhanyatwa of these three procedures in treatment they are also known as Trividha Anushastra karma. Along with Vata, Pitta and Kapha doshas, Rakta also plays a major role in causing different Netra rogas. So, it is advisable to go for safest Raktamokshana to do Dushita rakta dosha nirharana. In this article, an attempt is made to elaborate the complete knowledge of Anushastras used in different Netra rogas mentioned by our Acharyas. These procedures are simple, less time consuming, non-invasive, safe and cost-effective.

Determining the manner of death in victims in drug-induced psychosis: a case of an atypical head stab wound.

This case report presents a rare case of an atypical head stab wound suffered by a drug addict and inflicted with a screwdriver during drug-induced psychosis. It describes the diagnostic and treatment procedures in the hospital and the findings of the subsequent autopsy. It also analyzes the review of the interpretation of the CT scans made upon admission and the subsequent treatment by an independent medical review panel, which revealed signs of medical mismanagement. Therefore, it also discusses the legal consequences that the case may have involved for the attending physicians in addition to the consequences for the suspected perpetrator. The report raises many issues encountered in the case in terms of the clinical treatment and forensic determination of the manner of death in cases of injuries caused by sharp instruments and highlights the importance of comprehensive evaluation of the circumstantial evidence together with the clinical or autopsy findings, since such evidence may sometimes be overlooked in clinical practice.

How Sharp Objects Injuries Impact our Healthcare Workers: Unveiling Perspective and Preventive Imperatives.

Introduction Sharp object injuries in the medical field present a considerable occupational hazard for healthcare workers (HCWs), encompassing a spectrum of consequences from immediate discomfort to enduring health consequences. These injuries may expose HCWs to potential infections. Despite efforts to control sharp object injuries in healthcare environments, they are present at every stage involving using or disposing of medical sharp instruments. In Jordan, limited research has focused on sharp object injuries, with most data included from studies concentrating on practicing nurses or nursing students. Consequently, further research is necessary to comprehend the causes behind the high sharp object injury rate and the insufficient knowledge of safety practices and preventive guidelines. Objectives This study was conducted to investigate the impact of sharp object injuries on HCWs, underlying causes,and potential consequences causes of needlestick injuries. To highlight perspective and preventive imperatives. Methods and patients This retrospective institutional-based cross-sectional chart analysis was conducted by reviewing all sharp object injuries report sheets and extracting data directly from these reports for analysis. The study encompassed all reported cases occurring between 2018 and 2023. All the participants' data handling was accomplished according to the Declaration of Helsinki (2013) and the Health Insurance Portability and Accountability (HIPAA) Acts. Results A total of 146 self-reported hospital workers were included in the study. Within the final cohort, 52.73% of the participants were male (77/146), with an average age at diagnosis of 38.6±7.87 years (ranging from 20 to 52 years). Conversely, females comprised 47.27% of the cohort population (69/146) and had an average age at diagnosis of 34.73±6.73 years (ranging from 19 to 47 years). The age group 20-29 years was the most prominent age group, statistical analysis of age and gender data revealed significant differences. The overall prevalence of sharp object injuries was 11.83%, indicating that a sizable portion of HCWs is at risk of exposure to bloodborne pathogens. Among the different professional categories, Physicians constituted the majority of sharp object injuries reported victims in 41 cases (28.08%), followed by nurses in 38 cases (26.02%).Statistical analysis of the profession's data revealed significant differences (P<0.001). Notably, sharp object injuries were most reported in wards. The leading procedures that caused sharp object injuries were identified as during needle recapping in 53 instances (36.30%), then followed by medical waste treatment in 32 cases (21.92%). The left hand was the most affected body part, reported in 83 cases (56.84%).All injured individuals reported the incident promptly. No seroconversions were documented within the reviewed cases during the study period. Conclusion Injuries caused by sharp objects persist as a significant danger for hospital employees, posing immediate harm and long-term health risks linked to bloodborne pathogens. The findings stress the continuous responsibility of healthcare institutions to prioritize staff safety by addressing the root causes of sharp object injuries and fostering reporting and prevention cultures. Underreporting reasons are diverse, encompassing factors like time constraints, fear of consequences, and the misconception of injury insignificance.

Magnetic field control device for transplantation of corneal endothelial tissue with magnetic filaments.

