Objective: to analyze occupational accidents with exposure of nursing technicians to biological material in a school hospital. Method: nursing technicians were invited to answer a questionnaire related to occupational accidents with biological material. Results: 275 professionals from 9 hospital units participated. 76% reported having suffered an accident and the variables “age group” and “employment regime” showed a significant association for accidents (p<0.05). Those hired by the Consolidation of Labor Laws (CLT - Consolidação das Leis do Trabalho) employment regime were 3.5 times more likely to suffer accidents (p=0.04) and institutional capacity building did not show statistical significance (p>0.05). Conclusion: the increase in the number of training did not ensure the reduction of occupational accidents with biological material; and nursing technicians under the age of 30 were more vulnerable. Professionals with a CLT labor contract were more affected than the statutory employees.
The rotation of rollers in cardiopulmonary bypass pumps propels the blood through various devices to reach the patient. Very occlusive settings may squeeze red blood cells, whereas a nonocclusive setting may result in retrograde flow. Occlusion of roller pumps may be regulated either by measuring the drop rate or by dynamic calibration. This study evaluated the influence of silicone tubing residual stress found on pump regulation. Silicone tubes obtained from two different suppliers were used in 6-inch DeBakey roller pumps. The variations occurring over time in the measurements of drop rate, dynamic calibration, and tube residual stress were analyzed. Covariance analysis of the four linear regressions has shown a progressive and accentuated reduction in drop rate (p < 0.002). It is noticeable that the angular coefficients of the drop rate measurements of the four silicone tubes are the same (p > 0.56). This reduction in drop rate measurements may affect the regulation of the pumps before surgical procedures. One probable cause for this reduction is the residual stress found in the silicone tubes. Settings based on the dynamic calibration process tended to be repeated over time. Simple linear regression test (angular coefficient equals zero) has shown a p > 0.79 showing no interference of the silicone tubes residual stress on dynamic calibration, suggesting that one should use this method to calibrate roller pumps.
This study aims at the influence on hemolysis of the differences between the maximum and minimum amplitudes of pressure in the outlet of three roller pump models adjusted by dynamic calibration method. Tests were performed with silicone tubes (½ × (3)/(16) inches) in fluid analogous to blood and fresh bovine blood from slaughterhouse. Tests with analogous solution to blood were performed varying the dynamic calibration pressure between 78 and 500 mm Hg. Tests with fresh bovine blood were performed with the three pumps simultaneously, and pressure differences and free hemoglobin in the plasma were measured during 360 minutes. Tests with both analogous solution to blood and fresh bovine blood showed differences of mean pressures of pump 2 related to pumps 1 and 3 (p < 0.01). The different models of roller pumps analyzed presented differences in pressure amplitudes (p < 0.01) and hemolysis (p < 0.01) adjusted for the same dynamic calibration pressure. Raceway profile of pump 2 resulted in smaller pressure amplitude, implying lower hemolysis rate compared with pumps 1 and 3.
Objective: to analyze the working conditions perceived by nursing technicians and their relationship with accidents involving biological material. Method: this is a mixed, descriptive, cross-sectional study conducted in a public hospital. 275 professionals answered a questionnaire with questions related to the number of accidents, perception of working conditions and suggestions to minimize them. It is noted that the research was of simple random probability type, with proportional distribution in units and work shifts and the results presented from reports and tables. Results: 210 technicians claimed to have suffered an accident at work. It is revealed that the variables stressful work rhythm, monotony and influence of work on health were statistically significant, and the use of personal protective equipment and decreased overload were the measures most indicated by respondents. Conclusion: the analysis indicated a positive relationship between work overload and accidents with biological material. Although the institution makes personal protective equipment available to workers, there is strong evidence of non-use or partial use. It can be subsidized, by the instrument used in this research, managerial actions to readjust the work processes. Descriptors: Occupational Risks; Occupational Acidentes; Public Hospitals; Workplace; Working Environment; Nursing. RESUMOObjetivo: analisar as condições de trabalho percebidas por técnicos de Enfermagem e sua relação com acidentes envolvendo material biológico. Método: trata-se de um estudo misto, descritivo, transversal, realizado em um hospital público. Elencaram-se 275 profissionais que responderam a um questionário com perguntas relacionadas ao número de acidentes, percepção das condições de trabalho e sugestões para minimizá-los. Detalha-se que a pesquisa foi do tipo probabilística aleatória simples, com distribuição proporcional nas unidades e turnos de trabalho e os resultados apresentados a partir de relatos e tabelas. Resultados: declarou-se, por 210 técnicos, ter sofrido acidente de trabalho. Revela-se que as variáveis ritmo de trabalho estressante, monotonia e influência do trabalho na saúde tiveram significância estatística, e o uso de equipamentos de proteção individual e diminuição da sobrecarga foram as medidas mais indicadas pelos respondentes. Conclusão: indicou-se, pela análise, relação positiva entre sobrecarga de trabalho e acidentes com material biológico. Percebe-se que, apesar de a instituição disponibilizar equipamentos de proteção individual aos trabalhadores, há forte indício do não uso ou uso parcial. Podem-se subsidiar, pelo instrumento utilizado nesta pesquisa, ações gerenciais para readequações dos processos de trabalho. Descritores: Riscos Ocupacionais; Acidentes de Trabalho; Hospitais Públicos; Ambiente de Trabalho; Condições de Trabalho; Enfermagem. RESUMENObjetivo: analizar las condiciones de trabajo percibidas por los técnicos de Enfermería y su relación con los accidentes que involucran material biológico. Método: este es un estudio mixt...
