News Center

At present, the use of endoscopy is becoming more and more extensive, and the iatrogenic infection and injury caused by endoscopy are becoming more and more important. Because of the particularity of the profession, the medical staff in the endoscopy center have to be exposed to various risk factors every day. So, what are the occupational hazards and protective measures of the medical staff in the endoscopy center?

Factors of occupational exposure

Contamination from patients

With the spread of AIDS in the world, the number of drug users has increased, and the incidence of hepatitis B is high. The harm of these viruses to nurses in the endoscope room has also increased. Such as gastroscopy operation in patients with oral secretions, gastric juice, blood; enteroscopy abdominal pressure is too high, stool with the mirror body outflow can contaminate the operator's arm. These secretions and excretions can directly infect surgeons and assistants through the skin, mouth and nasal mucosa.

2. The poison of disinfectant

At present, the commonly used disinfectants are o-phthalaldehyde, glutaraldehyde, and peracetic acid. Glutaraldehyde and peracetic acid, at a certain concentration, will have obvious irritation to the eyes, skin, mucous membranes, and respiratory tract. Long-term contact can lead to dermatitis, Conjunctivitis.

3. Radiation damage

In the process of endoscopic diagnosis and treatment, especially in endoscopic retrograde cholangiopancreatography (ERCP) and various gastrointestinal stent implantation, medical staff are required to operate for patients in a radiation environment for a long time. After X-ray acts on the human body, it produces various effects on cells, tissues and organs. The light ones may have no effect on life activities. Long-term contacts directly lead to leukopenia, adverse fertility structure, radiation sickness, carcinogenesis, teratogenicity, etc.

4. Mechanical damage

Due to the long time consumption of some fine and complex operations, the relative concentration of endoscopic diagnosis and treatment time, the increasing number of patients and the acceleration of diagnosis and treatment turnover, endoscopic medical staff need to maintain a long-term fixed and standing posture during the work process. Therefore, endoscopic medical staff are a high-risk group of mechanical injuries. Varicose veins of lower limbs, neck and back pain, frozen shoulder, carpal tunnel syndrome, etc. are relatively common occupational injuries.

Occupational protective measures for endoscope-related operations

★(1) Strengthen the training and learning of infection knowledge of medical staff in endoscopy room, and improve the awareness of self-protection and iatrogenic infection prevention;

★(2) Before endoscopy, determine whether the patient has infectious diseases, such as HIV antibody, HBs antigen, HCV antibody, etc;

★(3) in the process of diagnosis and treatment, do a good job of standard prevention. Medical personnel must wear special work clothes, special work shoes, wear protective glasses, medical surgical masks, hats, rubber gloves, etc., and change gloves every patient. Change pillow towel, mouth ring, bending plate, etc. between each patient;

★(4) correct hand washing (six step hand washing method) is the most simple and effective way to prevent the spread of disease and safety protection;

★(5) When cleaning and disinfecting the endoscope, it must be in a well-ventilated environment, and wear medical surgical masks, hats, gloves, goggles, special work clothes, etc. to prevent chemical disinfectants from splashing into the eyes and Reduce inhalation;

★(6) reasonable arrangement of ultraviolet or air disinfection machine disinfection time, indoor ventilation after irradiation;

★(7) When performing ERCP or interventional therapy, you should wear lead clothing, lead cap, neck protection, protective glasses and other protective equipment. The lead clothing should be hung and stored, not folded, tested regularly, and the personal meter should be carried at any time. Regular monitoring of personal radiation dose, often alternate exposure to radiation, in order to avoid the accumulation of radiation in the individual.

★(8) Relieve work pressure, maintain physical and mental health, rationally allocate the proportion of medical staff, implement flexible scheduling system, pay attention to the physical and mental health of employees, and maintain good working conditions.

With the rapid development and popularization of endoscopic diagnosis and treatment technology, we should pay attention to the occupational safety and protection of endoscopic medical personnel while taking patients as the center in clinic. This requires the relevant departments and managers to give enough attention, the need for endoscopic practitioners of their own protection awareness, and jointly build a standardized safety protection management system, so as to reduce the occurrence of occupational hazards, maintain the physical and mental health of endoscopic medical staff, and better serve patients.

Source: Peking University's Window of Sense and Control Author: Li WenzhuReviewed by: 0.6 billion Li