Search

The objective was to identify the use of personal protection equipment by nursing workers during procedures which expose them to biological fluids. It was observational, descriptive and transversal research, with a quantitative approach, undertaken in a public hospital in the state of Paraná, in January – May 2014, using nonparticipant and intentional observation of 201 procedures through the use of a checklist. It was ascertained that, in the Surgical Center, procedure gloves (97%) obtained the greatest adherence, but that closed shoes and eye protection were not used on any occasion. In the Central Sterile Services Department, no worker used the procedure gloves, either rubber or heat-resistant, although the surgical mask (44.4%) had the greatest adherence in the cleaning room. In the Intensive Care Units and Emergency Room, the procedure gloves were used (100%), although adherence to the eye protection was low (0.86%). The nursing staff did not use all the equipment stipulated by legislation during their activities.

The objective was to identify concentrations of polycyclic aromatic hydrocarbons produced by electrocautery smoke in operating rooms, correlating these concentrations with time of electrocautery and surgical use. This is a cross-sectional and quantitative field study carried out in 50 gastrointestinal surgical procedures, between April and July 2015, in a university hospital in the state of Paraná. Hydrocarbons were collected using a suction pump and measurements were determined through liquid chromatography. These compounds were found to have an average of 0.0058 mg.m-3 and a mean of 0.0049 mg.m-3. The mean surgical time and electrocautery use were 136 minutes and 220.5 seconds, respectively. The Spearman correlation test was -0.512 between concentration variables and surgical time, and -0.183 between the concentrations and electrocautery use. The conclusion was the presence of hydrocarbons and a low correlation between the production of these compounds and the electrocautery usage time.

Este estudo objetivou avaliar as condições ergonômicas e o uso de Equipamentos de Proteção Individual de Unidades Produtoras de Refeições. É um estudo descritivo com pesquisa de campo com caráter observacional e o método empregado é quantitativo, de natureza transversal. Aplicou-se um instrumento nas unidades para avaliação dos aspectos ergonômicos e uso de EPIS. Na maior unidade do estudo, durante trinta dias observou-se o uso dos EPIs nas atividades. Os dados foram avaliados no programa EXCEL 2013 e descritos em tabelas e gráficos. Com a avaliação dos dados, observou-se inadequações de oito unidades na altura das bancadas (80%), nove unidades com inadequação na altura de prateleiras (90%) e apenas seis unidades (60%) apresentavam portas com abertura automática. Em relação aos EPIs, há negligência na utilização dos equipamentos durante as atividades, em especial ao avental térmico, em nove unidades (90% de inadequação;) podendo causar riscos aos colaboradores. Na maior unidade estudada, observou-se que o EPI com grande negligência na área de preparação dos alimentos foi a luva de malha de aço, totalizando vinte e duas inadequações (81,5%). Na área de cocção, apresentou-se onze inadequações no uso da luva térmica (40,7%) e o mangote térmico dez inadequações (37%). Conclui-se que as unidades apresentam condições inadequadas de trabalho que podem debilitar a saúde dos trabalhadores. Portanto, é importante avaliar os erros ergonômicos nas UPRs e investir na estrutura física. O uso de EPIs é bastante negligenciado pelos colaboradores, logo há necessidade de treinamento contínuo para manter a segurança e saúde do trabalhador.

Este estudo descritivo-exploratório, prospectivo, com abordagem quantitativa teve como objetivo verificar a adesão dos profissionais de enfermagem ao uso dos equipamentos de proteção individual na realização do procedimento de aspiração endotraqueal por sistema aberto. Os dados foram coletados através de observação, utilizando um check-list, no período de abril a setembro de 2011, em duas unidades de terapia intensiva (UTI) de um hospital universitário de Mato Grosso do Sul, Brasil, e analisados utilizando estatística descritiva. Dos 25 profissionais investigados, 11 trabalhavam na UTI Geral e 14 na Cardiológica. Dessa amostra, 14(56%) eram do sexo masculino. O uso de equipamentos de proteção individual variou de 60-100%, sendo que não ocorreu adesão para o uso de óculos; 28% não usaram máscara, 36% sapatos fechados e 40% avental descartável. Evidencia-se que os profissionais estão expostos ao risco biológico e, portanto, há necessidade de rever o processo de trabalho e as atividades educativas. ABSTRACT Descriptive-exploratory and prospective study with a quantitative approach. It aims at checking nursing professionals’ adherence to individual protection equipment during open-system endotracheal aspiration procedures. Data were collected through observation, with a checklist, at two intensive care units (ICU) of a teaching hospital in Mato Grosso do Sul, Brazil, from April to September, 2011. Data were analyzed on the basis of descriptive statistics. Out of the 25 professionals investigated, 11 worked at the General ICU and 14 at the Cardiologic ICU. In this sample, 14(56%) were male. Use of individual protection equipment ranged between 60 and 100%, with no adherence to eyewear; 28% did not wear a mask; 36% closed shoes and 40% disposable gowns. There’s evidence that those professionals are exposed to biological risk and, therefore, both the work process and educational activities must be enhanced. RESUMEN La finalidad de este estudio descriptivo-exploratorio, prospectivo, con enfoque cuantitativo fue verificar La adhesión de profesionales de enfermería al uso de equipos de protección individual durante la aspiración endotraqueal de sistema abierto. Los datos fueron recolectados mediante observación, utilizando un check-list, entre abril y septiembre Del 2011, en dos unidades de terapia intensiva (UTI) adultas de un hospital universitario los de Mato Grosso do Sul, Brazil, y analizados utilizando estadística descriptiva. De los 25 profesionales investigados, 11 trabajaban en la UTI General y 14 en La Cardiológica. En esa muestra, 14(56%) eran del género masculino. Respecto a la utilización de equipos de protección individual, el uso varió entre 60 y 100%, sin adhesión al uso de óculos; 28% no usó máscara; 36% zapatos cerrados y 40% delantal desechable. Se evidencia que los profesionales están expuestos al riesgo biológico y, por lo tanto, son necesarias La revisión del proceso de trabajo y actividades educativas.