The corneal endothelial transplantation involves the transfer and attachment of a single-layered corneal endothelial tissue to the narrow space between the cornea and iris. Given the high risk of damage to the endothelial tissue and surrounding corneal tissues when using sharp instruments inserted externally to apply force during the process, the development of a device capable of transferring corneal endothelial tissue using a magnetic field became necessary. This study aims to develop a magnetic control device for transferring corneal endothelial tissue with attached magnetic particles to the transplant site, validate its appropriate transfer capabilities, and assess its applicability to corneal endothelial transplantation. For this purpose, a magnetic field-generating manipulation device equipped with four electromagnets controlled by a joystick and microcomputer was developed. Through simulated experiments, the strength of the magnetic field and the attraction force on the tissue were predicted, and the actual magnetic field strength was measured for validation. To measure the magnetic transfer force, experiments were conducted by towing corneal endothelial tissue fixed with 6mg, 12mg, and 18mg plastic weights. Subsequently, the tissue's transfer speed was measured after applying continuous and pulsed magnetic fields. The results confirmed the feasibility of tissue transfer using the magnetic control device, and it was observed that pulsed magnetic fields led to faster transfer speeds and easier control compared to continuous magnetic fields. Exploratory animal experiments using rabbits were conducted to simulate real surgical conditions, confirming the feasibility of corneal endothelial tissue transfer and attachment.

A REVIEW OF MAGGOT DEBRIDEMENT THERAPY IN DIABETIC FOOT ULCER

the protocol for treating diabetic foot ulcers which occur in at least 15% of patients with diabetes and precede 84% of leg amputations. Debridement may be surgical or non-surgical. Surgical debridement is carried out using sharp instruments. It has some complications like perioperative bleeding and general complications of anaesthesia. It demands skilled surgeon. Non-surgical debridement includes autolytic, enzymatic, mechanical and biological debridement. All the methods have their own advantages and disadvantages. Biological debridement is a technique based on the use of maggots to remove necrotic tissues from chronic wound. Maggots or larvae of flies are applied on the infected wound. Maggots excrete the enzyme which degrade and liquefy necrotic tissue and later on ingest this from the wound. It is relatively painless procedure as compared to the surgical debridement. This technique has been granted FDA approval in US since 2004. All classical and contemporary literature especially PubMed database regarding maggot debridement therapy and diabetic foot ulcer is scrutinised for the review. It was found that Maggot debridement therapy (MDT) is the better technique as compared to other non-surgical debridement methods for management of diabetic foot ulcer. Sushruta the father of surgery was the first to introduce the maggot therapy in context to kaphaja arbuda (a type of tumour). It is the need of time to conserve this basic principle as a non-surgical method for debridement.

Suicide in Healthcare Workers: An Umbrella Review of Prevalence, Causes, and Preventive Strategies.

The medical profession faces a critical challenge with the mental health of its practitioners, leading to an alarming increase in suicide rates among healthcare workers (HCW). Factors such as the culture of perfectionism, excessive workloads, and stigma against seeking help exacerbate this issue. This umbrella review synthesizes the existing literature on HCW suicide, exploring the prevalence, causes, and potential preventive strategies. This study conducted a search of the literature from PubMed/Medline, Scopus, Web of Science, Cochrane Library, PsycINFO, and Google Scholar until April 2, 2024. The non-exhaustive search terms used were "doctor suicide," "physician suicide," "medical professional suicide," "suicide in healthcare," "healthcare worker suicide prevention," and "causes of healthcare worker suicide." Hand-searches were also conducted. Of the 487 studies initially identified, a total of 10 systematic reviews/meta-analyses were included. This umbrella review collates findings from 400 primary clinical studies conducted between the years 2004 and 2023. With a focus on mental health factors contributing to suicide in HCW, there are regional and specialty-specific variations in stress prevalence in the populace. Further, anesthesiologists and psychiatrics depicted higher rates of burnout compared to other HCW; causative factors such as seeking perfection and challenging work-life balance were key when assessing suicidal behaviors in these groups. Job demand level was found to correlate directly with suicidal thoughts, specifically among psychiatric ward HCW, where access to drugs and sharp instruments is readily available. In specific contexts, female HCWs showed a standardized mortality ratio (SMR), indicating that the rate of suicide was higher among them as compared to the general female population. Interventions such as cognitive behavioral therapy (CBT) and mindfulness were effective in decreasing depression, psychological distress, and anxiety in several included studies. This umbrella review also identified major obstacles to seeking help, including stigma and the fear of professional consequences. To reduce suicide rates among HCWs, it is the need of the hour to implement evidence-based interventions and create supportive work environments that encourage mutual care for each other's emotional health. Further research is necessary to determine the effectiveness of various measures in preventing suicide among HCW.

