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Biomedical subjects

J Jagger

Publications and source records attributed to J Jagger.

At least 37 records · Page 2Linked to original sources

Risk of needle stick and sharp object injuries among medical students.

BACKGROUND: Much is known about sharp object and needle stick injuries among employee health care workers, but relatively little attention has been directed to exposures among medical students. METHOD: The frequency and mechanisms of needle stick and sharp object injuries were determined retrospectively by surveying students in their fourth year of medical school. Students were questioned about the number of percutaneous injuries that they had sustained during their clinical years. Descriptive information was collected on their most recent injury. RESULTS: Of 137 students in the class, 106 (77%) responded. Thirty-five (33%) of the students who responded sustained one or more injuries; 24 (69%) were injured while on a surgical service, and 60% of the injuries occurred in an operating room. Suturing was the procedure most frequently associated with injury. In 34% of cases, the injury was caused by a needle or device being used by another person. The most frequent site of injury was the hand (97%). Ninety-four percent of students were wearing gloves at the time of the injury. None of the injuries was associated with recapping needles. Only 43% of students reported their injuries to proper authorities. CONCLUSION: Medical students frequently sustain needle stick and sharp object injuries during their clinical training. Concerted efforts are needed to protect them.

Gloves, Protective↗

Occupational human immunodeficiency virus infection in health care workers: worldwide cases through September 1997.

The average estimated risk of human immunodeficiency virus (HIV) infection for health care workers following a percutaneous or mucous exposure is <0.5% in incidence studies, although a case-control study suggests it is much higher for highest-risk percutaneous exposure. To characterize exposures resulting in HIV transmission, we reviewed available data on occupational cases reported worldwide, identifying 94 documented and 170 possible cases. The majority of documented infections occurred in nurses, after contact with the blood of a patient with AIDS by means of percutaneous exposure, with a device placed in an artery or vein. High-exposure job categories, e.g., midwives and surgeons, are represented mostly among possible cases. Transmission occurred also through splashes, cuts, and skin contaminations, and in some cases despite postexposure prophylaxis with zidovudine. Health care workers could benefit if these data were incorporated in educational programs designed to prevent occupational bloodborne infections.

Global Health↗

After the stick.

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Centers for Disease Control and Prevention, U.S.↗

Infected physicians and invasive procedures: national policy and legal reality.

Recent reports of the transmission of hepatitis B, hepatitis C, and HIV from physicians to patients during invasive procedures have again raised the question of whether physicians infected with bloodborne pathogens should perform invasive procedures that place patients at risk, and if so, under what conditions. Attempts to formulate a national policy on this subject must consider the competing interests of the patient's welfare versus the physician's livelihood. A review of the legal aspects of this topic is provided to assist policy makers and to serve as a foundation for the recommended establishment of a multidisciplinary committee to develop a uniform national policy. Both legal and medical realities call for the formulation of a clear policy to guide those who must make the decisions on this issue.

Centers for Disease Control and Prevention, U.S.↗

A study of patterns and prevention of blood exposures in OR personnel.

The authors conducted a surveillance study of occupational blood exposures in the ORs at six hospitals to identify risk patterns and prevention strategies. For 15 months, trained circulating nurses recorded OR staff members' exposures during all surgical procedures using a modified version of the Exposure Prevention Information Network surveillance system. It was discovered that a high proportion of percutaneous injuries were potentially preventable if safer devices had been used, and the authors estimate that use of blunt suture needles alone could reduce injuries by 30%. Increased use of barrier precautions is indicated to prevent mucocutaneous blood exposures. Health care workers' eyes were identified in the study as being the most vulnerable location for serious blood exposures.

Blood-Borne Pathogens↗