1
|
Fouad AM, Fahim AE, Bedewy AA, Al-Touny A, Al-Touny SA. Work-related musculoskeletal complaints and ergonomic risk factors among Egyptian anesthesiologists: a cross-sectional study. BMC Public Health 2024; 24:279. [PMID: 38263050 PMCID: PMC10807210 DOI: 10.1186/s12889-024-17757-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Anesthesiologists are vulnerable to work-related musculoskeletal disorders (WMSDs) due to sustained repetitive movements and awkward postures. This study aimed to assess the prevalence of WMSDs among anesthesiologists and to evaluate its association with ergonomic risk factors. METHODS A convenience sample of 380 Egyptian anesthesiologists were invited to participate in this cross-sectional study through an electronic questionnaire. Data were collected from May to August 2022 and involved questions about participants' demographic, health, and work-related characteristics; the ergonomic risks and perceived hazards; and the musculoskeletal complaints during the past 12 months and 7 days - using Nordic Musculoskeletal Questionnaire (NMQ). Descriptive, bivariate, and multivariate statistical analyses were used to estimate the prevalence of MSD and identify its determinants in the studied sample. RESULTS A total of 215 anesthesiologists were included in this study, with a 56.8% response rate, 66% males with an average age of 38 (± 0.7) years. 21% were resident physicians, 47% were specialists, and 32% were consultants. The 12-month prevalence of MSD among anesthesiologists was 71.6% (95% CI: 65.6- 77.7%). Multivariate analysis showed that the main determinants of MSD among the studied sample were age of 45-years and older (OR: 3.22, 95% CI: 1.21-8.52, p = 0.018), regular physical exercise (OR: 0.25, 95% CI: 0.10-0.65, p = 0.005), insufficient rest time between procedures (OR: 2.25, 95% CI: 1.15-4.41, p = 0.018), and three or more awkward postures of the trunk (OR: 3.55, 95% CI: 1.43-8.82, p = 0.006). CONCLUSIONS The study highlights a high prevalence of WMSDs among Egyptian anesthesiologists, linked to advancing age, lack of regular exercise, insufficient rest between procedures, and frequent awkward postures. Addressing these ergonomic risk factors through targeted workplace interventions is crucial for promoting the overall well-being of anesthesiologists and ensuring the provision of safe anesthesia services.
Collapse
Affiliation(s)
- Ahmed Mahmoud Fouad
- Department of Public Health, Occupational & Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
| | - Ayman Ekram Fahim
- Department of Public Health, Occupational & Environmental Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Ahmed Abdelmohsen Bedewy
- Department of Anesthesiology & Critical Care, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Aiman Al-Touny
- Department of Anesthesiology & Critical Care, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Shimaa A Al-Touny
- Department of Anesthesiology & Critical Care, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| |
Collapse
|
2
|
Saul SA, Ward PA, McNarry AF. Airway Management: The Current Role of Videolaryngoscopy. J Pers Med 2023; 13:1327. [PMID: 37763095 PMCID: PMC10532647 DOI: 10.3390/jpm13091327] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
Airway management is usually an uncomplicated and safe intervention; however, when problems arise with the primary airway technique, the clinical situation can rapidly deteriorate, resulting in significant patient harm. Videolaryngoscopy has been shown to improve patient outcomes when compared with direct laryngoscopy, including improved first-pass success at tracheal intubation, reduced difficult laryngeal views, reduced oxygen desaturation, reduced airway trauma, and improved recognition of oesophageal intubation. The shared view that videolaryngoscopy affords may also facilitate superior teaching, training, and multidisciplinary team performance. As such, its recommended role in airway management has evolved from occasional use as a rescue device (when direct laryngoscopy fails) to a first-intention technique that should be incorporated into routine clinical practice, and this is reflected in recently updated guidelines from a number of international airway societies. However, currently, overall videolaryngoscopy usage is not commensurate with its now widespread availability. A number of factors exist that may be preventing its full adoption, including perceived financial costs, inadequacy of education and training, challenges in achieving deliverable decontamination processes, concerns over sustainability, fears over "de-skilling" at direct laryngoscopy, and perceived limitations of videolaryngoscopes. This article reviews the most up-to-date evidence supporting videolaryngoscopy, explores its current scope of utilisation (including specialist techniques), the potential barriers preventing its full adoption, and areas for future advancement and research.
Collapse
Affiliation(s)
- Sophie A. Saul
- St. John’s Hospital, Howden West Road, NHS Lothian, Livingston EH54 6PP, UK; (S.A.S.); (A.F.M.)
| | - Patrick A. Ward
- St. John’s Hospital, Howden West Road, NHS Lothian, Livingston EH54 6PP, UK; (S.A.S.); (A.F.M.)
| | - Alistair F. McNarry
- St. John’s Hospital, Howden West Road, NHS Lothian, Livingston EH54 6PP, UK; (S.A.S.); (A.F.M.)
