scholarly journals Building Capacities to Conduct Respirator Fit Testing for Pesticide Applicators

2021 ◽  
Vol 59 (Summer 2021) ◽  
Author(s):  
Michael Wierda ◽  
Janet Hygnstrom ◽  
Natalie Hoidal ◽  
Thia Walker ◽  
Jessica Wilburn ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Medical Evaluation ◽  
Fit Testing ◽  
Pesticide Safety ◽  
Extension Professionals ◽  
Pesticide Applicators

The 2015 revision of the Worker Protection Standard (WPS) mandates requirements for medical evaluation, fit testing, and respirator training when the pesticide label requires a respirator. An ad-hoc group of Extension pesticide safety educators came together to address a lack of training and infrastructure for respirator compliance. In the ensuing years, programs of varied audiences and formats were hosted. Errors and shortcomings were realized, knowledge was gained, and lessons were learned. Those lessons are summarized here with links, resources, and suggestions for the implementation of similar efforts by Extension professionals.

scholarly journals Prevalence and Therapeutic Approach of Acute Pain in Emergency Provided by Triage Nursing

Aquichan ◽  
2019 ◽  
Vol 19 (4) ◽  
pp. 1-10
Author(s):  
Jonay Perera Gil ◽  
Francisco López Muñoz ◽  
Rosa María Candelas Ocejo ◽  
Rodrigo Chacón Ferrera ◽  
Gloria Morizot
Keyword(s):  
Acute Pain ◽  
Emergency Service ◽  
Ad Hoc ◽  
Central Tendency ◽  
Cross Sectional ◽  
Numerical Scale ◽  
Medical Evaluation ◽  
Intervention Protocol ◽  
Pain Intervention ◽  
Observational Descriptive Study

Objective: This work sought to assess the effectiveness of the treatment applied in patients with acute pain in the emergency service by triage nursing. Materials and Methods: Cross-sectional, observational descriptive study of quantitative approach, with measures of central tendency in 348 patients, conducted in 2016. An ad hoc questionnaire was used, elaborated by the emergency service, which assesses the intensity of pain through a numerical scale and a pain intervention protocol that includes physical and pharmacological measures. Results: After applying the first treatment, 80.17 % of the patients experienced improvement; 7.18 % required a second treatment and, of these, 87.5 % improved and 12.5 % suffered no modifications. The nursing staff treated the patients according to the protocol, with AINES and Metamizole, primarily. The rest were remitted to medical evaluation and another 40 patients rejected treatment. Conclusions: A high percentage of patients exist who improve their perception of pain after the first treatment administered by the triage nursing personnel. The results suggest revising and updating the protocol in the first treatment.

Exploring Pesticide Safety Education in Idaho

2019 ◽  
Vol 44 (2) ◽  
pp. 56-87
Author(s):  
Iris Mayes ◽  
Laura B. Holyoke
Keyword(s):  
A Priori ◽  
Adult Learning Theory ◽  
Safety Information ◽  
Safety Training ◽  
Worker Safety ◽  
Safety Education ◽  
Reduce Risk ◽  
Pesticide Safety ◽  
Pesticide Applicators ◽  
Additional Safety

This paper summarizes an exploratory study probing perspectives of pesticide applicators and educators regarding pesticide licensing and safety training in Idaho. The purpose of the study was to identify lines of inquiry concerning critical learning components for pesticide worker safety. Information was gathered about training practices for pesticide applicators. Adult learning theory provided a foundation for a priori themes combined with grounded theory to explore emergent concepts and categories. Four categories relevant to pesticide applicator safety training emerged from the literature review and interviews: knowledge and learning, worker practices, worker beliefs and attitudes, and the work environment. Understanding why workers take risks is central to developing effective safety training. Providing workers with access to research-based information may reduce risk. Narrative may play an important part in developing educational curriculum. There is a need to develop additional safety education programming that is designed for this specific audience.