Analysis of Forensic Death Statistics From 2013 to 2022 and Autopsy Practices in Türkiye

Autopsy rates are significantly lower that what they should be worldwide. Additionally, autopsy practices vary between countries. To examine the autopsy rates, the distribution and temporal changes of forensic autopsy cases, so as to identify the areas in the death investigation system that require improvement in Türkiye. Cross-sectional study. “Forensic Death Examination Statistics” of the Council of Forensic Medicine (CFM) and “Death Statistics” of the Turkish Statistical Institute were compared and analyzed for the years 2013-2022 in Türkiye. The number of forensic death cases sent to the CFM has increased over time. For all causes of deaths, the autopsy rate is approximately 3.6-4.8%. The cause-specific mortality rates for deaths due to sharp instrument trauma, blunt trauma, occupational accident, undetermined, and poisoning have increased over the years. “The percentage of “undetermined” deaths, which are important to demonstrate negative autopsies, was 14.2% in 2021. Although the autopsy rates have slightly increased in a volatile trend over time in Türkiye, they are still not at the desired level. Thus, it is essential to further raise awareness among all professionals involved in death investigations about the importance of autopsies.

Treatment of Brachial Plexus Injuries following Gunshot Injuries: A Systematic Review.

Brachial plexus injuries (BPI) from gunshot injuries are uncommon but usually severe and can cause chronic pain, loss of function, and permanent nerve damage. Multiple surgical techniques including neurolysis, end-to-end suture repair, and graft repair have been described for the treatment of these injuries. However, surgical indication, timing, and technique for these injuries remain controversial. This systematic review aims to investigate the treatment modalities for patients with BPI due to gunshot-related injuries. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology was employed for this review. PubMed, Cochrane Reviews, Embase, and CINAHL databases were included. The following keywords constituted our search criteria: gun-shot-wounds, brachial plexus, traum∗, and management. A total of 90 studies were imported for screening, from which 9 papers met our final inclusion/exclusion criteria. The most common studies utilized in this review were retrospective chart reviews followed by case series. In total, there were 628 patients that suffered from gunshot wounds to the brachial plexus. Most patients underwent some form of delayed nerve repair consisting of neurolysis, end-to-end epineural repair, or graft repair with a sural or antebrachial cutaneous nerve graft. Several patients suffered from complications, with neuroma being the most common long-term complication that required reoperation. The optimal timing for surgeries involving BPIs should be determined after examining the level of nerve damage, associated injuries, operative risks, and electrophysiological workup for indications of spontaneous regeneration. Early surgical interventions were indicated for patients presenting with associated vascular or thoracic injuries, compressive masses, and nerve transection by sharp instruments in most selected papers.

Experiences with Penetrating Trauma in the Pediatric Intensive Care Unit

Aim:Penetrating traumas in children, caused by firearms or sharp instruments, are relatively rare, accounting for 10-20% of pediatric traumas. These traumas are serious and can lead to significant consequences, hence the need for prompt and multidisciplinary management. Materials and Methods:The study is a retrospective analysis of pediatric patients treated for PT in the intensive care unit. Patients were divided into two groups based on the cause of injury: sharp instrument wounds and firearm wounds. Data collected included age, gender, diagnosis at ICU admission, type of trauma, cause of trauma (assault, suicide), vital signs, nature of trauma (thoracic, abdominal, cranial, extremity), associated organ failures, surgical needs, performed surgeries or procedures, need for respiratory and cardiovascular support, transfusion requirements, lab parameters (blood gases and organ functions), ICU stay duration, and outcomes. Results:Between April 2022 and November 2023, a total of 425 pediatric cases were treated for trauma in the ICU, with a 6% frequency of PT. The majority of PT cases were in the adolescent age group and were male (76%). The cause of PT was violence in 88% (22/25) cases and attempted suicide in 12% (3/25) cases. 72% were caused by sharp objects and 28% were caused by gunshot wounds. The location of trauma was thoracic in 48% (12/25), abdominal in 44% (11/25), thoraco-abdominal in 4% (1/25), and lower extremity in 4% (1/25). There was no cranial penetrating trauma. In most cases (80%), thoracic and/or abdominal surgery, including tube thoracostomy, was required to treat hemopneumothorax. Blood transfusion was performed in 52% of the cases (13/25). Two cases required non-invasive mechanical ventilation, and one case required mechanical ventilation. The cases were hospitalized in the PICU for a mean period of 3,7 days. All cases were discharged. There were no deaths. Conclusion: Penetrating traumas are rare in children but can lead to serious consequences. Therefore, a rapid and multidisciplinary approach is vital in the management of PT cases in children.