Objetivo: identificar modos de exposição a material biológico dos profissionais de enfermagem de unidades da atenção primária à saúde de um Distrito Sanitário de Goiânia-GO. Método: cumpridos os aspectos éticos, os dados foram obtidos por meio de questio­nário e observação direta, registrados em check list. Foram observados 149 procedimentos: testes do pezinho e pré-natais, exame colpocitológico, vacinação e curativos, entre janeiro e maio de 2010. Resultados: houve risco de exposição a material biológico de­vido ao manuseio de perfurocortantes, possibilidade de contato com sangue, secreções e imunobiológicos, formação de aerossóis, proximidade entre membro puncionado e face do profissional, agitação e/ou reação inesperada do usuário. Conclusão: há risco de exposição a material biológico nos procedimentos realizados pelos profissionais de enfermagem na atenção primária à saúde e esse risco é potencializado pela inobservância das precauções-padrão. Aponta-se necessidade de comissões de controle de infecção no distrito sanitário, orientando e supervisionando procedimentos seguros. ABSTRACT Objective: to identify modes of exposure to biological material involving nursing professionals at Primary Care Centers in a Health District of Goiânia, Goiás. Method: once ethical requirements were met, data were obtained by questionnaire and direct observa­tion, and recorded on a check list. From January to May 2010, 149 procedures were observed: neonatal and antenatal screening, Papanicolaou test, immunization and dressings. Results: risk of exposure to biological material was found during sharps handling, possible contact with blood, secretions and immunobiologics, aerosol formation, proximity between an accessed limb and nurse’s face, and agitation and/or unexpected reaction from user. Conclusion: there is risk of exposure to biological material in procedures performed by primary health care nurses and that risk is heightened by non-observance of standard precautions. There is a need for infection control committees in the health district, to give guidance and supervision on safe procedures. RESUMEN Objetivo: identificar modos de exposición a material biológico de los profesionales de enfermería de Unidades de Atención Primaria a la Salud en un Distrito Sanitario de Goiânia-GO. Método: tras haber cumplido los aspectos éticos, se han obtenido los datos por medio de cuestionario y observación directa, y posteriormente registrados en un chek-list. Entre enero y mayo de 2010, se han observado 149 procedimientos: pruebas del talón y prenatales, citología vaginal, inmunización y curativos. Resultados: se presentó el riesgo de exposición a material biológico por la manipulación de objetos cortopunzantes, la posibilidad de contacto con sangre, secreciones e inmunobiológicos, formación de aerosoles, proximidad entre el miembro puncionado y la cara del profesional, agitación y/o reacción inesperada por parte del usuario. Conclusión: existe el riesgo de exposición a material biológico en los procedimientos realizados por los profesionales de enfermería durante la asistencia en la atención primaria de salud, el cual se potencializa por la no observación de las precauciones estándar. Señalamos la necesidad de comisiones de control de infecciones, en el distrito de salud, orientando y supervisando procedimientos seguros. DOI: http://dx.doi.org/10.12957/reuerj.2016.6442

