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Occupational hazards and protective measures of medical staff in interventional operating room


Release time:

2020-04-10

With the rapid development of medical science and technology, interventional radiology has the distinctive characteristics of imaging diagnosis and minimally invasive treatment as one of the disciplines. It is known as the third largest diagnosis and treatment system in modern clinical therapeutics, and it is one of the three major medical technologies juxtaposed with internal medicine and surgery. It has the characteristics of minimally invasive, high efficiency, safety, less complications, short recovery period, strong repeatability and no damage to the original anatomical structure and physiological function, and its rapid development also makes the interventional operating room continue to develop and grow, the number of medical staff is increasing, and various environmental factors in the interventional operating room have an impact on the medical staff. The occupational hazard factors analysis and protective measures of medical staff in the interventional operating room are reported as follows.

Occupational hazard factors of medical staff in interventional operating room

1.1 physical hazard factors

1.1.1 noise pollution the noise of interventional operating room mainly comes from the working sound of dsa of angiography machine, defibrillator, monitor, radiofrequency ablation instrument, micro pump, air conditioner, air disinfector and other machines, the pain and groan of patients during operation, the discussion sound of too many visiting and learning personnel, etc. Long-term noise pollution in the environment, medical staff easily emotional, irritable, adverse to their physical and mental.

 

1.1.2 X-ray radiation

The damage caused by X-rays to the human body is mainly due to the characteristics of X-rays-biological effects. After X-ray irradiation of the body, a series of changes can occur in the tissues and body fluids, and the cells in the tissues are inactivated by ionizing radiation, which causes radioactive damage mainly to hematopoietic tissue. The interventional operating room is a special place for patients to undergo radiographic examination and treatment under the guidance of X-ray. The medical staff engaged in interventional radiology work, the body is continuously or intermittently subjected to super-dose ionizing radiation for a long time, which can lead to damage to tissues and organs that are more sensitive to radiation, such as skin, eye lens, gonad and bone marrow tissue, make people produce fatigue, dizziness, headache, memory loss, loss of appetite, decreased immunity. Long-term low-dose chronic radiation can cause chronic radiation syndrome, especially on hematopoietic, immune and neurological effects.

1.1.3 If medical personnel with negative and serious injuries wear lead clothes, lead caps and lead glasses for a long time, it is easy to cause shoulder and back injuries, head discomfort and pressure on the bridge of the nose. Standing in lead clothes for a long time can easily lead to poor blood return of the lower limbs and swelling of the lower limbs, resulting in varicose veins.

1.1.4 Relatively closed environment Medical staff work in the relatively closed environment of the interventional operating room for a long time, emotional irritability, anxiety, irritability.

1.2 social psychological pressure  

The characteristics of minimally invasive intervention has become a hot spot in the emergency department, and it is overloaded with work every day. In the face of emergency patients, medical staff have greater psychological pressure.

1.3 chemical hazard factors

Due to the long exposure time of interventional surgery, X-rays cause the air in the room to ionize, produce nitrogen oxides, ozone, free radicals and other products and cause the imbalance of positive and negative ions, toxic chemicals volatilize for a long time, pollute the air in the room, and affect the human skin, mucous membrane, respiratory tract and nervous system to a certain extent. Interventional operating room medical staff daily work exposure to various chemical disinfectants suchChlorine-containing disinfectants, glutaraldehyde, iodine, etc., are corrosive, volatile, and irritating, and can easily cause allergic rhinitis, chest tightness, asthma, pharyngitis, etc..

The medical staff in the interventional operating room are mainly accidental injuries during the interventional treatment process. In their daily work, they accidentally contact vascular puncture needles, surgical blades, and surgical suture needles to cause needle stick injuries, etc., and sometimes their own protection is not in place, and there are wounds on their hands without wearing gloves. The operation comes into contact with infectious blood. Because some blood-borne diseases are easy to repeat and turn into chronic diseases, the treatment is difficult and long, which has a serious impact on families and units, resulting in a series of adverse consequences and social problems, which is a key point of hospital infection control [4]. The most common threats are hepatitis B (HBV), hepatitis C (HCV), and AIDS (HIV). Some data show that the infection rate of hepatitis B among hospital staff is 3-6 times higher than that of ordinary residents. The average infection rates of HBV, HCV and HIV exposed by one acupuncture or other means are 6-30, 3-10 and 0.2-0.5 respectively, while needle stick injuries account for 80 percent of the infection routes caused by occupation ﹪.