FMEA-based risk management improves the ability of oral healthcare personnel to prevent needlestick injuries.

To explore the application value of the Failure Mode and Effects Analysis (FMEA) method in the risk management of needlestick injuries among oral healthcare personnel. A total of 37 healthcare workers from the dental department of Zhujiang Hospital, Southern Medical University, were selected as study subjects. Routine risk management procedures were followed from January 2021 to December 2021, serving as the control group, while FMEA-based risk management was implemented from January 2022 to December 2022, representing the research group. The Risk Priority Number (RPN) was calculated, and interventions were implemented for the top five identified failure modes. The RPN score, incidence of needlestick injuries, healthcare personnel's knowledge and awareness levels, prevention behavior, and rate of satisfaction with management were compared between the two groups. FMEA-based risk management identified weak knowledge of protection, disorganized placement of sharp instruments, failure to adhere to operational standards, improper operational procedures, and insufficient regulations for preventing needlestick injuries as the top five failure modes. The RPN scores for these modes were significantly lower in the research group (P<0.05). The research group also experienced a lower frequency and incidence of needlestick injury (P<0.05), along with higher levels of healthcare knowledge, awareness of prevention, and prevention behavior (P<0.05). Additionally, satisfaction with management was higher in the research group compared to the control group (P<0.05). FMEA-based risk management can improve the ability of oral healthcare personnel to prevent needlestick injury, reduce the occurrence of such incidents, and enhance satisfaction with management. This approach holds promise for wider adoption.

Clinical effectiveness and parental acceptance of silver diamine fluoride in preschool children: a non-randomized trial.

Silver diamine fluoride (SDF) presents a promising approach in pediatric dentistry, simplifying procedures by eliminating the need for sharp instruments or anesthesia. This study aimed to evaluate the effectiveness of 38% SDF application in arresting active caries lesions in preschool children and to assess parental acceptance of the treatment. This non-randomized, prospective, single-arm clinical study included 48 children, presenting with a total of 158 active caries lesions. The lesions were treated with 38% SDF, and their characteristics, including changes in dentin color and lesion texture, were evaluated at baseline and at a 6-month follow-up visit. The rate of lesion non-progression post-SDF application was calculated. Additionally, parents completed an oral health behavior form and the Parental Perceptions of Silver Diamine Fluoride Dental Color Changes Questionnaire to assess acceptance. The study observed a high rate of caries arrest in multi-surface teeth following SDF application. There was a statistically significant improvement in parental acceptance of SDF treatment. However, no significant interaction was observed between the treatment and either child- or parent-related variables regarding parental acceptability. The application of 38% SDF effectively arrested caries lesions in preschool children, with an observed increase in parental acceptance pre- and post-treatment.

Risk Factors and Prevention of Needlestick Instruments in the Medical Field: Systematic Review

Introduction: Needlestick and sharp object injuries represent a significant occupational hazard faced by healthcare workers worldwide. A systematic review focusing on needlestick and sharp object injuries among healthcare workers is essential due to the heterogeneous nature of existing research. The aim of this systematic review is to comprehensively synthesize existing literature to provide a comprehensive understanding of the prevalence, risk factors, and prevention strategies related to needlestick and sharp object injuries among healthcare workers. Methods: This thorough examination adheres to PRISMA principles and implements a pre-planned research plan to promote transparency and minimize partiality. It encompasses investigations involving medical personnel (such as nurses and physicians) centered on puncture wounds and sharp instrument mishaps, exploring contributing factors, occurrence rate, aftermaths, and preventative measures. A thorough exploration is conducted through various databases, with two separate evaluators examining and evaluating the studies. Suitable studies encompass both observational and intervention-based studies without constraints on publication dates. Information is extracted using a standardized format, and ethical clearance is not required as the review solely relies on already published data. Results: In our systematic review, we initially identified 1,523 articles through a database search, which underwent a stepwise screening process, resulting in 198 articles after assessing titles and abstracts. Subsequently, these 198 articles underwent a rigorous full-text evaluation. After this thorough assessment, 14 studies were included that met our predefined eligibility criteria. Our synthesis of the observational studies revealed recurring risk factors for needlestick and sharp object injuries among healthcare workers, including inadequate training, the impact of fatigue and extended working hours, and insufficient personal protective equipment (PPE). Additional factors like job category, experience level, and compliance with safety protocols were also highlighted in specific studies. Conclusions: This systematic review highlights the importance of standardized approaches to enhance healthcare worker safety, particularly in addressing risk factors like inadequate training, fatigue, and inadequate personal protective equipment (PPE). The effectiveness of prevention strategies, as demonstrated in our meta-analysis, underscores the value of comprehensive programs in reducing injury rates, emphasizing the need for more standardized and multifaceted safety measures across healthcare settings.