This clinical trial aimed at comparing the intensity of pain and bruising by subcutaneous and intramuscular injections using and retractable fixed syringes and needles and syringes with no needles combined, at a public hospital in Sao Paulo, for six months. We evaluated the perception of pain in case of intramuscular (n=1000) and subcutaneous injections (n=240). In subcutaneous application, bruise formation was also verified. Pain and bruising scores were higher in the group with no needles combined (pEste ensayo clínico tuvo como objetivo comparar la intensidad del dolor y hematoma de inyecciones por vía subcutánea e intramuscular utilizando jeringas y agujas fijas retráctiles y jeringas con agujas no conjugadas, en un hospital público en la ciudad de Sao Paulo, durante seis meses. Fue evaluada la percepción del dolor de la inyección intramuscular (n=1000) y la subcutánea (n=240). En la aplicación por vía subcutánea se verificó también la formación de hematoma. La puntuación del dolor y hematoma fue mayor en el Grupo con agujas no conjugadas (pEste ensaio clínico teve como objetivo comparar a intensidade da dor e hematoma consequentes a injeções por via subcutânea e intramuscular, utilizando seringas e agulhas fixas retráteis e seringas com agulhas não conjugadas, em hospital público na cidade de São Paulo, durante seis meses. Foi avaliada a percepção da dor na injeção intramuscular (n=1.000) e na subcutânea (n=240). Na aplicação por via subcutânea, verificou-se também a formação de hematoma. A pontuação de dor e hematoma foi maior no grupo com agulhas não conjugadas (p

A qualitative study conducted in a teaching hospital with 15 nursing professionals. Attempted to analyze the reasons, attitudes and beliefs of nursing staff regarding adherence to personal protective equipment. Data were collected through focus groups, analyzed by the method of interpretation of meanings, considering Rosenstock’s model of health beliefs as a reference framework. Data revealed two themes: Occupational safety and Interpersonal Relationship. We identified several barriers that interfere in matters of safety and personal protective equipment, such as communication, work overload, physical structure, accessibility of protective equipment and organizational and management aspects. Adherence to personal protective equipment is determined by the context experienced in the workplace, as well as by individual values and beliefs, but the decision to use the personal protective equipment is individual.Estudio cualitativo realizado en un hospital universitario con 15 profesionales de enfermería. Objetivó analizar las razones, actitudes y creencias de los trabajadores de enfermería referentes a la adhesión a los equipamientos de protección individual. Los datos fueron recolectados por medio de grupo focal, analizados por el método de interpretación de sentidos, considerando el referencial del modelo de creencias sobre salud de Rosenstock. De los datos surgieron dos categorías temáticas, Seguridad en el trabajo y Relaciones Interpersonales. Identificamos varias barreras que interfieren en las cuestiones de seguridad y protección individual como comunicación, sobrecarga de trabajo, estructura física, accesibilidad a los equipamientos de protección y aspectos organizacionales y administrativos. La adhesión a los equipamientos de protección es determinada tanto por el contexto experimentado en el ambiente de trabajo, como por valores y creencias individuales; sin embargo, la decisión del uso de los equipamientos de protección es individual.Trata-se de estudo qualitativo, realizado em um hospital universitário, com 15 profissionais de enfermagem. Objetivaram-se analisar as razões, atitudes e crenças dos trabalhadores de enfermagem, referentes à adesão aos equipamentos de proteção individual. Os dados foram coletados por meio do grupo focal, analisados pelo método de interpretação de sentidos, considerando o referencial do modelo de crenças em saúde de Rosenstock. Dos dados, emergiram duas categorias temáticas, segurança no trabalho e relacionamento interpessoal. Identificaram-se várias barreiras que interferem nas questões de segurança e proteção individual como comunicação, sobrecarga do trabalho, estrutura física, acessibilidade aos equipamentos de proteção e aspectos organizacionais e gerenciais. A adesão aos equipamentos de proteção é determinada tanto pelo contexto vivenciado, no ambiente de trabalho, como, também, por valores e crenças individuais, mas a decisão sobre o uso dos equipamentos de proteção é individual.

