Medicine of the Future in America

Musculoskeletal injuries among ERCP endoscopists in Canada: DISCUSSION Part 3

DISCUSSIONOur data indicate that performing more procedures over time is positively correlated with musculoskeletal injury. Due to the vasoelastic nature of all biological tissues, the spine and other joints may develop residual deformation under static loads. Repeated load can result in cumulative fatigue, which decreases the ability of the joints — especially the spine — to bear future stress. Prolonged standing and bent-over postures increase the likelihood of developing low back pain, and are both characteristics of physicians who perform ERCP. Twisting and bending motions drastically increase forces throughout the spine. Facilities that are designed to promote natural postures and limit the amount of twisting and bending protect operators from the development of cumulative trauma disorders. The risk factors involved in performing ERCP, the survey results and the appropriate modification strategies are summarized in Table 3. Cheapest online shopping – find cialis professional at best fully-licensed pharmacy.

Summary of the risks and associated modification strategies for performing endoscopic retrograde cholangiopancreatography

Risk factor Percentage of respondents at risk Risk factor modification strategy
Ergonomic design of facilities 58 Design should resemble that shown in Figure 3, promoting natural postures and reducing the amount of twisting and bending
Adjustable fluoroscopy tables 75 Tables should have adjustable heights so that the operators can perform procedures with their elbows in a neutral posture, gently flexed at a 90° angle
Type of endoscope used 11 Videoscopes are superior to fibre optic scopes, especially in the prevention of neck injuries
Type of lead apron worn 61 Two-piece aprons should be worn to prevent unnecessary heavy physical loads on the lower back and upper extremity
Frequency of breaks 34 It is essential to take breaks between procedures that require prolonged standing and the maintenance of static postures, as in ERCPs
Type of treatment used for musculoskeletal injuries 81

(45% no treatment; 36% medication; 15% physical therapy)

Exercise is critical to reverse and prevent cumulative trauma disorders
This entry was posted in Occupational injuries and tagged Endoscopic retrograde cholangiopancreatography, Occupational injuries, Repetitive strain injuries.
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