- Western General Hospital, Crewe Road South, NHS Lothian, Edinburgh EH4 2XU, UK
| |
Collapse
|
3
|
Porta M, Porceddu S, Leban B, Casu G, Mura GM, Campagna M, Pau M. Characterization of upper limb use in health care workers during regular shifts: A quantitative approach based on wrist-worn accelerometers. APPLIED ERGONOMICS 2023; 112:104046. [PMID: 37267772 DOI: 10.1016/j.apergo.2023.104046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/09/2023] [Accepted: 05/11/2023] [Indexed: 06/04/2023]
Abstract
Despite the high prevalence of upper limb (UL) work-related musculoskeletal disorders (WRMSD) among health care workers (HCWs), little is known about their relationship with exposure to biomechanical risk factors. This study aimed to assess UL activity features under actual working conditions using two wrist-worn accelerometers. Accelerometric data were processed to obtain duration, intensity, and asymmetry of UL use in 32 HCWs during the execution of commonly performed tasks (e.g., patient hygiene, transfer, and meal distribution) within a regular shift. The results show that such tasks are characterized by significantly different patterns of UL use, in particular, higher intensities and larger asymmetries were observed respectively for patient hygiene and meal distribution. The proposed approach appears, thus, suitable to discriminate tasks characterized by different UL motion patterns. Future studies could benefit from the integration of such measures with self-reported workers' perception to elucidate the relationship between dynamic UL movements and WRMSD.
Collapse
Affiliation(s)
- Micaela Porta
- Department of Mechanical, Chemical and Materials Engineering University of Cagliari, Italy.
| | - Simona Porceddu
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Bruno Leban
- Department of Mechanical, Chemical and Materials Engineering University of Cagliari, Italy
| | - Giulia Casu
- Department of Mechanical, Chemical and Materials Engineering University of Cagliari, Italy
| | - Giovanni M Mura
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering University of Cagliari, Italy
| |
Collapse
|
4
|
Kang D, Bae HB, Choi YH, Bom JS, Kim J. A prospective randomized study of different height of operation table for tracheal intubation with videolaryngoscopy in ramped position. BMC Anesthesiol 2022; 22:378. [PMID: 36476332 PMCID: PMC9727988 DOI: 10.1186/s12871-022-01929-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies have reported that the ramped position provides a better laryngoscopic view, reduces tracheal intubation time, and increases the success rate of endotracheal intubation. However, the patient's head height changes while in the ramped position, which in turn changes the relative positions of the patient and intubator. Thus, making these changes may affect the efficiency of tracheal intubation; however, few studies have addressed this problem. This study analyzed intubation time and conditions during tracheal intubation using videolaryngoscope in the ramped position. METHODS This prospective study included 144 patients who were scheduled to receive general anesthesia for surgeries involving orotracheal intubation. The participants were randomly allocated to either the nipple or umbilical group according to the table height. Mask ventilation was assessed using the Warters grading scale. Tracheal intubation was performed using a McGrath MAC laryngoscope. The total intubation time, laryngoscopy time, tube insertion time, and difficulty of intubation (IDS score) were measured. RESULTS The umbilical group had a significantly shorter laryngoscopy time (10 ± 3 vs. 16 ± 4 s), tube insertion time (18 ± 4 vs. 24 ± 6 s), and total intubation time (28 ± 5 vs. 40 ± 7 s) compared to the nipple group. No significant difference in the difficulty of mask ventilation was observed between the two groups. The IDS score was higher in the nipple than umbilical group. CONCLUSION The lower (umbilical) table level reduced the intubation time and difficulty of videolaryngoscopy compared to the higher (nipple) table level. TRIAL REGISTRATION This study was registered at KCT0005987, 11/03/2021, Retrospectively registered.