Visando quantificar os danos impostos a respiradores PFF-2 ao longo do tempo de uso e estimar seu período de validade na prática clínica, este estudo baseou-se na análise descritiva de máscaras cônicas do tipo PFF-2, coletadas por auxiliares de enfermagem após um, cinco, 15 e 30 dias consecutivos de uso, num hospital de referência para doenças infecciosas. Marcas de identificação pessoal foram encontradas em todos os respiradores já no primeiro dia de uso. A partir do quinto dia, todas as máscaras apresentavam sujeiras, enquanto dobraduras foram observadas em mais de 80% dos equipamentos. Manchas internas e dobras foram mais freqüentes após turnos de 12 horas do que plantões de 6 horas (p < 0.05). 16,17% das máscaras estavam extraviadas no quinto dia e 38.93% após o 30º dia de uso. O prazo de validade do respirador PFF-2, embora não seja conveniente reutilizá-lo, deve se limitar a cinco dias.En la intención de cuantificar los daños impuestos a respiradores PFF-2 a lo largo del tiempo de uso y estimar su vida útil en la práctica clínica, este estudio se basó en el análisis descriptivo de máscaras cónicas del tipo PFF-2 revisadas después de uno, cinco, quince y treinta días consecutivos de uso por auxiliares de enfermería en un hospital de referencia para enfermedades infecciosas. Ya en el primer día de uso fueron encontradas marcas de identificación personal en todos los respiradores. A partir del quinto día, todas las máscaras presentaban suciedad, mientras que fueron observados pliegues en más del 80% de los equipos. Las manchas internas y pliegues fueron más frecuentes luego de turnos de 12 horas que de guardias de 6 horas (pWith the purpose of assessing the damages to N95 respirator masks over time and to estimate their expiration after use in clinical practice, this study was based on the descriptive analysis of N95 cone-shaped masks collected by nursing assistants after one, five, 15, and 30 consecutive days of use. Personal identification marks were founds in every respirator already on the first day of use. From the fifth day onward, all masks presented some type of dirt while folds were observed in more than 80% of the devices. Internal stains and folds were more frequent among workers of the 12-hour shift in comparison to the 6-hour shift (p < 0.05). The percentage of misplaced respirators was 16.17% by day five and reached 38.93% by day thirty. Though there is no convenience in reusing N95 respirators, their expiration should not exceed 5 days of use.

OBJETIVO: Estimar a prevalência de utilização de assentos de segurança infantil e fatores associados. MÉTODOS: Estudo transversal observacional, com amostragem estratificada, realizado em 15 creches da cidade de Maringá, PR, entre os meses de março e maio de 2007. Cada creche foi visitada em apenas um dia letivo. O desfecho considerado foi a utilização de assento de segurança infantil por crianças de até quatro anos de idade. Carros (N=301) que transportavam crianças menores de quatro anos de idade foram abordados e as informações foram coletadas por meio de questionários semi-estruturados. Variáveis relacionadas a distribuição de adultos e crianças nos assentos do veículo, situação de restrição dos ocupantes e sexo do condutor foram analisadas. Para análise dos dados aplicou-se o teste exato de Fisher, qui-quadrado de Mantel-Haenszel e regressão logística. RESULTADOS: Entre os motoristas abordados, 51,8% usavam cinto de segurança (60,4% das mulheres, 44,9% dos homens). Entre as crianças, 36,1% usavam assentos de segurança infantil, 45,4% eram transportadas soltas, 16,0% estavam no colo de adultos, 2,7% usavam o cinto de segurança. Segundo a regressão logística, os fatores que mais influenciaram o uso dos assentos de segurança infantil foram: idade da criança inferior a 15 meses (OR= 3,76), uso de cinto de segurança pelo condutor (OR= 2,45) e crianças pertencentes aos estratos sociocupacionais de maior renda e escolaridade (OR= 1,37). CONCLUSÕES: A utilização de assentos de segurança infantil mostrou-se associada à idade da criança, uso de cinto de segurança pelo condutor e estrato sociocupacional da creche. Frente ao baixo índice de utilização, o uso dos assentos de segurança infantil surge como desafio à medicina preventiva no Brasil, exigindo atenção e atuação para sua disseminação na população.OBJETIVO: Estimar la prevalencia de utilización de asientos de seguridad infantil y factores asociados. MÉTODOS: Estudio transversal observacional, con muestreo estratificado, realizado en 15 guarderías de la ciudad de Maringá (Sur de Brasil), entre los meses de marzo y mayo de 2007. Cada guardería fue visitada en sólo un día lectivo. El resultado considerado fue la utilización de asiento de seguridad infantil por niños de hasta cuatro anos de edad. Carros (N=301) que transportaban niños menores de cuatro anos de edad fueron abordados y las informaciones fueron colectadas por medio de cuestionarios semi-estructurados. Las variables relacionadas a distribución de adultos y niños en los asientos del vehículo, situación de restricción de adultos pasajeros y niños y sexo del conductor fueron analizadas. Para análisis de los datos se aplicó la prueba exacta de Fisher, ji-cuadrado de Mantel-Haenszel y regresión logística. RESULTADOS: Entre los conductores abordados, 51,8% usaban cinturón de seguridad (60,4% de las mujeres, 44,9% de los hombres). Entre los niños, 36,1% usaban asientos de seguridad infantil, 45,4% eran transportadas sueltas, 16,0% estaban en las piernas de adultos, 2,7% usaban el cinturón de seguridad. Según la regresión logística, los factores que más influenciaron el uso de asientos de seguridad infantil fueron: edad del niño inferior a 15 meses (OR=3,76), uso de cinturón de seguridad por el conductor (OR= 2,45) y niños pertenecientes a los estratos sociocupacionales de mayor renta y escolaridad (OR=1,37). CONCLUSIONES: La utilización de asientos de seguridad infantil se mostró asociada a la edad del niño, uso de cinturón de seguridad por el conductor y estrato sociocupacional de la guardería. Frente al bajo índice de utilización, el uso de los asientos de seguridad infantil surge como desafío a la medicina preventiva en Brasil, exigiendo atención y actuación para su diseminación en la población.OBJECTIVE: To estimate the prevalence of child safety restraint use and factors associated. METHODS: Observational cross-sectional study using a stratified sampling conducted in the city of Maringá, Southern Brazil, between March and May 2007. Each day care center was visited at one day only. The outcome was use of child safety restraints by children under four. Vehicles (N=301) driving children under four were approached and information was collected using semi-structured questionnaires. Variables regarding child and adult seat distribution, use of safety restraints by occupants and driver's gender were analyzed. Data analyses included Fisher's exact test, Mantel-Haenszel chi-square test, and logistic regression. RESULTS: Of the drivers approached, 51.8% were using seat belts (60.4% among women, 44.9% among men). Among children, 36.1% were using child safety seats, 45.4% were unrestrained during traveling, 16.0% were seated on an adult lap, and 2.7% were using seat belts. The logistic regression showed the following factors affecting child safety restraint use: child age under 15 months (OR = 3.76); seat belt use by the driver (OR = 2.45); and children from socio-occupational condition with higher income and education (OR = 1.37). CONCLUSIONS: Child safety restraint use was associated to child age, seat belt use by the driver, and socio-occupational condition of day care centers. The finding of low rates of child safety restraint use poses a challenge to preventive medicine in Brazil, requiring attention and action to promote its widespread use.

