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An audit of analgesic use for hand injuries in a private emergency department in JohannesburgMaloney, Jan Rust 25 April 2014 (has links)
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfillment of the requirements for the degree of Master Science in Medicine in Emergency Medicine, Johannesburg, 2013 / Objectives:
To describe the current analgesic practices for hand injuries used at a private
hospital emergency department in Johannesburg, Gauteng and to explore any
differences in analgesic practice between different doctor groups with different
backgrounds, working in the ED.
Design:
Retrospective descriptive review.
Setting:
Private hospital emergency department in Johannesburg.
Patients:
A study sample of 423 patients who presented to the emergency department with
hand injuries during 2010.
Methods:
The emergency department register was used to identify patients who presented
with hand injuries. The clinical notes and where appropriate, nursing notes of the
identified patients were reviewed.
Main Results:
Hand injuries were found to represent 9.3% of patients presenting to the
emergency department. The most commonly used form of analgesia for hand
injuries was found to be nerve blocks, which constituted 30% of the analgesic use.
Digital blocks were the most frequently used block accounting for 69% of all nerve
blocks done. Parenteral analgesia was the second most common form of
analgesia implemented with the intramuscular route being most favoured.
Specialised techniques such as nerve blocks are possibly underutilised by doctors
with less surgical and emergency department experience.
Conclusions:
Analgesic practices between different doctor groups are varied. Standardising
pain management for hand injuries should lead to improved utilisation of
techniques such as nerve blocks. Guidelines should be available and include
nerve block techniques. Training should be provided to doctors who are unfamiliar
with the use of additional modalities such as nerve blocks.
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The plastic replacement of severed flexor tendons of the fingers.Sarkin, Theodore Leonard 16 May 2017 (has links)
No description available.
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Understanding the occupational therapists use of splinting the affected hand of adult patients with neurological injuriesChazen, Lee-Anne 23 April 2014 (has links)
ABSTRACT
This study explored the clinical reasoning expert therapists use in relation to splinting the affected hand following neurological injury. An exploratory, descriptive, qualitative methodology was used in three focus groups with occupational therapists, experienced in neurorehabilitation. Data was analysed based on priori themes, specifically
1. The Model of Practice Development (Higgs and Titchen 2001b) - most value was placed on Procedural knowledge or clinical experience; reflection on protocols, working with and learning from others and having clear outcomes. Undergraduate training and current literature is insufficient to provide guidelines for practice.
2. The Three Track Model of Clinical Reasoning (Fleming 1991) –splinting was used to improve range of motion, maintain muscle length and affect muscle tone. Effectiveness of the splints depended on the patient’s response and the therapists’ ability to adapt to preferences and goals. Interactive reasoning was essential in understanding the South African context. The study provided guidelines for a newly qualified therapist.
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The effect of corrective splintage on the flexion contractures of rheumatoid fingers.January 1993 (has links)
by Cecilia Li Tsang Wai Ping. