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Arm Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Arm and links to relevant pages within the course.

Learn more about laboratory continuing education for medical technologists to earn CE credit for AMT, ASCP, NCA, and state license renewal and recertification. Or get information about laboratory safety and compliance courses that deliver cost-effective OSHA safety training and continuing education to your laboratory's employees.

Laboratories Individuals

First Aid
How to Perform the Heimlich Maneuver

Stand behind the victim, and wrap your arms around her waist. Grasp your fist with your other hand.Make a fist with one of your hands, and place the thumb side of your fist against the middle of the victim's abdomen, slightly above the navel and well below ribs and breastbone.Grab your fist with your other hand.Press your fist into the victim's abdomen with a quick upward thrust and repeat until the obstructing object is dislodged.

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Introduction to Bioterrorism
The early symptoms of anthrax include:View Page
Agent: Botulism (bacterium)

Most likely means of dissemination: Aerosol (eating contaminated food)Primary route of entry: Inhalation (oral)General signs and symptoms: Difficulty with speaking, swallowing, or blurred or double vision, drooping eyelids (ptosis), dilated pupils, dry mouth, decreased gag reflex, weakening of the reflexes (hyporeflexia), abnormal sensations such as numbness, prickling, tingling, and arm or leg weakness.Botulism is caused by a neurotoxin and technically could be classified as a chemical WMD. For our discussion it is placed under biological agents because the toxin is derived from a bacterium. Botulism is potentially life-threatening, producing a characteristic clinical picture of muscular paralysis leading to respiratory failure.                Photo courtesy of the CDC archives.    

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Laboratory Ergonomics
Ergonomic Guidelines for Computer Users

A. Computer monitors should be approximately 18" - 24" away from the eyes. The top of the monitor is best set at eye level so that the eyes gravitate toward the center of the screen. B. Try to avoid glare from the light. C. Computer monitors should be set directly in front of the user D. Keep forearms 90° from your spine and keep elbows in close to the body. E. If seated, thighs should be parallel to the floor and about a 90° angle with the calves. F. Use an adjustable chair, preferably with padded arms. Adjust the chair or work surface (if possible) to the correct position. Avoid leaning forward or to the side. Do not lean on work surfaces. Do not lean on elbows or armrests. Keep neck and shoulders in a relaxed position.G. Place keyboard in a comfortable position (preferably on an adjustable keyboard tray) and use a wrist/palm rest. H. Place feet flat on the floor or on a footrest and do not crowd the legs or body into a cramped or cluttered work space. Use a document holder to keep working documents at eye level with the screen. To avoid eyestrain, follow the 20/20/20 rule. Every 20 minutes, take a 20 second break to focus on a spot 20 feet away.

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Body Position

Take frequent posture breaks; if standing, sit periodically. If sitting, stand about every 20 minutes and walk around. Shoulders and Arms Keep the shoulders relaxed, not shrugged-up or slumped-down. Keep your elbows close to your body Keep work at elbow height and directly in front of you as shown in the image below. Head and Neck Avoid situations that require prolonged or repetitive twisting, forward-bending, or backward-bending of the neck.Hands and Wrists Keep the hand in line with the forearm. Avoid repetitive twisting of the wrists. Avoid working with wrists pressed against hard surfaces or edges as shown in the image below. Feet and Legs Place a foot on a footrest for comfort Provide a toe space to allow work closer to counters and reduce reaching. Use mats on hard floors to reduce fatigue as shown in the image below.Back Stand straight. Avoid situations that require bending forward, backward, leaning side-to-side, or twisting. Use a stool to provide an occasional change in posture. If working seated, use a back rest/support to maintain proper posture. The chair that is shown in the image below offers neck, back, and lumbar support.

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Repetitive Motion Injuries

Repetitive motions can cause a variety of disorders that affect nerves, tendons, and muscles. Symptoms can include tingling or numbness in the fingers or hands, decreased range of motion, decreased grip strength, sleep interupted by numbness or discomfort in the hands, pain in fingers, hands, or wrist, or pain shooting up into the forearms or arms.Some common afflictions that could affect laboratory workers due to the nature of their jobs are listed in the table below. Condition Symptoms Cause Carpal tunnel syndrome Pain that radiates up the arm, numbness or tingling in the thumb, index, or middle finger and weakness in the wrist and hand Compression of the median nerve that runs from the forearm into the hand Thoracic outlet syndrome Numbness and tingling in the hand, intensified with overhead activities Compression of the nerves and blood vessels between the neck and shoulder Radial tunnel syndrome Elbow pain, pain near the base of thumb, or pain anywhere in between. A common symptom is wrist weakness. Compression or entrapment of the radial nerve; may be caused by repetitive wrist and finger extension or repetitive forearm turning. Tendinitis Stiffness, tightness, and burning sensation; may experience a deep nonspecific pain. Grip impairment. Occurs most often in the tendons of the fingers, thumb, forearm, elbow, and shoulder. Repetitive motions or maintaining an awkward position that stresses tendons beyond their strength. Friction from overuse can cause inflammation. Tenosynovitis Pain, swelling, difficulty moving the joint in the affected area Inflammation of the tendon sheath

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Which of the following is a symptom of a repetitive motion injury?View Page

Medical Error Prevention
Direct Error Detection Even perfect systems designs cannot avert human limitations. Medical errors occur and they have to be detected before they can be resolved. Sometimes people directly observe and immediately report these mistakes.View Page

Phlebotomy
Discussion

A phlebotomist should never use an arm with restricted usage for the venipuncture. Even if no sign is posted, the patient may tell you not to use a particular arm for various reasons, i.e. previous mastectomy, history of phlebitis, active AV fistula, etc. Do not draw blood above an IV line. If blood is taken from a vein above an IV line it might be diluted by the IV fluid, which could cause incorrect test results. In this case, Bobby should choose a vein on the dorsum of Mrs. Grayson’s hand, below the IV. A butterfly needle would facilitate drawing blood from these small hand veins.Relevant topics:Alternate sites, Sites to avoid, Signs, Arms to avoid

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Sites to avoid

Avoid the following sites:Scarred, abraded, or inflamed skin.Arms containing IV catheters.Edematous armsArms with casts.

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Arms to avoid

In general, do not collect blood from:Arms on the same side as a previous mastectomy.Arms with phlebitis or infection.Arms with a vascular shunt.

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Blood should not be drawn from arms with IVs

Blood drawn from veins with intravenous lines (IVs) may be diluted by the IV fluids. Arms containing IVs should therefore not be used to draw blood specimens.  If an arm with an IV line in place must be used for venipuncture, be sure to choose a site below the location of the IV, so that the specimen will not be diluted with IV fluids.

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