Durante 1993 e 1994 foi realizada reciclagem em Precauções-Padrão para os profissionais de enfermagem do Centro de Atenção Integral à Saúde da Mulher (CAISM). Em 1995 foi avaliada, por observação direta nos setores, a adesão a estas medidas, o uso adequado, a acessibilidade e disponibilidade de luvas e caixas para descarte de materiais pérfuro-cortantes. Registraram-se 60 observações e 232 procedimentos. Em 164 (71%) destes houve adoção das medidas, não ocorrendo o mesmo em outros 68 (29%). Evidenciou-se a necessidade de enfatizar a lavagem de mãos e o não-reencape de agulhas.Durante el periodo de 1993 y 1994 se realizó la actualización en medidas de precaución patrón para los profisionales de enfermeria del Centro de Atención Integral a la Salud de la Mujer (CAISM). En 1995, se realizó una evaluación a través de la observación directa en los sectores; la adhesión a estas medidas, el uso adecuado y la disposición de guantes y cajas para descarte de materiales corto-punzantes. Se registraron 60 observaciones e 232 procedimientos, 164 de ellos (71%) adoptaron el uso de las medidas y en 68 (29%) esto no ocurrió. Es evidente la necesidad de dar énfasis al lavado de las manos y colocar de nuevo la camisa (tapa) a las agujas.During 1993 and 1994, a recycling program on Standard Precautions was conducted for the nursing personnel at the Women's Health Centre (CAISM). In 1995, an evaluation was obtained through direct observation of these sectors regarding the adoption of these measures, the adequate use, access and availability of gloves and boxes for the disposal of perforating, sharp material. Sixty observations and 232 procedures were reported. One hundred sixty four procedures (71%) adopted these measures and 68 procedures (29%) did not. It was evident that the need to wash hands and not to use needles twice should be emphasized.

No Centro de Atenção Integral à Saúde da Mulher (CAISM) desenvolveu-se um programa de reciclagem sobre as Medidas de Precaução Universais (MPU) e divulgou-se, através de uma cartilha, essas medidas e os procedimentos em caso de acidente de trabalho. Primeiramente, o funcionário era sensibilizado para a questão do estresse e sua influência sobre a qualidade de vida e, após, era realizada a reciclagem promovendo-se a reflexão sobre as conseqüências da não adoção das MPU. Foram respondidos e analisados 286 pré-testes e 242 pós-testes com um índice de acertos significativamente maior nestes últimos (pEl Centro de Atención Integral a la Salud de la Mujer (CAISM) desarrolló un programa de reciclaje sobre Medidas de Precaución Universales (MPU). Se divulgó por medio de un material educativo (cartilla) las MPU y procedimientos en caso de accidentes de trabajo. En primer lugar se cuestionó al funcionário sobre el stress y su influencia en la calidad de vida, llevando se a cabo el reciclaje en el cual se promovió la reflexión sobre consecuencias cuando las MPU no son adoptadas. Fueron respondidas y analizadas 286 pre-test y 242 pos-test con un índice de acierto significativamente mayor en este último (p < 0,01), principalmente con relación al uso adecuado de los guantes.An updating program on measures of universal precautions (M.U.P.) was developed at the Center of Whole Care of Woman's Health (Centro de Atenção Integral à Saúde da Mulher - CAISM). These measures and the procedures in the case of work accident were published in a booklet. First, servants should be aware of the matter of stress and its influence on the quality of life. Then, updating was carried through encouraging the reflection on the consequences of the non-adoption of M.U.P. The answers to 286 pre-tests and 242 post-tests were analyzed and the results showed a significantly higher index of correct answers (p< 0,01), mainly regarding the appropriate use of glove.