Parental Knowledge, Attitude, and Practice towards Dental Care Visits for Children 6-12 Years of Age during the Covid-19 Pandemic Period

Covid-19 is an infectious disease that is growing rapidly throughout the world. Dental care carries a risk of infection, as the procedure involves face-to-face communication with the patient, exposure to saliva, blood, other body fluids and the use of sharp instruments. Parents are afraid to take their children to visit the dentist because it will affect the child's oral and dental health. The aim of this study was to examine the relationship between parents' knowledge, attitudes and practices regarding children's dental care visits during the Covid-19 pandemic and parents' age and education level. Descriptive research with a cross-sectional design. The research subjects were 106 parents of children aged 6-12 years. Sampling was taken using the interview method with 11 questions. Analysis using Chi square. Research results: 26.4% of parents from the 30-39 year age group stated that dental care could cause children to be infected with the Covid-19 virus (p&lt;0.05), based on the level of knowledge, parents with a postgraduate level of knowledge answered that dental care could cause 19.8% of children were infected with the Covid virus (p&lt;0.05). There were no differences in parental attitudes based on age and parental education level in taking their children to the dentist (p&gt;0.05). It was concluded that there was no relationship between age and parents' level of knowledge regarding children's dental care visits during the Covid-19 pandemic.

Associations between unintentional injuries and deliberate self-harm behaviors of children and adolescents: A school-based cross-sectional survey

While statistics from hospitals showed that the proportion of self-harm or attempted suicide kept growing among children and adolescents aged 6–17 attending the emergency department, cases of self-harm or attempted suicide dissimulated as accidents received scant attention or were neglected. This study aimed to examine associations between unintentional injuries subtypes and deliberate self-harm behaviors from a school-based large-scale survey. A school-based cross-sectional study was conducted in Anhui, China, between November 2022 to January 2023. A total of 28,013 students (aged 11–17, 5th–12th grade) from 35 primary schools, 27 middle schools, and 6 high schools were included for the present study. Unintentional injuries in the past year of children and adolescents reported by parents. Self-harm behaviors in the past year of children and adolescents was measured with one question reported by students. Children and adolescents whose parents reported their contacts with sharp instruments demonstrated the highest risk for self-harm behaviors, followed by poisoning, exposure to electric current, falls, vehicle and traffic injuries, accidental drowning and submersion, and eating foreign bodies. And these associations distributed differently among children and adolescents reporting different frequencies of self-harm behaviors. Thus, we urge attention from parents, child caregivers, and teachers on children and adolescents experiencing certain types of unintentional injuries.

The perception of the Tiktok platform as China’s sharp power instrument in US politics

Public diplomacy can be defined as managing a country’s foreign policy objectives and protecting its national interests by establishing direct social relations and communication with the citizen or government of another country. Public diplomacy, which we know that each country has its own strategy, is handled from a different perspective in China as well. China, which has been identified with the concept of sharp power is confronted with the claims of the new rival of the USA. Recently, claims from the United States that China-based social media platform TikTok has been carrying out sharp power activities have come to the fore. TikTok is considered to be a major force for China as it has over one billion active users. However, there are debates as to whether China manipulates the peoples of other countries through this practice. Censorship and manipulation, the two main concepts of sharp power, are used in TikTok or does TikTok exist independently? The purpose of this article is to explore whether the TikTok platform, one of China's important public diplomacy tools, is perceived as a threat by American politicians. For this purpose, TikTok CEO Shou Zi Chew’s US Congress testimony were analyzed by content analysis method. As a result, it has been confirmed that American politicians perceive TikTok as a sharp power instrument of the Chinese Communist Party. It has been observed that concerns have been expressed about the concepts of censorship, manipulation, propaganda, control, and influence, which are the five elements of sharp power. It has been found that the TikTok platform is perceived as a propaganda device, a psychological warfare weapon, and not a public diplomacy tool or soft power element.

