Preventing Injury. and Occupational Diseases in Medical Evacuation Mission

Transcription

1 Preventing Injury and Occupational Diseases in Medical Evacuation Mission

2 Medical evacuation, (medevac / medivac) : is the timely and efficient movement and en route care provided by medical personnel using medically equipped ground vehicles (ambulances), watercraft or aircraft. Merriam-Webster (2012)

3 Service to wounded, being evacuated from a battlefield, to injured patients, being evacuated from the scene of an accident to receiving medical facilities, to patients at a hospital, requiring urgent care at a better-equipped facility Merriam-Webster (2012)

4 Basics Transport/ movement Time Continuous, en route medical care Patient, victim Limited by : Suplies Workspace Regulations Hazards Risks to Health Care Workers!!!

5 Occupational Injury, Accident, and Disesase

6 stats.oecd.org/glossary ILO Occupational Injury : any personal injury, disease or death resulting from an occupational accident; distinct from an occupational disease: a disease contracted as a result of an exposure over a period of time to risk factors arising from work activity.

7 stats.oecd.org/glossary ILO Occupational Accident : Unexpected and unplanned occurrence, including acts of violence, arising out of or in connection with work, which results in workers incurring a personal injury, disease or death. To be considered in travel, transport or road traffic accidents in which workers are injured and which arise out of or in the course of work, i.e. while engaged in an economic activity, or at work, or carrying on the business of the employer.

8 Occupational Disease PERATURAN MENTERI KESEHATAN REPUBLIK INDONESIA NOMOR 56 TAHUN 2016 TENTANG PENYELENGGARAAN PELAYANAN PENYAKIT AKIBAT KERJA Pasal 4 b. penentuan pajanan yang dialami pekerja di tempat kerja; c. penentuan hubungan antara pajanan dengan penyakit; d. penentuan kecukupan pajanan UU No 1 tahun 1970 (Keselamatan kerja) Pasal 9 (kewajiban pengurus) Pasal 12 (hak dan kewajiban pekerja)

9 stats.oecd.org/glossary Definition: Occupational Disease The term is linked to the identification of a specific cause-effect relationship between a harmful agent and the affected human organism. However, it is not easy and considerably more difficult than in the case of accidents to prove that a disease is occupationally conditioned, i.e. caused by conditions at, not outside work. Because of the difficulty in proving a disease to be occupational in origin, most countries have produced lists of prescribed occupational diseases. These are generally limited to those diseases where a strong cause-effect relationship has been proven.

10 Basics Transport/ movement Time Continuous, en route medical care Patient, victim Limited by : Suplies Workspace Regulations Hazards Risks to Health Care Workers!!!

11 Hazard Assessment Process

12 Hazards in Medevac Biological Physical Psychological Chemical

13 Hazard Assessment Process 1. List all work-related tasks and activities. 2. Identify potential biological, chemical, physical and psychological hazards associated with each task. 3. Assess the risk of the hazard by considering the severity of consequences of exposure, the probability that the exposure will occur and the frequency the task is done. 4. Identify the controls that will eliminate or reduce the risk. 5. Implement the controls for each hazard 6. Communicate the hazard assessments and required controls to all workers who perform the tasks. 7. Evaluate the controls periodically to ensure they are effective. The hierarchy of controls should be followed. This means that engineering controls are the most effective, followed by administrative controls (such as training and rules), and followed by personal protective equipment (PPE).

14 Psychological Hazard Fatigue Sleep Deprivation Stress (critical incidents, technostress) Violence, Abuse : Clients, public, co workers. Substance abuse Noise induced Stress

15 Psychological Hazard Control Worker education about the signs and symptoms of stress Management policies and procedures to address working hours and shift Train workers and management in fatigue and shift work issues

16 Chemical Hazard Alcohol Desinfectants Latex Oxygen Vehicle Exhaust Other

17 Chemical Hazard Control Vehicle exhaust Garages, vehicle maintenance areas, ambulance bays, loading docks, emergency generators, helipads Irritation of respiratory tract, eye, nose and throat, neurological impacts, and may be carcinogenic Through ventilation system if air intakes are located near loading docks or in proximity to vehicle traffic.

18 Chemical Hazard Control Properly designed and maintained ventilation systems. Vehicle maintenance to reduce emissions and leaks. Isolation of workers. Education of vehicle operators. Engine shut down procedures.

19 Biological Hazard Infectious Airborne, Blood bourne, Droplets Body fluids. From : Sharps/needles, blood to mucosa, wounds/cuts Contact with secretions from infectious patients (cough, sneeze, droplets, infected air) Work surface.