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1993. / Includes bibliographical references (leaves [175-185]). / ABSTRACT / AKNOWLEDGEMENTS / Chapter CHAPTER ONE --- INTRODUCTION / Chapter 1.1 --- INTRODUCTION --- p.1 / Chapter 1.2 --- AIMS OF STUDY --- p.3 / Chapter CHAPTER TWO --- RHEUMATOID ARTHRITIS / Chapter 2.1 --- DEFINITION --- p.4 / Chapter 2.2 --- PREVALENCE --- p.4 / Chapter 2.3 --- AETIOLOGY --- p.4 / Chapter 2.4 --- PATHOLOGY --- p.5 / Chapter 2.5 --- CLINICAL FEATURES OF RHEUMATOID ARTHRITIS IN HAND --- p.5 / Chapter 2.6 --- CRITERIA FOR DIAGNOSIS OF RHEUMATOID ARTHRITIS --- p.7 / Chapter CHAPTER THREE --- HAND DEFORMITIES IN RHEUMATOID ARTHRITIS / Chapter 3.1 --- THE HAND --- p.9 / Chapter 3.2 --- THE RHEUMATOID HAND --- p.13 / Chapter 3.4 --- CAUSES OF FLEXION CONTRACTURE AT THE PROXIMAL INTERPHALANEAL JOINT --- p.16 / Chapter CHAPTER FOUR --- SPLINTING FOR THE RHEUMATOID HAND / Chapter 4.1 --- SPLINTING IN RHEUMATOID ARTHRITIS --- p.19 / Chapter 4.2 --- SPLINTING FLEXION CONTRACTURES AT THE PROXIMAL INTERPHALANGEAL (PIP) JOINTS --- p.24 / Chapter 4.3 --- THE MECHANICAL ANALYSIS OF SPLINT DESIGN --- p.32 / Chapter CHAPTER FIVE --- HAND ASSESSMENT IN RHEUMATOID ARTHRITIS / Chapter 5.1 --- INTRODUCTION --- p.41 / Chapter 5.2 --- A REVIEW OF THE STANDARDISED HAND FUNCTION ASSESSMENT --- p.42 / Chapter 5.3 --- MEASUREMENT OF GRIP STRENGTHS --- p.48 / Chapter 5.4 --- MEASUREMENT OF ACTIVE RANGE OF MOTION OF FINGER JOINTS --- p.52 / Chapter CHAPTER SIX --- DEVELOPMENT OF HAND EVALUATION SYSTEM in RHEUMATOID ARTHRITIS / Chapter 6.1 --- INTRODUCTION --- p.56 / Chapter 6.2 --- AIMS OF STUDY --- p.56 / Chapter 6.3 --- DEVELOPMENT OF THE HAND EVALUATION SYSTEM --- p.57 / Chapter 6.4 --- A COMPARATIVE STUDY OF HAND GRIP ASSESSMENT TOOLS: THE JAMAR DYNAMOMETER AND THE REC PROTOTYPE GRIP ANALYSER --- p.58 / Chapter 6.5 --- A COMPARATIVE STUDY ON THE JEBSEN HAND FUNCTION TEST IN HONG KONG --- p.67 / Chapter 6.6 --- ASSESSMENT OF FUNCTIONAL RANGE OF MOTION --- p.77 / Chapter 6.7 --- CONCLUSION --- p.83 / Chapter CHAPTER SEVEN --- THE MAIN STUDY / Chapter 7.1 --- INTRODUCTION --- p.85 / Chapter 7.2 --- RESEARCH DESIGN --- p.85 / Chapter 7.3 --- DEFINITION OF VARIABLES --- p.86 / Chapter 7.4 --- SUBJECT SELECTION --- p.89 / Chapter 7.5 --- EXPERIMENTAL PROCEDURES --- p.89 / Chapter 7.6 --- PILOT STUDY --- p.91 / Chapter 7.7 --- STATISTICAL ANALYSIS OF DATA --- p.94 / Chapter CHAPTER EIGHT --- RESULTS / Chapter 8.1 --- RESULTS --- p.95 / Chapter 8.1.1 --- Age distribution --- p.96 / Chapter 8.1.2 --- Occupation --- p.98 / Chapter 8.1.3 --- Functional class --- p.98 / Chapter 8.1.4 --- Group characteristics --- p.99 / Chapter 8.1.5 --- Comparison of the effect of corrective splints on hand functions of clients --- p.100 / Chapter 8.1.6 --- Comparison of the effect of two types of corrective splintage on hand functions of clients --- p.103 / Chapter 8.2 --- SUMMARY --- p.113 / Chapter 8.2.1 --- Summary of findings --- p.113 / Chapter 8.2.2 --- Compliance and complication of the splint intervention programme --- p.114 / Chapter CHAPTER NINE --- DISCUSSION / Chapter 9.1 --- INTRODUCTION --- p.116 / Chapter 9.2 --- COMMENTS ON THE HAND EVALUATION PROTOCOL … --- p.117 / Chapter 9.3 --- DISCUSSIONS OF THE RESULTS OF THE PILOT STUDY --- p.121 / Chapter 9.4 --- DISCUSSION OF THE RESULTS OF THE MAIN STUDY --- p.125 / Chapter 9.5 --- IMPLICATION OF STUDY INTO OCCUPATIONAL THERAPY PRACTICE --- p.130 / Chapter 9.6 --- LIMITATION OF THE STUDY --- p.131 / Chapter 9.7 --- SUMMARY --- p.132 / Chapter CHAPTER TEN --- CONCLUSION AND RECOMMENDATIONS / Chapter 10.1 --- CONCLUSION --- p.134 / Chapter 10.2 --- RECOMMENDATIONS --- p.138 / Chapter 10.3 --- SUGGESTIONS FOR FURTHER RESEARCH --- p.139 / APPENDICES / REFERENCES
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Aktyvios chirurginės taktikos veismingumas gydant gilius dalies odos storio plaštakų ir riešų nudegimus / The effectiveness of active surgical tactic in treatment of deep partial thickness burn of hand and wristMaslauskas, Kęstutis 07 July 2005 (has links)
ABBREVIATIONS
MPJ – Metacarpophalangeal joints
PIPJ – Proximal interphalangeal joints
DIPJ – Distal interphalangeal joints
OIJ – Own interphalangeal joints (PIPJ + DIPJ)
DPTB – Deep partial thickness burns
ST– Sparing tactics
AST – Active surgical tactics
KMUH–Kaunas Medical University Hospital
MRSA - Meticylin resistant Staphylococcus aureus
MSSA - Meticylin sensitive Staphylococcus aureus
ADP – Autodermoplastics
TBSA – Total burn surface area
BAH– Burnt area of hand
IHF – Impairment of hand’ function
AASH – The Association of American Surgeons of Hand
1. INTRODUCTION
Hand actively participate in daily activities of a human, therefore hand are the mostly vulnerable part of human’s body. According to the data of various authors, the injuries of hand and fingers make even 30-75% of all industrial traumas (Antonopulos et al. 1992, Burm et al. 1999), and burns of hand make about 6% of all traumas of hand (Mam et al. 1998).