A descriptive study of percutaneous injuries in National Healthcare Group POLYCLINICS dental clinics in Singapore from 2014 to 2020

IntroductionAll dental staff face risk of percutaneous injuries (PCI)s. Blood-borne diseases may be transmitted to staff via contaminated sharp instruments. Hence there are significant impacts on staff when PCIs occur. Though a PCI is an occupational hazard, it is preventable.AimThis study aims to identify factors associated with PCIs among dental staff by evaluating the circumstances and staff designations involved.MethodsPCIs were reported through an electronic incident reporting system from 2014 to 2020. Reports involved their nature and extent. Statistical analysis was carried out to find associations between factors such as injury site, type of instrument and staff designation.ResultsA total of 63 PCIs were included in this study. The type of instrument was found to be significantly associated with staff designation (p = 0.04, p < 0.05) with significantly more dental burs causing injury in dentists and more injuries caused by ‘other instruments’ in health attendants (p = 0.0083). Majority of PCIs occurred in dentists, then dental assistants and health attendants. Staff designation was significantly associated with the instance where PCIs occurred (p < 0.001). Dentists and dental assistants were more likely to sustain injuries during a dental procedure than before procedure and after procedure (p = 0.0167). The mean incidence of PCIs among our dentists was 15.6/100.ConclusionsAll dental staff are at risk of PCIs however dentists sustain the highest number of PCIs. Needles, dental burs and metal matrices are the top three instruments. Targeted interventions might help prevent/reduce PCIs.

Barbers’ compliance with biological hazard preventive measures and predictors in selected towns, Southeast Ethiopia: a cross-sectional study

ObjectiveThe barber’s profession exposes their customers to several health risks. Negligence when using sharp instruments in barbershops can increase the risk of bloodborne infections, resulting in serious health problems for...

Cognitive models for mentally visualizing a sharp instrument in a blind procedure.

Our objective was to understand the cognitive strategies used by surgeons to mentally visualize navigation of a surgical instrument through blind space. We conducted semi-structured interviews with 15 expert and novice surgeons following simulated retropubic trocar passage on 3D-printed models of pelvises segmented from preop MRIs. Midurethral sling surgery involves blind passage of a trocar among the urethra, bladder, iliac vessels, and bowel while relying primarily on haptic feedback from the suprapubic bone (SPB) for guidance. Our conceptual foundation was based on Lahav's study on blind people's mental mapping of spaces using haptic cues. Participants detailed how they mentally pictured the trocar's location relative to vital anatomy. We coded all responses and used constant comparative analysis to generate themes, confirmed with member checking. Expert and novice participants utilized multiple cognitive strategies combined with haptic feedback to accomplish safe trocar passage. Some used a step-by-step route strategy, visualizing sequential 2D axial images of anatomy adjacent to the SPB. Others used a map strategy, forming global 3D pictures. Although these mental pictures vanished when they were "lost," a safe zone could be reestablished by touching the SPB. Experts were more likely to relate their body position to the trocar path and rely on minor variations in resistance. Novices were more inclined toward backtracking of the trocar. Our findings may be extended to any blind surgical procedure. Teaching visualization strategies and incorporating tactile feedback can be used intraoperatively to help learners navigate their instrument safely around vital organs.

Analysis of Occupational Safety and Health Risk in Emergency Installations with Hospital X Yogyakarta Using The Failure Mode Effect and Analysis (FMEA) Method

Background: Risk management of occupational safety and health in hospital can be used to limit, minimize, and eliminate hazards in hospitals. While the emergency department is the major service for emergency patients, there is a significant risk of five hospital components, including health professionals, patients, patient families, visitors, and the environment, because of X Hospital Yogyakarta has developed a risk management program. The goal of this study was to analyze the risk of occupational safety and health in X hospital Yogyakarta emergency department. Method: This research employs a qualitative approach using form Failure Mode Effect and Analysis (FMEA). Direct observation and conducting in depth interviews with informants are two methods for gathering data. The research carried out in and covered all work activities at X Hospital emergency department. Result: There are 21 work activities with recognized OSH concerns, with 4 work activities having a high risk level, 8 work activities having a potential risk , and 9 work activities having a torelable risk. Taking anamnesis, blood sampling, patient examination, patient admission, and medical acts using sharp instruments are the most common sources of danger; there have been incidents in the emergency department cause medical action with sharp tools resulted in cases of like needle stick injuries to health workers hit by broken glass ampoules and so on. Conclusion: The implementation occupational health and safety culture, can influence worker behavior in order to reduce the number of errors and infractions, as well as the likelihood of work accidents occurring again.