The set of measures proposed by SEPD, AEEH, GETECCU and AEG are aimed to help departments in their resumption of usual activity. We have prepared a number of practical recommendations regarding patient management and the stepwise resumption of healthcare activity. These recommendations are based on the sparse, changing evidence available, and will be updated in the future according to daily needs and the availability of expendable materials to suit them; in each department they will be implemented depending upon the cumulative incidence of SARS-CoV-2 infection in each region, and the burden the pandemic has represented for each hospital. The general objectives of these recommendations include: (a)To protect our patients against the risks of infection with SARS-CoV-2 and to provide them with high-quality care. (b)To protect all healthcare professionals against the risks of infection with SARS-CoV-2. (c)To resume normal functioning of our departments in a setting of ongoing risk for infection with SARS-CoV-2., (Copyright © 2020 Elsevier España, S.L.U. All rights reserved.)

Objectives: To compare self-extraction with and without a cervical collar in subjects at low risk of cervical spine injuries., Material and Methods: Simulation study analyzing biomechanical data from inertial sensors to detect misalignment of the cervical spine during self-extraction with and without a cervical collar., Results: Misalignment was a mean (SD) 3.12 (34.62) degrees greater during self-extraction with a Stiffneck collar in place (95% CI, -15.33 to 21.57 degrees; P=.7234) than during extraction without a collar. Misalignment was also greater, by 5.95 (31.76) degrees, with an X-collar in place (95% CI, -10.98 to 22.87; P=.4654) than without a collar. The between-collar comparison of differences showed that misalignment was 2.83 (12.10) degrees greater with the X-collar (95% CI, -3.62 to 9.27 degrees; P=.3650)., Conclusion: Misalignment of the cervical spinal column is similar during self-extraction with or without a cervical collar in place.

ABSTRACT Objective: To evaluate the knowledge of health professionals about radiological protection and to implement educational actions to promote a safe working environment for professionals, patients and companions. Method: An exploratory cross-sectional study, applying a questionnaire to 59 participants from different sectors of a teaching hospital. Open-ended questions were analyzed through the discourse of the collective subject and closed-ended questions were analyzed through quantitative analysis. Results: In the opinion of the participants, their professional training did not offer radioprotection class or the training was insufficient for the practice. In addition, the work environment does not provide regulatory norms and training on radioprotection. Most participants do not have solid knowledge and do not present safe behavior in radioprotection. In the internal week for the prevention of work accidents, a lecture and a theatricalisation about the topic of radioprotection were conducted and a booklet was distributed. Conclusion: Radiation protection education is necessary in the curricula of the training courses for health professionals and in the work environment.

ABSTRACT Objective: To identify in the literature the efficacy of needlesticks with safety devices to reduce the occurrence of occupational accidents with exposure to biological material among health workers. Method: Integrative literature review, structured in the stages: Guiding question, search, categorization of studies, evaluation, discussion and interpretation of results, and synthesis of knowledge. Search for original articles and systematic reviews on the main bases of the Health area, published from 2000 to 2016 in Portuguese, English and Spanish, with descriptors: needlesticks injuries, exposure to biological agents, needles, protective devices, occupational accidents, accident prevention and health personnel. Results: We selected eleven articles, most characterized the passive safety devices as more effective in reducing the occurrence of injuries by needlesticks. Conclusion: The use of needlesticks with safety devices reduces the occurrence of accidents, bringing greater solvency when combined with the training of workers.

