Archive May 2014 XV, No. 5

Editor's Page: Staying Upright in the OR

Fallproof your operating rooms before another person hits the deck.

Dan O

Dan O'Connor, Editor-in-Chief


As OR workplace dangers go, falls don't get nearly the attention that sharps injuries, wrenched backs, scalpel-throwing surgeons and bullying nurses get. But it's time to treat slips, trips and falls like the serious hazards they are.

As we detail in this issue's cover story (see "Watch Your Step" on page 24), we're not talking about bumps and scrapes from schoolyard falls. OR falls can cause serious, sometimes career-threatening injuries: fractures, concussions, contusions requiring stitches and, in the case of Paula Watkins, RN, CNOR, contusions that get infected and require surgery.

A year ago, Ms. Watkins, our Behind Closed Doors columnist, tripped over an unsecured C-arm cord. Her head (concussion) and thumb (sprain) hit the OR door, and the rest of her landed with a thud on the floor. She was on a stretcher and in the emergency department before she realized that the blood on the sleeve of her scrubs was from her elbow, not her last patient. The impact of the fall split open the skin on her elbow wide enough that it required a few stitches to close the next morning.

Ms. Watkins healed up. When she returned to work, she took care to keep her elbow covered. Everything seemed fine until she accidentally bumped her elbow while getting into her car. The skin broke open again at the elbow. A burst of clear fluid gushed out. That's what happens when you rupture an infected elbow bursa sac.

She was on the surgery schedule within a week. The surgeon extended the incision past her elbow where the infection had tracked and sutured up the bursa. Twenty-six staples and a Jackson-Pratt drain were in her left elbow for 3 weeks.

And now, a year later, despite occupational therapy, the arm's "acting up." If she sets it down on a flat surface, Ms. Watkins says she feels pain, cramping and spasms. She estimates she has 60% usage of her arm.

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