Conference 2008

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Dates: Friday 7th Saturday 8th March 2008

Hosted by: Student Health Department University College Cork

In addition to the workshops summarised below, Dr Eddie O' Sullivan presented Headaches and Migraine, Dr David McGrath demonstated on Minor Surgery and Student Health and Dr Emer Loughrey facilitated a Secretarial Workshop.

Ankle Injuries and the Ottawa Ankle Rules

Chartered Physiotherapist Brid McEvoy led a session on examination of ankle injuries and application of the Ottawa Ankle Rules in practice. Attached is the explanation and diagram of the rule.

Playing Away - Travel Health and Vaccination

Dr Andy Lynne is President of the Irish Society of Travel Medicine www.istm.ie . ISTM provides up to date information on Travel Medicine and runs seminars and meetings across the country. On becoming a member you benefit from subsidized access to Travax. http://www.travax.nhs.uk/

Other useful links are www.cdc.gov/ www.who.int/en/

Sudden Cardiac Death in Young Athletes

Sudden Cardiac Death in Young Athletes

Average age 17 (range 12-40)

Predominantly male - 90%

Mainly team field/court sports

When? During or immediately after intense physical exertion or at night

Frustratingly cardiovascular disease is usually unsuspected during life in these individuals and is rarely identified by pre-participation screening (and this screening is rarely done!)

The most common causes are HCM 36%, anomolous cardiac arteries 23%, idiopathic LVH 9%.

Less common are ruptured AA, myocarditis,aortic stenosis, CAD, arrythmogenic RV dysplasia.

Sould we have pre-participation screening? The task force on SCD says YES. Anyone 14 or over joining a club should be given a questionaire. If this is positive they should be referred to a GP. GP assessment - if positive family history of SCD, cardiac symptoms or an abnormal exam refer to a cardiologist.

Sensible Questions - Any family history of premature (<45) cardiac death? Any family history of unusual cardiac diagnosis? Any family history of cardiac arrythmias?Any personal history of a murmur? Any history of a blackout? Did you ever experience unexpected, excessive or unexplained breathlessness or weakness?

Sensible Exam - Assessment of body habitus (Marfans), Assessment of pulses (both radial, femoral), BP, Auscultation

Consider - ECG,Echo, Cardiology referral

Different populations have different causes of SCD

We are not even close to effective screening

SCD in the young is shocking and unnatural to us all

Infection Control in Primary Care

Infection control in Primary Care

Function of the infection Control Nurse - prompt identification of potential infecion hazards; compiling records of infected patients; arranging prompt isolation of infected patients; regular audits to ensure infection control procedures are being adhered to; increasing awareness of infection control issues and motivating staff to improve practice.

Universal Precautions and Standard Precautions

Healthcare workers should condsider all patients as potentially infected with HIV or other blood bourne pathogens and to adhere rigorously to infection control precautions for minimising the risk of exposure to blood and body fluids of all patients.

Standard Precautions - Main componants - Protective clothing(latex gloves, aprons, facemasks, goggles) ; Hand Washing; Sharps Awareness; Decomtamination of body fluids; Immunisation programmes.

Glove Wearing - when? If any direct contact with blood or body fluids/mucous membranes/non-intact skin is anticipated; Handling or touching potentially contaminated patient care equipment

Gloves offer a false sense of security - glove perforation rates are documented as high as 37.5%

Transmission of SARS in A+E by patients and families highlights the need for vigilence and prompt infection control measures at the first point of patient contact i.e reception, triage areas, doctors office

Hand hygiene includes both hand washing with either plain or antiseptic soap and water and use of alcohol based products(gels, rinces, foams)

In the absence of visible soiling of the hands, alcohol based products for hand disinfection are preferred over soap and water because of their superior microbial activity.

Reasons why people don't wash their hands - Time; Effects of agents on skin; Lack of facilities;Lack of motivation

Wearing of hand jewellery, rings and wrist watches are associated with increased carriage of transient micro-organisms increasing potential for cross infection. Only a smooth wedding back to be worn

Air dryers are not ideal - quality disposable hand towels. Hand hygiene products shouild be wall mounted, closed containers and should never be topped up.

Environmental Hygiene - Work surfaces should be cleaned and dried before and after each session with warm water and ph neutral detergent

MRSA - no special precautions beyond standard precautions are necessary for care of people with MRSA. Patients who are found to be carrying MRSA should be informed and provided with information. Must have 3 consecutive negative screens post treatment before being deemed negative.

SRSV aka Winter Vomiting Bug - spread is person to person, infected food handlers, contaminated fruit, may survive on carpets and curtains for days. It is the most common cause of gastroenteritis outbreaks in hospitals, schools etc. Outbreaks affect both patients and staff, attack rates in excess of 50%. Precautions/management - contact precautions and facemasks; monitor staff - symptomatic staff off work until 48-72 hours asymptomatic. Environmental cleaning (carpets/curtains), hand hygiene, microbiology.

ISHA Conference and AGM 2008 images

Dr Michael Byrne and Mr Con O Brien

Assessing Student Fitness : A UK Perspective

Assessing Student Fitness : A UK Perspective

Assessing Fitness to study (current ability); Fitness to continue (recovery of ability) and Fitness to Practice (future ability)

Concerns - Competence - skills; judgement; communication. Safety - infection; incapacity; dangerousness

Why Screen?

Regulatory Pressure - Only those who are fit to become doctors (should be) allowed to enter medical school - General Medical Council

Sector Guidance - Schools must evaluate circumstances which will preclude being able to practice as a doctor

School concern - disability support, minimising drop-out. Occupational Health interest - infection control, vaccination programmes

Entry Screening of all Imperial Medical Students

-All successful applicants are screened ~650/year. ~50 require further enquiry. 4-5 are seen for clinical assessment. There have been 7 deferrals in the past 10 years (all due to mental health issues) and 1 rejection (Hepatitis B)

5 Year Retrospective Study of 31 UK medical schools - showed no correlation between rates for deferrals/rejection due to screening and school drop out rates. Mental Health is the most common cause of health related drop out and 90% of problems only develop after entry. Overall there are low numbers of disabled applicants and students.

Conclusions

FtP issues occur but are very rare in applicants; Temporarily disabiling illness is more common; Health clearance can deter and discriminate; clinical competancy is best assessed on the course.

IHSA Conference and AGM 2008 images

Mr Con O Brien, Dr Paddy Ryan, Dr Michael Byrne, Prof Colin Bradley, Dr Brendan Clune

ISHA Conference Art Competition

Dr Michael Byrne with the 4 winners of the Student Art Competition

Attached Documents

DOC icon OAR (25 kB)
PPT icon Malaria Maps (978 kB)