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David Revez on puncture indication and why he double gloves

当被问及双手套作为安全实践时,无论手术类型,都有混合反应。虽然所有外科医生都会惊叹,“我的手是我的一切!”,我的双手是我所有历史的延伸,或者在我的大脑之后,我的手是我身体中最重要的部分。如果没有我的手,我就不能做任何事情',一些外科医生仍然存在于双重手套的抵抗力,而其他外科医生则拒绝运行而不使用双手套。

Any contact with blood introduces risk in the form of blood borne illnesses, such as hepatitis and HIV, which is why the use of surgical gloves was universally adopted in the first place. But knowing that glove punctures happen frequently (up to 45 percent in some types of surgery)并且可以轻松地未被发现(高达92%的时间), double gloving has been recommended as an extra layer of protection in all surgical procedures – not only high-risk cases。双手手套被证明可以降低传播血液疾病的风险,减轻患者和外科医生暴露的风险,以危险和昂贵的交叉污染和感染。与单手套相比,Cochrane审查2014年使用双手套将血液污染风险降低了65%,并将内手套穿孔的风险降低了71%,与单手套相比

Protecting human investment

Why is this extra layer of safety important, and where does the resistance come from? Apart from the peace of mind and proven protection to staff and patient health that double gloving provides, double gloving is also a protective measure in other ways. For example, for a hospital, double-gloving practice and policy is a form of protecting its investment. How?

First and foremost, a surgeon's hands and training are his/her livelihood, and by extension, the "life blood" of the hospital. The training and work s/he has done at a hospital has a value. The same applies for the entire surgical staff. From a health economics perspective, double gloving protects hospital staff and the hospital by reducing risk.

Healthcare professionals who have sustained a sharps or needlestick injuries have explained the anxiety, sleeplessness and worry of waiting for days after exposure to blood to learn their status. They work with their hands and depend on having the most protection they can get. This kind of injury can lead to lost work time, potential emotional trauma for patient and staff and even legal action and financial consequences.

暴露后测试和预防性处理可能是昂贵的。根据四个美国医疗保健设施,管理暴露于丙型肝炎患者的平均成本是650美元,并且暴露于艾滋病毒感染的患者是2,456。欧洲的成本也很高;如果患者对乙型肝炎和C和HIV的患者测试阴性,则在172欧元的价格范围为172欧元,如果患者对丙型肝炎和艾滋病毒阳性阳性,则为乙型肝炎和C和HIV的患者

当然,另一个问题是手术部位感染的风险和治疗,这可以将患者住院住院的长度增加(平均额外的日子),并且需要额外的一周(7.4天)的抗生素治疗。Essentially this is a 61 percent increase in the overall cost of care

双手套是一种简单有效的方法,可以降低职业暴露于经皮损伤的成本。

恢复大脑进行保护:最后一个触觉英里

Trauma Karlsson的引用:Trauma护士:对不跳过手套的临床医生,我说,'做吧!'。这是一种保护自己和其他人的简单方法。证据表明了风险和成本,最后一块拼图正在反对抵抗双手套的抵抗力,并为双手套提供更多动力。更多的外科医生及其员工需要保护自己免受危险和风险,从重新思考和再培训,以更加警惕,基于证据,安全 - 首先方法的重新思考和再培训。

医疗专家表示需要和想要的for extra protection, and this demand appears as a priority in legislation and recommendations. The Sharps Agenda in the US and the EU Sharps Directive (external link, opens in a new window) in Europe, for example, both recommend double gloving as a protective measure against sharps injuries and their real consequences. In conjunction, authorities such as the Centers for Disease Control and Prevention (CDC),职业安全与健康管理局(OSHA), the Association of Perioperative Registered Nurses (AORN)and American College of Surgeons (ACS), to name a few, all recommend double gloving for invasive surgeries. Evidence supports making double gloving standard for all surgical procedures, and most recommendations, legislation and evidence name double gloving as best practice.

反对 - 以及最后一英里的最后一个论点 - 采用双重手套通常是触觉敏感性。与安全的增益相比,双层手套产生的触觉敏感性的损失是微不足道的。性能没有损害双手套;研究表明,在初始习惯双手手术时(大多数外科医生在两天内完全适应),与没有手套或单一手套相比,手动灵活性和触觉敏感性不会降低 。创造较薄的创新,更敏感的手术手套是反击双手套的争论的一种方式。

The next step in complete protection is adopting a double gloving puncture indication system. Double gloving with a coloured puncture indication system (with a clear, fast and large indicator for early detection and enabling quick action to reduce risk)means even greater safety in the O.R. and is the best protected a surgeon, her staff and patient can be.

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