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[Viral hepatitis. Occupational hazard for anaesthesists (author's transl)].

Hepatitis has been recognized as an occupational hazard of health professionals for many years. The recent findings concerning the structure of hepatitis A, B, non-A non-B, as well as refined testing procedures have increased the ability and thus the frequency of its diagnosis in occupationally exposed medical personnel. Other viruses such as Epstein Barr virus (EBV) and cytomegalovirus (CMV) can also be involved. Among the inferences to be drawn from recent research is that hepatitis B virus has been detected in virtually all body secretions, and several non-percutaneous modes of transmission have been implicated. Other than overt percutaneous inoculation with HBsAg contaminated needle or scalpel, many other possibilities for infection exist for anesthesiologists as demonstrated by the increased incidence of HbsASb in this population and operating room staff frequently exposed to blood and body fluids. Among the preventive measures in the O. R., the anesthesiologist should be aware and attempt to diagnose firstly the population at risk as chronic carriers, and use specific preventive measures when caring for such patients so as to minimize cross-infections (from the patient to the anesthesiologist) and from one patient to the other.

Anesthesiology↗

Competency based training.

The Level 3 Operating Department Practice Award within Health Care, which is a National Vocational Qualification (NVQ), has been available since 1991. It is open to all personnel who wish to practise as the equivalent of assistants to the anaesthetist and/or surgeon or who wish to work in the recovery area. It has replaced the City and Guilds of London Institute (CGLI) 752 qualification but in no way disadvantages those who already hold the latter qualification or ENB theatre certificates. The NVQ involves competence based training because the greater emphasis is placed on the practical skills of the student. As the standards are demanding this means that holders of the NVQ are well able to complete and perform all the tasks necessary to be effective in their jobs and, in addition, have the necessary background knowledge and understanding to produce a safe practitioner. Since the introduction of the ODP/NVQ, theatre managers and their staff have been able to observe its progress, some with interest and, regrettably, some with cynicism.

Clinical Competence↗