Occupational Hygiene of Surgeons and Anesthesiologists

During their professional work surgeons and anesthesiologists come across a number of harmful factors, such as:

· action of chemical substances (preparations for narcosis) – professional poisonings;

· adverse microclimate (hot temperature) - overheating;

· increase of СО2 concentration and decrease of О2 content (sterile mask on face) – hypoxia and hypercapnia;

· psychoemotional and physical overloads with long overstrain of visual, acoustical, tactile analyzers – cardiac diseases;

· effect of X-rays;

· compelled position of body (long stay in vertical position) – radiculitis, osteochondrosis;

· contact with infectious agents (including AIDS);

· frequent violation of working and rest regimen.

To prevent a professional pathology a number of preventive measures are carried out:

· creation of good artificial microclimate (air-conditioning);

· the centralized supply of О2 to operating room;

· combined extract and input ventilation with prevalence of input ventilation;

· observance of working and rest regimen (working hours in operation day should be not more than 5 hours, alternation of one operation and two non-operation days, gymnastic exercises and taking a shower after operation);

· rational nutrition;

· after operation it is not recommended to have reception hours at the out-patient department.

· supplying surgeons and anesthesiologists with white gowns made of materials providing good ventilation;

· change of white gowns every four hours, mask - 2 hours after the beginning of operation (because after this period of time the sterility is lost).

Recommendations for Practical Classes on the Topic

Lesson No 1.

Hospital Hygiene

Key Questions

1.The medical protective regimen in hospital and its components.

2.Hygienic requirements to a hospital site and structural divisions of hospital.

3.Hygienic requirements to functional zones of a hospital site.

4.Hygienic requirements to a ward section and a hospital ward.

5.Hygienic requirements to a surgery unit and operating room.

6.Hygienic requirements to the infectious department.

7.Causes of growth, sources, ways of transmission and prevention of intrahospital infections.

8.Occupational hygiene of surgeons and anaesthesiologists and doctors of other specialities.

Learning Objectives and Their Concrete Definition

To do the test on checking the initial level of knowledge.

To master skills of locating a hospital site, systems of hospital construction according to the suggested tables and instruction.

To draw the general plan of hospital in the notebook.

To draw schematically in the notebook the layout of:

a typical ward section;

an operating room;

a box, half-box, infectious department.

Substantiation of necessary measures for struggle against intrahospital infections. The decision of situational tasks with estimation of necessary measures to prevent or fight against intrahospital infections.

To do the test on checking the final level of knowledge on the topic.

Self Test

1. One of the methods of specific prevention of intrahospital infections is

A. isolation of surgery units.

B. rational location of departments on floors.

*C. emergency immunization of patients.

D. zoning of a hospital site.

E. sanitary-antiepidemic measures.

 

2. On sanitary examination of the project of infectious hospital it was established that the basic premises are boxes and half-boxes. Identify the element which distinguishes half-box from box.

*A. Entrance from outside

B. Wards

C. Lavatory

D. Sluice

E. Entrance from the department

 

3. On sanitary inspection of pulmonary department for adults it was established that wards per 4 cots had the area of 28 m2. What should be the minimal area of ward in the department?

A. 40 m2

B. 24 m2

*C. 28 m2

D. 30 m2

E. 52 m2

Problem Solving

1. The obstetric department is located in a 3-storey building. The second floor is occupied by admission department, the first one – by the physiologic pregnancy department, the third one - by the pathologic pregnancy department. All the floors incorporate by channels of extract ventilation. What does not correspond to hygienic norms in the obstetric division and needs re-planning?

2. The total area of the ward is 28 m2. What number of patients is the given ward designed for?

3. In regional hospital the room for reception and discharge of patients of children department is combined with other departments. Is the similar location of reception rooms admissible in the children department and in what case?

Standard Answers:

1. The admission department should be located on the first floor, thus it is necessary to interchange the physiologic pregnancy department and admission department.

2. For 4 patients, the norm is 7 m2 per patient.

3. According to the hygienic standards the admission department in the children department should always be separate. It is allowed to combine rooms for discharging patients with other rooms of the department.