<p>Objetivo: quantificar a subnotificação e motivos do não registro dos acidentes de trabalho com material biológico de técnicos de enfermagem em hospital universitário. Método: pesquisa de corte transversal quantitativa com proporção amostral de 25%. Participaram 275 profissionais de 9 unidades que responderam questionário sobre risco ocupacional. Resultados: foram relatados 747 acidentes, sendo 71% não notificados. As variáveis: horário de trabalho, unidades e tipos de exposição foram correlacionadas estatisticamente à subnotificação (p < 0,05). Os motivos para não registro: “Quem trabalha na enfermagem sofre acidente com material biológico” apresentou 3,5 vezes mais chances de subnotificar acidente percutâneo com sangue; e “A saída pode sobrecarregar colegas de trabalho” teve 2,3 vezes mais chances de subnotificar acidente mucocutâneo. Conclusão: as subnotificações dos acidentes foram 2,4 vezes maiores que as notificações, com predomínio da exposição mucocutânea e os principais motivos foram relacionados à pouca percepção sobre o risco ocupacional e a sobrecarga de trabalho.</p><p>Descritores:<em> </em>Saúde do trabalhador. Riscos ocupacionais. Acidentes de trabalho. Enfermagem. Exposição ocupacional. Notificação.</p>
Introduction: Extracorporeal circulation (EC) is very important in cardiac surgery but causes significant damage to the blood, including hemolysis.Objective: To quantify the rate of hemolysis at different times during EC in elective coronary artery bypass grafting.Methods: We measured rates of hemolysis of 22 patients at 6 different times during myocardial revascularization during EC: T0 -before the start of EC, T1 -five minutes after of the EC initiation, T2 -30 minutes of EC, T3 -immediately before the aortic unclamping, T4 -immediately before passage of the residual volume to the patient and T5 -five minutes after the passage of the residual volume to the patient. Rates of hemolysis were calculated between the intervals of time: T0-T1; T1-T2; T2-T3; T3-T4 and T4-T5.Results: The first 5 minutes after the EC showed the highest rate of hemolysis (P = 0.0003) compared to the others calculated rates, representing 29% of the total haemolysis until T4 (Immediately before passage of the residual volume to the patient).Conclusion: There were no significant changes in the rate of hemolysis during the suction in the aortic root (P > 0.38), nor with the procedure used for the passage of the residual volume of blood in the circuit to the patient.Keywords: Extracorporeal circulation. Hemolysis. Blood. ResumoIntrodução: A circulação extracorpórea (CEC) é indispensável para a maioria das operações cardíacas, mas causa danos significantes ao sangue, dentre eles a hemólise.Objetivo: Quantificar as taxas de hemólise em diferentes tempos nas operações para revascularização do miocárdio com uso de CEC. 536Rev Bras Cir Cardiovasc 2012;27(4) Resultados: Os primeiros 5 minutos após a CEC demonstraram maior taxa de hemólise (P = 0,0003) em comparação às outras taxas calculadas, representando 29% da hemólise total até T4 (imediatamente antes da passagem do volume residual para o paciente).Conclusão: Não foram observadas variações significantes nas taxas de hemólise durante a aspiração na raiz da aorta (P > 0,38) nem com o procedimento utilizado para a passagem do volume residual de sangue no circuito para os pacientes.
Análise do perfil hidrodinâmico em diferentes modelos de bombas de rolete utilizadas em circulação extracorpóreaAnalysis of the hydrodynamic profile in different roller pumps models used in cardiopulmonary bypass Abstract Objective: Among the equipments used in cardiopulmonary bypass the roller pumps have great importance with various models available from several manufacturers. The calibration is an important factor in hemolysis rates and its potential is different in each. Researchers do not always approach details on the pump bed profiles assuming that the standardized calibration settings ensure equal and comparable values for all models of roller pumps. We have mainly two methods for calibration of pumps which also interferes on the hemolytic potential. In both of them, the characteristics of fluid impulsion defined by the pump bed design are not considered. The aim of this study is to compare the hydrodynamic profile of three models of roller pumps available in the Brazilian market.Method: The rollers occlusion was performed by measures of drop and dynamic calibration. Two different silicone diameter tubes were used (3/8 x 1/16 and 1/2 x 3/32 inches).Results: The profiles showed differences in their variances, P<0.01 for drop rate measures and P<0.0001 for dynamic calibration. Different changes in pressure were found between the pumps analyzed (P<0.002).
IntroductionIn vitro hydrodynamic characterization of prosthetic heart valves provides important information regarding their operation, especially if performed by noninvasive techniques of anemometry. Once velocity profiles for each valve are provided, it is possible to compare them in terms of hydrodynamic performance. In this first experimental study using laser doppler anemometry with mechanical valves, the simulations were performed at a steady flow workbench.Objective To compare unidimensional velocity profiles at the central plane of two bi-leaflet aortic prosthesis from St. Jude (AGN 21 - 751 and 21 AJ - 501 models) exposed to a steady flow regime, on four distinct sections, three downstream and one upstream. MethodsTo provide similar conditions for the flow through each prosthesis by a steady flow workbench (water, flow rate of 17L/min. ) and, for the same sections and sweeps, to obtain the velocity profiles of each heart valve by unidimensional measurements. ResultsIt was found that higher velocities correspond to the prosthesis with smaller inner diameter and instabilities of flow are larger as the section of interest is closer to the valve. Regions of recirculation, stagnation of flow, low pressure, and flow peak velocities were also found. Conclusions Considering the hydrodynamic aspect and for every section measured, it could be concluded that the prosthesis model AGN 21 - 751 (RegentTM) is superior to the 21 AJ - 501 model (Master Series). Based on the results, future studies can choose to focus on specific regions of the these valves.
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