Impairment Tutorial: Spinal Cord Stimulation and Intraspinal Opioids:Impairment Rating Issues

2000 ◽  
Vol 5 (5) ◽  
pp. 4-5
Author(s):  
James B. Talmage ◽  
Leon H. Ensalada
Keyword(s):  
Medical Records ◽  
Evaluation Process ◽  
Current Approach ◽  
Satisfaction Survey ◽  
Start Time ◽  
Medical Evaluation ◽  
Independent Medical Evaluation ◽  
Other Information ◽  
Physician Reviews ◽  
Written Informed Consent

Abstract Evaluators must understand the complex overall process that makes up an independent medical evaluation (IME), whether the purpose of the evaluation is to assess impairment or other care issues. Part 1 of this article provides an overview of the process, and Part 2 [in this issue] reviews the pre-evaluation process in detail. The IME process comprises three phases: pre-evaluation, evaluation, and postevaluation. Pre-evaluation begins when a client requests an IME and provides the physician with medical records and other information. The following steps occur at the time of an evaluation: 1) patient is greeted; arrival time is noted; 2) identity of the examinee is verified; 3) the evaluation process is explained and written informed consent is obtained; 4) questions or inventories are completed; 5) physician reviews radiographs or diagnostic studies; 6) physician records start time and interviews examinee; 7) physician may dictate the history in the presence of the examinee; 8) physician examines examinee with staff member in attendance, documenting negative, physical, and nonphysiologic findings; 9) physician concludes evaluation, records end time, and provides a satisfaction survey to examinee; 10) examinee returns satisfaction survey before departure. Postevaluation work includes preparing the IME report, which is best done immediately after the evaluation. To perfect the IME process, examiners can assess their current approach to IMEs, identify strengths and weaknesses, and consider what can be done to improve efficiency and quality.

Fifth Edition: the New Standard

2000 ◽  
Vol 5 (6) ◽  
pp. 1-7
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage ◽  
Leon H. Ensalada
Keyword(s):  
Musculoskeletal System ◽  
Medical Information ◽  
Objective Assessment ◽  
Scientific Data ◽  
Practical Application ◽  
Fourth Edition ◽  
Appropriate Use ◽  
Medical Evaluation ◽  
Single Set

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is available and includes numerous changes that will affect both evaluators who and systems that use the AMA Guides. The Fifth Edition is nearly twice the size of its predecessor (613 pages vs 339 pages) and contains three additional chapters (the musculoskeletal system now is split into three chapters and the cardiovascular system into two). Table 1 shows how chapters in the Fifth Edition were reorganized from the Fourth Edition. In addition, each of the chapters is presented in a consistent format, as shown in Table 2. This article and subsequent issues of The Guides Newsletter will examine these changes, and the present discussion focuses on major revisions, particularly those in the first two chapters. (See Table 3 for a summary of the revisions to the musculoskeletal and pain chapters.) Chapter 1, Philosophy, Purpose, and Appropriate Use of the AMA Guides, emphasizes objective assessment necessitating a medical evaluation. Most impairment percentages in the Fifth Edition are unchanged from the Fourth because the majority of ratings currently are accepted, there is limited scientific data to support changes, and ratings should not be changed arbitrarily. Chapter 2, Practical Application of the AMA Guides, describes how to use the AMA Guides for consistent and reliable acquisition, analysis, communication, and utilization of medical information through a single set of standards.

Clinical Update: Assessing Maximum Medical Improvement in Carpal Tunnel Syndrome

2003 ◽  
Vol 8 (4) ◽  
pp. 4-5
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Proper Time ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Factors Affecting ◽  
Early Results ◽  
Medical Evaluation ◽  
Nerve Recovery ◽  
Tunnel Syndrome

Abstract Permanent impairment cannot be assessed until the patient is at maximum medical improvement (MMI), but the proper time to test following carpal tunnel release often is not clear. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) states: “Factors affecting nerve recovery in compression lesions include nerve fiber pathology, level of injury, duration of injury, and status of end organs,” but age is not prognostic. The AMA Guides clarifies: “High axonotmesis lesions may take 1 to 2 years for maximum recovery, whereas even lesions at the wrist may take 6 to 9 months for maximal recovery of nerve function.” The authors review 3 studies that followed patients’ long-term recovery of hand function after open carpal tunnel release surgery and found that estimates of MMI ranged from 25 weeks to 24 months (for “significant improvement”) to 18 to 24 months. The authors suggest that if the early results of surgery suggest a patient's improvement in the activities of daily living (ADL) and an examination shows few or no symptoms, the result can be assessed early. If major symptoms and ADL problems persist, the examiner should wait at least 6 to 12 months, until symptoms appear to stop improving. A patient with carpal tunnel syndrome who declines a release can be rated for impairment, and, as appropriate, the physician may wish to make a written note of this in the medical evaluation report.

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