20 Bio Hazard Control Engineering Airborne : Early detection of infection status. Vaccines Droplets : Medical history of patients. Vaccines Bloodbourne : Safe design of emergency vehicles (sharps, corners) Engineered needle stick prevention devices. Availability of sharps containers for disposal. Use of waterproof, disposable pads if appropriate. Vaccines

21 Biological Hazard Control Administrative Compliance with all infection prevention and control practices. Worker immunization. Worker education. Good Housekeeping. Proper disinfection of equipment. Proper waste disposal. PPE : gloves, respiratory protection, eye and face protection (Face shields ) Masks worn by patients to reduce exposure through droplet containment at the source, Respirators worn by HCW reduce exposure to the respiratory system.

22 Masks worn by patients to reduce exposure through droplet containment at the source. Not designed to seal tightly against the HCW s face, or certified to prevent inhalation of small droplets/particles. Provide a physical barrier for protection from splashes of large droplets of blood or body fluids.

23 A fit-tested NIOSH approved respirator provides a proper seal at the HCWs face, forcing inhaled air to be pulled through the filter material and not through gaps between the face and the respirator. Designed to reduce HCW s exposure to airborne contaminants. Use when required, based on hazard assessment.

24 Physical Hazzards Ergonomics Slips trips fall and Pinch Sharps cut and stabs Heat and Cold Fire, Projectiles, Explosion Electric shock Trafic Accidents/ MV Collision Noise Vibration Motion sickness Compounding : Small space, moving.

25 Physical Hazard Control Ergonomic hazard Handling of equipment, instruments and supplies including lifting, carrying, pushing, pulling, etc. Awkward and sustained postures. Engineering Ergonomically designed storage and interior space in ambulances, etc. Ergonomically designed equipment, instruments and containers.

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30 Ergonomics Proper Lifting Techniques Use a minimum of two people Call for additional help if necessary Use an even number of people to maintain balance Know the weight limitations of equipment If the lifting situation is unsafe, don t move the patient Keep weight as close to body as possible Patient safety & avoid injury

31 Back Bent Improper Lifting

32 Improper Lifting Twisted Torso

33 Improper Lifting Twisted Torso

34 Proper Lifting Squat lift (or power-lift).

35 Proper Lifting Squat, bending at the knees

36 Proper Lifting Use the power grip

37 Proper Lifting Stand up Locking your back

38 Physical Hazard Control Safe work procedures. Worker education and awareness sessions. Stretches and micro-breaks. Maintenance program for equipment, instruments and containers. Early reporting of signs and symptoms of ergonomic concerns. Purchasing standards for ergonomically designed quality equipment, instruments and containers.

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40 Physical Hazard Control Slips, Trips, Falls and Pinch Install slip resistant flooring in vehicle or facilities. Appropriate footwear with gripping soles and good support Ensure adequate lighting. Regular maintenance on walking surfaces. Maintain good housekeeping practices and minimize clutter and tripping hazards (cables, wire, iv line, O2 line)

41 Physical Hazard Control Cuts from sharp instruments, including medical instruments and scissors Avoid use of sharps when not required. Replace sharps with Safety Engineered Medical Devices. Proper storage and dispossal of sharps. Worker education. Safe work procedures

42 Physical Hazard Control Electrical hazards arising from use of electrical cords and appliances Safe work procedures that include use of electrical cords, power bars and appliances that includes approval requirements. Worker training.

43 Compressed Gasses Hazards include Explosions, Fire hazards, Flying projectiles, and release of gas, and cold injury. A- Appropriate store of products to decrease exposure and minimize fire and explosion hazards. Safe work procedures including transportation. Worker education. Good housekeeping. P- PPE based on hazard assessment

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45 Physical Hazard Motor Vehicle Collision

46 BANDUNG, 23 April 2017

47 Bangka 4 Juli 2016

48 Banyuwangi 24 Juli 2017

49 Karo 10 Agustus 2016

50 Kerinci 7 Nov 2014

51 Medan 9 Nov 2015

52 30 Januari 2017 Simalungun

53 30 Januari 2017 Simalungun

54 Sinjai 18 Juli 2017

55 Prabumulih 31 Mei 2017

56 MotorVehicle Collision Driver qualifications and training (Safe driving) Mindset Work scheduling to prevent fatigue. Standards for vehicles (collision worthiness) Inspection and maintenance of vehicles. Safe work procedures for driving including the issue of cell phone use. MVA incident reporting process.

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62 THANK YOU, Any Questions?