ERGONOMIC RECOMMENDATION FOR SURGEONS.pptx

Ergonomic recommendation for surgeons

1. ERGONOMIC RECOMMENDATION FOR SURGEONS Presention by- Komal Sharma BPT- Final year Subject - Rehabilitation

2. Ergonomics - law of working ergonomics is “understanding of interaction among humans, and other elements of a system to optimize human well-being and overall system performance.” It includes Making suitable modification in task environment and machinery to obtain best productivity by the men and prevent injury

3. INTRODUCTION Surgeons face hazardous working conditions due to ergonomic deficiencies found throughout the operating room. More than 80% of surgeons have succumbed to a work-related injury as a consequence of sustaining awkward static positions throughout lengthy operations over a career. Work related muskulosleteal disorders are most prevalent in healthcare workers having direct contact with the patient such as surgeon, physiotherapist and nurses

4. Aims and Objectives of Ergonomic Recommendation Aims To reduce incident of work related muskulosleteal disorders, ctd, rsd To reduce physical , visual and psychological stress Provide comfortable working environment All is possible by the implementation of Proper Ergonomics Tools and measueres Detailed analysis of the following points Correct posture during work leverage Suitable Work space modification i.e OT, surgical tools modification Evaluation of anthropometry for formulation of protocol and modifications best suited to individual surgeon Incorporation of stretching breaks prior and post surgery / simple postural rest after surgery Add strengthening regimen and promoting overall physical fitness

5. GOALS OF ERGONOMICS Increase proficiency and work effectiveness reduce injuries increase comfort level increase over all productivity of individual without any risks of injury

6. RISK FACTORS FOR SURGEONS CONTRIBUTING TO MSD’S Physical stress Orthostatic standing for long periods Manual handling and Manipulation of surgical instruments Monotonous repetitive movements in case of successive surgeries

7. ERGONOMICS ISSUES FOR SURGEONS These includes (A) MSD’s of the following areas Neck -Pains , stiffness, forward head posture, cervico brachial injuries Back- low back pain , degenerative lumbar disease shoulder arms - pain and numbness wrist- ctd like carpal tunnel due to continuous manipulation of surgical instruments in palm down position Elbow -lateral epicondylitis due to grip and manipulation of instrument and other problems related to grip PHYSICAL PLIGHT OF SURGERY

8. (B) VISUAL FIELD RELATED PROBLEMS (C) PSYCHOLOGICAL STRESS

9. ERGONOMIC MODIFICATION Maintenance of correct posture Operating table adjustment correct monitor placement modification in hand grips surgical instrument Addressing visualization issues Management of psychological stress

10. correct BODY POSTURE Head and Neck- The head should be vertical and should not be tilted more than 15 degrees Back- neutral in sitting or standing no flexion or extension maintaining s shaped cure if required flexion should not be more than 6-10 degrees Arms- should be hanged by the slide of body or supported in table in 90° while sitting ,should be maintained vertically between the waist and the middle of the chest when reaching out Lower Body-Standing upright, shifting weight occasionally from one leg to the other Use foot pedal support or stool to adjust height accordingly

11. DEMONSTRATION OF CORRECT BODY POSTURE WHILE SURGERY

12. correct posture for standing work according to Ergonomic recommendation HEAD, NECK & SHOULDERS keep in a neutrol & laxed position to avoid strain on your neck and shoulder muscles ADJUST YOUR TABLE HEIGHT is comectly set to the level of your elbows, and elbows om bent of 90-120 degrees KEEP YOUR BODY NEUTRAL & IN LINE knees, hips, spine, shoulders & eas should fall in a straight vertical line (line of gravity) avoid ovestaining the knees, ankles, lower back, hips & spine by changing between sitting & standing frequently throughout the day FEET feet are flat, weight in both feet are even. Also important to wear comfortable shoes

13. MONITOR PLACEMENT The upper edge of the display should be at eye level so that the center of the monitor would be slightly below eye level to maintain a neutral vertical neck posture.. Monitor should be at 15° approx visual angle

14. montior placement Position the monitor at least 20 inches (51 cm) from your eyes—about an arm's length distance montior should be at eye level and thirty-degrees below your line of sight.

15. Hands and Instruments Avoid instruments or tools with high-pressure contact areas and sharp edges. Use trigger locks, ratchets, or other features to minimize the sustained gripping and squeezing forces. Hold instruments using a power grip to minimize finger fatigue whenever possible Choose powered tools where available to reduce hand force requirements. Choose instruments with finger holes that are large enough to fit the fingers comfortably.

16. Visualization KNOWN ISSUES Improper lighting and display orientation can have an adverse effect on task performance as well as cause eye strain and musculoskeletal fatigue, potentially leading to limitation of practice, long-term disability, and the need for corrective surgery. Recommendations : • Ensure that the open surgical field has high illuminance using two or more OR lights at different angles • When using a display monitor, place it directly in front of a user with the upper boundary of the display at eye level and the center of the screen slightly below eye level

17. Correct light placement operation table should be well lit there should be 2 light sources form different angle it should be from the top there shouldn't be any reflection on the monitor form these lights

18. Stress KNOWN ISSUES Surgery-related stress may be caused by time pressures, equipment problems, poor OR layouts, crowding, new technologies, unexpectedly challenging patients, conflicting goals, , communication difficulties, physical/cognitive workload differences, and variable skills and experience within the team. These stress may accumulate over time and can manifest in many forms, including excessive fatigue, reduced performance, mood swings, and reduced quality of life. Recommendation Use preparation, communication tools, and mutual support from your team to decrease stress before, during, and after surgery some other methods of managing stress are yoga meditation recreational activities building a hobby exercise taking care of for own physical fitness

19. Pre- and Postcase Stretching and Stabilization Exercises Cervical ROM Exercise Exercises for the Neck and Shoulder -Deep cervical flexor training,standing Scapular Retraction Cervical and Shoulder Stretching - stretching pf upper trapezius ,levator scapulae and pectorals Improving Thoracic Mobility - using foam roller Specific Hand and Arm Stretches - -Lumbrical stretching: -Passive wrist extension with elbow straight -Median nerve mobilization/ flossing

20. Pectoralis: Place your forearm against the corner of a wall and step forward with the ipsilateral foot. While looking ahead, gently bend the forward knee; the contralateral leg remains straight.

21. a )Hook fist b) table top position c) full fist

22. MEDIAN NERVE FLOSSING Place the palm of your hand against the wall, fingers pointing downward. A stretch should be felt at the wrist, elbow, or possibly the shoulder. Take the pressure off the stretch by leaning your head towards the wall. Hold the stretch for 1–2 seconds. Repeat 10–20 times

23. THANK YOU 😊