Objectives: The main purpose of this study in healthy volunteers was to compare the lung function effects of 2 extrication devices that use spinal vests: the Kendrick Extrication Device (KED) and the Ferno KED-XT board., Material and Methods: Randomized crossover trial in 50 healthy adult volunteers. The subjects were placed in the KED and KED-XT devices for 5 minutes each and rested for 10 minutes between devices. Assignment to the first device was randomized. Each subject underwent spirometry at baseline and after placement of each device. The subjects were seated for all tests. The main outcome measures were the mean absolute differences between baseline and other measurements of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and the FVC/FEV1 ratio., Results: Use of the devices led to statistically significant mean decreases from baseline FVC (KED-XT, -0.48 L; 95% CI, -0.16 to -0.81 L [P=.016] and KED, -0.79 L; 95% CI, -0.44 to -1.13 L [P<.001]) and from baseline FEV1 (KED-XT, -0.35 L/s; 95% CI, -0.14 to -0.56 L/s [P=.002] and KED, -0.52 L/s; 95% CI, -0.31 to -0.72 L/s [P<.001]). The decrease in FVC was greater after use of the KED device (mean difference, KED vs KED-XT, -0.30 L; 95% CI, -0.08 to -0.69 L [P<.016])., Conclusion: The use of spinal vests leads to decreases in lung function variables. The KED vest causes a greater decrease in FVC than the new KED-XT board, possibly because the crossed straps on the board compress the abdomen less.

Introduction: Sun exposure can cause both acute and chronic lesions of the skin due to ultraviolet (UV) radiation. While driving or traveling inside a vehicle, a person is exposed to this radiation, which can induce or exacerbate certain dermatoses., Objective: To determine if the window glasses of commercial vehicles in Mexico can block UV transmission or if the addition of tinted films is necessary., Material and Methods: Sixty models of vehicles manufactured between 1998 and 2011 were randomly selected. UVA and UVB were measured through the windshield and lateral window glasses, and their transmission was calculated compared to ambient UV radiation. Four commercial tinted films were also evaluated for UV transmission., Results: The average UVB transmission from the windshield was 0.01% and 0.9% for UVA. For the driver's and front seat's glasses, UVB transmission was 2% and 16% for UVA. Tinted films transmitted less than 4.5% of UVA, and almost 0% of UVB., Conclusions: Driving with the vehicle's windows closed eliminates 98% of UVB and 84% of UVA. Therefore, the addition of tinted films provides a marginal benefit in most clinical conditions that manifest photosensibility.

Unlabelled: Accidental exposures to blood and biological material were the most frequent and potentially serious accidents in healthcare workers, reported in the Prevention of Occupational Risks Unit within 2002., Background: Evaluate the biological percutaneous accidents decrease after a progressive introduction of safety devices. Biological accidents produced between 2.002 and 2.006 were analyzed and reported by the injured healthcare workers to the Level 2b Hospital Prevention of Occupational Risk Unit with 238 beds and 750 employees. The key of the study was the safety devices (peripheral i.v. catheter, needleless i.v. access device and capillary blood collection lancet). Within 2002, 54 percutaneous biological accidents were registered and 19 in 2006, that represents a 64.8% decreased. There has been no safety devices accident reported involving these material. Accidents registered during the implantation period occurred because safety devices were not used at that time. Safety devices have proven to be effective in reducing needle stick percutaneous accidents, so that they are a good choice in the primary prevention of biological accidents contact.

The application of the advanced technologies in medicine has led to the appearance of new risk factors for health personnel. One of these could be the surgical smoke produced by electrosurgical instruments, ultrasounds or laser. However, there is still insufficient evidence in the published population studies on the detrimental effects of chronic exposure to surgical smoke. The main concern on the possible damage to the health of operating room staff is mainly based on the components currently detected until the date and laboratory experiments. Caution must also be used when extrapolating the results of in vitro studies to daily clinical practice. The organisations responsible for protecting the health of the workers in different countries have still not issued guidelines for the treatment and removal of the surgical smoke generated in both open and laparoscopic procedures. In this article we try to present a view of the consequences that surgical smoke has on health and the preventive measures that can be adopted.

CONS-32: Factor structure and psychometric properties. Risk prevention in the construction industry has a psychosocial etiology. This article studies the psychometric properties of a scale (CONS-32) created to detect personal prevention and job-related risks. The 336 participants in the present study are from the construction industry and reside in Catalonia. After exploratory factor analysis of the scale, the structure is shown to consist of four factors that involve job characteristics and individual behaviours. The results indicate adequate reliability. Therefore, the present scale may be ideal for identifying safety risks in the construction industry.

