Acupuncture in Mtl, Qc

[Guest cutieyellow]

I thought this was definitely interesting:

 

sympatico.ctv.ca/servlet/...topstories

 

 

 

Que. alerts acupuncture clients of HIV risk

 

CTV.ca News Staff

 

The Quebec government is asking 1,144 people to undergo tests for HIV and hepatitis after discovering that a Montreal-area acupuncture clinic was illegally reusing needles.

 

Health officials told a news conference Monday that the risk of infection is "virtually nil."

 

"The risks of infection from HIV or the hepatitis B and C viruses during acupuncture treatments are minimal, virtually nil. But we can't say they don't exist,'' said Dr. John Carsley, head of the infectious diseases unit with the Montreal public health department.

 

"In this case, we can't be sure that minimal measures of prevention were adequately followed.''

 

Carsley said he's worked in public health for 25 years and has never come across a case of infectious disease cause by acupuncture.

 

The patients being contacted attended a clinic run by Suzanne Sicotte, between 1979 and last January. Sicotte was not a member of the professional order that represents acupuncturists in Quebec. She was an osteopath by training and illegally offered acupuncture to some clients.

 

She has been fined $7,000 and is no longer practising.

 

Raymond Bourret, head of Quebec's professional order for acupuncturists, said Sicotte practised illegally for 25 years without being detected because she didn't place any ads. As well, no one launched a complaint about the clinic until recently.

 

Carsley says Sicotte disinfected needles after use, but only by dipping them into a chemical solution. The method is not sufficiently effective, he said.

 

"There's a certain effectiveness to kill viruses, but it's not acceptable,'' he said of the practice.

 

Needles for acupuncture treatment can be used only once, under regulations established in April, 2003. Previously, needles had to be sterilized with heat before they could be reused.

 

Under the same regulations, only those who are members of the province's professional order can perform acupuncture.

 

Letters are being sent to 1,071 people, most of them in the Montreal area. Authorities are seeking addresses for 73 other people.

 

Marc Plamondon, Sicotte's lawyer, said in a statement that Sicotte had always practised with the best of intentions and is sorry for the worry she's caused.

 

"In the circumstances, our client regrets the inconvenience suffered by her clients as they verify the state of their health," Plamondon said, noting Sicotte's mission was to promote "prevention and well-being in a global approach to health care."

 

This is the second patient recall in the Montreal area this year over the risk of HIV infection.

 

In January, the Ste-Justine Children's Hospital asked 2,614 patients to be tested for the virus after learning that an HIV-infected surgeon performed operations on thousands of children at the hospital between 1990 and 2003.

 

The doctor involved, Maria Di Lorenzo, 48, died last year. The hospital's administration wasn't aware the doctor was HIV-positive until January, although her supervisor and a committee of doctors knew in 1991.

 

About 2,240 of Di Lorenzo's patients had been tested for HIV as of early February, a hospital spokeswoman said Monday. She would not say if any had tested positive.

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<title>"Fellowship training, workload, fatigue...a study"</title>

<pagetext>Here's an interesting article published in today's CMAJ. It's a small prospective study regarding the workload of critical care fellows at Toronto's Hospital for Sick Children. A fellow is a physician who has completed a residency, and is seeking further subspecialization within that field. Critical care physicians, also known as intensivists, are those physicians in charge of running the Intensive Care Units, aka the ICU.

 

Not surprisingly, the work is both difficult and intense, as these are literally the sickest patients in the hospital, who require constant monitoring and receive 1 to 1 nursing care.

 

Anyway, to summarize, during this 6 month study, the fellows at Sick Kids worked an average of 25.5 hours per shift (and slept 1.9 hours in that time, with a further 1.2 hours worth of break-time), and worked an average of 70 hours per week.

 

The full article can be found on the CMAJ website. I have quoted the abstract below.

 

Ian

 

Fellowship training, workload, fatigue and physical stress: a prospective observational study. Christopher S. Parshuram, Sonny Dhanani, Joel A. Kirsh and Peter N. Cox. CMAJ • March 16, 2004; 170(6):965-970.

 

www.cmaj.ca/cgi/content/full/170/6/965

 

Abstract:

 

Background: Fatigue in physician trainees may compromise patient safety and the well-being of the trainees and limit the educational opportunities provided by training programs. Anecdotal evidence suggests that the on-call workload and physical demands experienced by trainees are significant despite duty-hour regulation and support from nursing staff, other trainees and staff physicians.

 

Methods: We measured the workload and the level of fatigue and physical stress of 11 senior fellows during 35 shifts in the critical care unit at the Hospital for Sick Children in Toronto. We determined number of rostered hours, number of admissions and discharges, number and type of procedures, nurse:patient ratios and related measures of workload. Fellows self-reported the number of pages they received and the amount of time they slept. We estimated physical stress by using a commercially available pedometer to measure the distance walked, by using ambulatory electrocardiographic monitoring to determine arrhythmias and by determining urine specific gravity and ketone levels to estimate hydration.

 

Results: The number of rostered hours were within current Ontario guidelines. The mean shift duration was 25.5 hours (range 24–27 hours). The fellows worked on average 69 hours (range 55–106) per week. On average during a shift, the fellows received 41 pages, were on non-sleeping breaks for 1.2 hours, slept 1.9 hours and walked 6.3 km. Ketonuria was found in participants in 7 (21%) of the 33 shifts during which it was measured. Arrhythmia (1 atrial, 1 ventricular) or heart rate abnormalities occurred in all 6 participants. These fellows were the most senior in-house physician for a mean of 9.4 hours per shift and were responsible for performing invasive procedures in two-thirds of their shifts.

 

Interpretation: Established Canadian and proposed American guidelines expose trainees to significant on-call workload, physical stress and sleep deprivation.

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