According to the data of the Lithuanian Information Center of Health, the number of injuries of shoulder bend and hand in these latter years is increasing constantly (Picture 1). Moreover, every year more than 6000 people sustain burns and about 2000 of them are treated at hospitals. About 500 people, who sustained burns, are treated every year at the specialized hospitals. Burns of one or both hand are diagnosed to about half of hospitalized patients, and deep partial thickness burns of hand are diagnosed to 15-20% of them.
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Vibration-induced neuropathy in the handStrömberg, Trygve. January 1997 (has links)
Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted.
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Vibration-induced neuropathy in the handStrömberg, Trygve. January 1997 (has links)
Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted.
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An Analysis of Time-Loss Duration Following Work-Related Traumatic Injuries to the Hand and WristLandry, Karen 02 June 2010 (has links)
Objective: The purposes of this thesis included: i) To explore the annual incidence and time-loss duration of traumatic, work-related injuries of four nature-of-injury (fractures, nerve lacerations, tendon lacerations/disruptions and amputations) and two part-of-body categories (hand and wrist); and ii) To identify the incidence and time-loss duration, and examine explanatory variables that were associated with time-loss duration for subjects with hand fractures. Methodology: Data on incidence, time-loss duration and explanatory variables were reviewed on claims accepted between January – December 2006 at WorkSafe-New Brunswick. Descriptive statistics and non-parametric tests were used to explore incidence and time-loss duration. Using a biopsychosocial framework, explanatory variables associated with time-loss duration were analyzed using Cox Proportional Hazards regression. Results: The incidence for hand and wrist trauma involving fractures, tendon lacerations/disruptions and amputations was low (3%). Incidence was significantly higher for fractures and for injuries to the hand, while time-loss duration was significantly higher for the wrist (p< .05). The incidence rate of hand fractures was low (1.5%) and average time-loss duration was high (92 days). Increased time-loss duration was associated with greater medical aid costs (used as a proxy for injury severity) older age and increased receipt of therapy (Physiotherapy/Occupational Therapy). Conclusions: The annual incidence of specific injuries involving the hand and wrist is challenging to compare to the literature since incidence is presented in many ways. Time-loss duration following hand and wrist injuries is highly variable. Time-loss duration for hand fractures exceeded reports in the literature and predicted values reported in disability duration guidelines. Consideration of the impairment, personal and environmental factors is warranted to provide a framework to the return-to-work process for all stakeholders involved in the care of the hand- and wrist-injured worker.
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Konsekvenser av en akut traumatisk handskada : en prospektiv studie av patientens situation under det första året efter olyckan /Gustafsson, Margareta, January 2003 (has links)
Diss. (sammanfattning) Örebro : Univ., 2003. / Härtill 4 uppsatser.
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A quasi-experimental pilot study examining the effects of occupation-based hand therapy on clients with hand injuries in occupational therapy practice in the Eastern Cape, South AfricaNero, Kayla January 2021 (has links)
Magister Scientiae (Occupational Therapy) - MSc(OT) / Occupation-based hand therapy (OBHT) is an approach to practice that integrates multiple frames of reference while remaining rooted in an occupational therapy perspective. Hand function is important for participation in daily occupations. The current focus in assessment and treatment of clients in occupational therapy remains on body structure and function which is also true in South Africa. The gap in the literature about the effects of OBHT indicates that there is a need for a study in a South African context. This research was conducted to examine the influences of an OBHT among clients with hand injuries within occupational therapy practice in a South African context.
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