Protective Measures for Occupational Hazards of Medical Staff in Interventional Operating Room

Protection of 2.1 Physical Hazards

2.1.1 Noise protection  

All kinds of instruments and equipment in the interventional operating room shall be managed by special personnel, and shall be inspected and maintained regularly. During the operation, the alarm sound shall be set correctly, and the noise shall be checked in time. Actively communicate with patients, do a good job of psychological care, to avoid excessive irritability, loud groans, reduce the number of visitors to learn, try to create a quiet catheter room operation environment.

 

2.1.2 Reduction of X-ray radiation  

Improve and improve medical equipment supplies, increase the cost of protection investment, hospitals should actively for the intervention of medical staff equipped with complete protective equipment such as lead clothing, lead collar, lead glasses, etc., to reduce the super dose of ionizing radiation. Lead clothes should be hung on hangers and cannot be folded up. If any damage is found, report it in time and stop using it. The staff in the interventional operating room must always use 0.5mm lead equivalent apron. Conscientiously study and implement Article 23 of the "the People's Republic of China Occupational Disease Prevention and Control Law", carefully wear personal dosimeters, monitor personal radiation doses, master the purpose and significance of monitoring, reasonably allocate working hours, and avoid prolonged overdose of ionizing radiation. In addition, two major principles of radiation protection should be observed: the principle of justification of medical exposure and the principle of optimization of radiation protection. Do a good job of four protection: time protection, distance protection, source control protection, shielding protection [1]. The preparation of interventional surgical articles is completed in a planned way within non-exposure time, with reasonable placement and convenient use, minimizing unnecessary X-ray radiation, preventing the occurrence of definite effects and limiting the probability of random effects.

2.1.3 Protection against negative and serious injuries  

Master the principle of force, reduce the negative serious injury. Pay attention to master the skills of the work, try to wear split lead clothing, lead skirt, scattered shoulder back strength, prevent neck, lumbar discomfort. Try to wear elastic stockings during work, and try to raise the lower limbs when resting to prevent the formation of varicose veins of the lower limbs.

 

Protection of 2.2 chemical hazardsReasonable layout of cardiac catheterization room, to ensure good ventilation facilities, regular ventilation, the standard use of various chemical disinfectants.

 

Protection 2.3 the influence of biological factorsImprove self-protection awareness to overcome fluke seriously implement standard prevention to prevent occupational exposure. The following preventive measures shall be taken immediately after stab wounds and abrasions occur:

2.3.1 Squeeze the wound first to let the blood flow out of the wound; it is forbidden to press the wound directly.

2.3.2 with sterile water (or clean water, pure water, unconditional with warm tap water) thoroughly rinse; rinse time of not less than 1 minute.

2.3.3 Wash and disinfect the wound with iodine or alcohol (it can be treated in the department where it is located);

2.3.4 Report to the Infection Management Department for the record; Vaccination, follow-up, in order to give further intervention treatment!

Contaminated parts: Rinse with soapy water and disinfect with an appropriate disinfectant, such as 70% ethanol or skin disinfectant. Splash into the eyes: You must rinse quickly with normal saline and avoid rubbing the eyes for at least 10 minutes. Medical personnel, patients, and others should wear gloves when performing the following operations: contact with patient body fluids, dirt, and disposal of dirt. In the operation should be firm tree owner self-protection consciousness.

The infectious patient is scheduled at the end of each day of surgery..

2.4 relieve social psychological pressure and promote physical and mental health.Strengthen the training of psychological quality of doctors and patients, improve professional skills, ease the tension in the operating room, strengthen their own exercise, enhance physical fitness, get along with colleagues, and maintain a happy mood.

In short, with the continuous development of interventional diagnosis and treatment methods, the occupational hazards of medical staff in the interventional operating room gradually show the characteristics of long-term effect, chronic effect, and frequently-occurring diseases. The protective measures of occupational hazards of medical staff in the interventional operating room should focus on prevention. The hospital should continuously formulate a sound protection management system, enhance the protection knowledge and skills of medical staff, actively improve the working environment of the interventional operating room, improve self-protection ability, and reduce occupational hazards.

 

Source: Intervention Home

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