Objective: To detect the percentage of patients with dementia admitted to a psychogeriatric department, who have a high risk of falls, and to evaluate acceptance and compliance with hip protectors during their stay in hospital and 2 weeks and 3 months after discharge., Material and Methods: We performed a hospital-based prospective cohort study. Risk of falling was evaluated on the basis of immediate bipedal standing instability or abnormal semi-tandem posture, a get-up-and-go test time of more than 20 seconds, or clinical judgement. Compliance during hospital stay was evaluated through nursing records and compliance outside hospital by telephone interviews at 15 days and 3 months after discharge., Results: A total of 115 patients consecutively admitted to the psychogeriatric department of the Santa Creu Hospital in Vic were assessed. Sixty patients (52.2%) were excluded from the study, the main reason being dependence on another person for walking. Of the 55 patients included, 44 (80.0%) had a high risk of falls and were candidates for hip protectors. In-hospital compliance was 80.5% (95% CI: 65.1-91.2). The most common cause of non-compliance was removal of the hip protector by the patient. Compliance after discharge was 64.5% (95% CI: 45.4-80.8) at 2 weeks and 57.1% (95% CI: 28.9-82.4) at 3 months., Conclusions: A high risk of falling was found in a large percentage of patients with dementia who were not dependent on others for walking. Compliance was not a problem in the use of hip protectors in a high-risk population in the hospital-admission setting but was weaker in the community setting.

Several agencies have proposed infection control guidelines for management of patients admitted with the diagnosis of avian influenza. These guidelines aim to prevent transmission from the patient to hospital personnel and other inpatients. The guidelines presented here by the Advisory Committee of Nosocomial Infections have been elaborated for the local medical community after reviewing currently available recommendations. Key recommendations include admission to an isolation ward, cohorting of confirmed cases, hand hygiene with antiseptic solutions, use of N95 type masks, non-sterile disposable gloves and eye protection equipment during examination or when performing aerosols-generating procedures. Use of patient-exclusive clinical instruments, daily disinfection of the hospital ward, implementation of measures to reduce risk of needle stick injuries and eye splashing, and reinforcement of appropriate sampling and transport of blood and other corporal fluids, are also recommended.

In the middle of the 1980s, Centers for Disease Control and Prevention (CDCs) began insisting on the necessity for universal prevention measures and protocols as the best means to prevent the transmission of blood-borne viruses. These CDCs have been carrying out an essential task, one which at first had little success, but in the past five years have been better accepted; their programs focus on ensuring that all personnel at risk to these blood-borne infections receive effective protection.

In a very exhaustive way the authors describe the different types and usefulness of materials, among which some for arterial extraction (syringes for extracting blood from arteries) are included, although, in their majority, these materials which have biologically safe mechanisms have a venous utility. (They are used with veins).

Background: Exposure to ionizing radiation is a known hazard of radiological procedures., Aim: To compare the emission of secondary ionizing radiation from two coronary angiographic equipment, one with digital and the other with analog image generation. To evaluate the effectiveness of external radiological protection devices., Material and Methods: Environmental and fluoroscopy generated radiation in the cephalic region of the patient was measured during diagnostic coronary angiographies. Ionizing radiation generated in anterior left oblique projection (ALO) and in anterior right oblique projection (ARO) were measured with and without leaded protections. In 19 patients (group 1), a digital equipment was used and in 21 (group 2), an analog equipment., Results: Header radiation for groups 1 and 2 was 1194 +/- 337 and 364 +/- 222 microGray/h respectively (p < 0.001). During fluoroscopy and with leaded protection generated radiation for groups 1 and 2 was 612 +/- 947 and 70 +/- 61 microGray/h respectively (p < 0.001). For ALO projection, generated radiation for groups 1 and 2 was 105 +/- 47 and 71 +/- 192 microGray/h respectively (p < 0.001). During filming the radiation for ALO projection for groups 1 and 2 was 7252 +/- 9569 and 1671 +/- 2038 microGray/h respectively (p = 0.03). Out of the protection zone, registered radiation during fluoroscopy for groups 1 and 2 was 2800 +/- 1741 and 1318 +/- 954 microGray/h respectively (p < 0.001); during filming, the figures were 15,500 +/- 5840 and 18,961 +/- 10,599 microGray/h respectively (NS)., Conclusions: Digital radiological equipment has a lower level of ionizing radiation emission than the analog equipment.

Objective: To know the use of security measures in motor vehicles for under-6 children, in the town of Cervera (Lleida, Spain)., Design: Study based on observation, transverse, through a public-opinion poll, to a representative sample of young children (0 to 6)., Location: Primary health care., Participants: 251 children from 0 to 6 years old, from a whole of 504, through the method of simple fortuitous sampling, from whom, 185 answered., Intervention: Interview with the parents. MEASURING AND RESULTS: It was used a Data base and the results were analysed through a statistical technics, in a PC computer (IBM)., Conclusions: There is a frequent use of the motor vehicles from very tender years: 61.9% of children do not use any security measures when they travel, and from children that use them, there is a 46.9% that use the child safety seats, in a bad way.

The purpose of this clinical study is to analyse the effectiveness of a sealant. Rubber dam and cotton roll methods of isolation where compared with respect to the effect of isolation method on retreatment and protection from caries during 12 months. We study the cost effectiveness ratio for both methods of isolation. The results could not be substantiated any differences between two methods.