Collapse
Affiliation(s)
- Dongho Kang
- grid.411602.00000 0004 0647 9534Department of Anesthesiology and Pain Medicine, Chonnam National University Hwasun Hospital, Hwasun, Chonnam, Korea
| | - Hong-Beom Bae
- grid.14005.300000 0001 0356 9399Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, 61469 Korea ,grid.411597.f0000 0004 0647 2471Department of Anesthesiology and Pain Medicine, Chonnam National University Hospital, Kwangju, Korea
| | - Yun Ha Choi
- grid.443803.80000 0001 0522 719XDepartment of Nursing, Honam University, Gwangju, Korea
| | - Joon-suk Bom
- grid.411597.f0000 0004 0647 2471Department of Anesthesiology and Pain Medicine, Chonnam National University Hospital, Kwangju, Korea
| | - Joungmin Kim
- grid.14005.300000 0001 0356 9399Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, 61469 Korea ,grid.411597.f0000 0004 0647 2471Department of Anesthesiology and Pain Medicine, Chonnam National University Hospital, Kwangju, Korea
| |
Collapse
|
5
|
Reducing musculoskeletal pain in the operating theatre. BJA Educ 2022; 22:154-159. [PMID: 35531080 PMCID: PMC9073315 DOI: 10.1016/j.bjae.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 11/20/2022] Open
|
6
|
Bailey CR, Radhakrishna S, Asanati K, Dill N, Hodgson K, McKeown C, Pawa A, Plaat F, Wilkes A. Ergonomics in the anaesthetic workplace: Guideline from the Association of Anaesthetists. Anaesthesia 2021; 76:1635-1647. [PMID: 34251028 PMCID: PMC9292255 DOI: 10.1111/anae.15530] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 11/26/2022]
Abstract
Ergonomics in relation to anaesthesia is the scientific study of the interaction between anaesthetists and their workspace environment in order to promote safety, performance and well-being. The foundation for avoiding pain or discomfort at work is to adopt and maintain a good posture, whether sitting or standing. Anaesthetists should aim to keep their posture as natural and neutral as possible. The successful practice of anaesthesia relies on optimisation of ergonomics and lack of attention to detail in this area is associated with impaired performance. The anaesthetic team should wear comfortable clothing, including appropriately-sized personal protective equipment where necessary. Temperature, humidity and light should be adequate at all times. The team should comply with infection prevention and control guidelines and monitoring as recommended by the Association of Anaesthetists. Any equipment or machinery that is mobile should be positioned where it is easy to view or reach without having to change the body or head position significantly when interacting with it. Patients who are supine should, whenever possible, be raised upwards to limit the need to lean towards them. Any item required during a procedure should be positioned on trays or trolleys that are close to the dominant hand. Pregnancy affects the requirements for standing, manually handling, applying force when operating equipment or moving machines and the period over which the individual might have to work without a break. Employers have a duty to make reasonable adjustments to accommodate disability in the workplace. Any member of staff with a physical impairment needs to be accommodated and this includes making provision for a wheelchair user who needs to enter the operating theatre and perform their work.
Collapse
Affiliation(s)
- C R Bailey
- Department of Anaesthesia, Guy's and St. Thomas' NHS Foundation Trust, Council Member, Association of Anaesthetists and Co-Chair of the Working Party, London, UK
| | - S Radhakrishna
- Department of Anaesthesia, University Hospitals of Coventry and Warwickshire, Difficult Airway Society representative and Co-Chair of the Working Party, Coventry, UK
| | | | - N Dill
- British Anaesthetic Respiratory Equipment Manufacturers Association (BAREMA), Bromley, UK
| | - K Hodgson
- South East Scotland School of Anaesthesia, Member of the Association of Anaesthetists Training Committee, UK
| | | | - A Pawa
- Department of Anaesthesia, Guy's and St. Thomas' NHS Foundation Trust, President of Regional Anaesthesia (RA) UK, London, UK
| | - F Plaat
- Department of Anaesthesia, Imperial College Healthcare NHS Trust, Council Member, Royal College of Anaesthetists, London, UK
| | - A Wilkes
- Department of Anaesthesia, Edinburgh, UK
| |
Collapse
|
7
|
Marks RRD. Anaesthesia workspace layout and intervertebral disc prolapse. Br J Anaesth 2021; 126:e146-e147. [PMID: 33549324 DOI: 10.1016/j.bja.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/10/2020] [Accepted: 01/02/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Rex R D Marks
- Department of Anaesthesia, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
| |
Collapse
|
8
|
Zdravkovic M, Berger‐Estilita J, Sorbello M, Hagberg CA. An international survey about rapid sequence intubation of 10,003 anaesthetists and 16 airway experts. Anaesthesia 2019; 75:313-322. [DOI: 10.1111/anae.14867] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2019] [Indexed: 12/14/2022]
Affiliation(s)
- M. Zdravkovic
- Department of Anaesthesiology, Intensive Care and Pain Management University Medical Centre Maribor Maribor Slovenia
- Faculty of Medicine University of Maribor Maribor Slovenia
| | - J. Berger‐Estilita
- Department of Anaesthesiology and Pain Medicine, Inselspital Bern University Hospital Bern Switzerland
| | - M. Sorbello
- Department of Anesthesia and Intensive Care AOU Policlinico Vittorio Emanuele Catania Italy
| | - C. A. Hagberg
- Department of Anesthesiology, Critical Care and Pain Medicine University of Texas MD Anderson Cancer Center Houston TX USA
| |
Collapse
|
9
|
Choi S, Thomson P. Increasing incidence of oral cancer in Hong Kong—Who, where…and why? J Oral Pathol Med 2019; 48:483-490. [DOI: 10.1111/jop.12868] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Siu‐Wai Choi
- Oral & Maxillofacial Surgery, Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
| | - Peter Thomson
- Oral & Maxillofacial Surgery, Faculty of Dentistry The University of Hong Kong Hong Kong SAR China
| |
Collapse
|
10
|
Vargas-Prada S, Macdonald EB. Increased reporting of musculoskeletal pain in anaesthetists: is it an occupational issue? Anaesthesia 2019; 74:274-276. [PMID: 30657588 DOI: 10.1111/anae.14537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2018] [Indexed: 11/30/2022]
Affiliation(s)
- S Vargas-Prada
- Healthy Working Lives Group, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,Salus Occupational Health, Safety and Return to Work Services, NHS Lanarkshire, Hamilton, UK
| | - E B Macdonald
- Head of the Healthy Working lives Group, Healthy Working Lives Group, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| |
Collapse
|