Zusammenfassung
Daten über Häufigkeit, Ursachen und Folgen unerwünschter Ereignisse in der Physiotherapie liegen nicht vor. Eine Literaturrecherche im Hinblick auf Risiken in der Elektrotherapie zeigt, dass tatsächlich bei vielen Anwendungen ernste Schädigungen an Patienten auftreten können, siehe dazu die Anmerkungen zu Risiken und Nebenwirkungen bei den verschiedenen Anwendungen. Es handelt sich bei den wenigen Publikationen vor allem um Fallbeschreibungen, wobei die Ursachen und Folgen der Schädigungen lediglich in zwei Fällen weiter analysiert wurden (Frye JL, Johns LD, Tom JA, Ingersoll CD (2007) Blisters on the anterior shin in 3 research subjects after a 1-MHz, 1.5W/cm2, continuous ultrasound treatment: a case series. J Athl Train 42(3):425–430; Ruggera PS, Witters DM, von Maltzahn G, Bassen HI (2003) In vitro assessment of tissue heating near metallic medical implants by exposure to pulsed radio frequency diathermy. Phys Med Biol 48:2919–2928). Die im Nachfolgenden geschilderte Lage zeigt die Notwendigkeit der Einführung eines Risikomanagements in der Physiotherapie. Dies kann in einem Krankenhaus oder in einer Praxis ohne großen Aufwand mit wenigen Personen unter der Führung eines dazu ausgebildeten Kollegen in relativ kurzer Zeit geschehen. Man kann die Ergebnisse einer solchen Arbeit in einer Fachzeitschrift publizieren und damit Kollegen die Ziele und die Hintergründe eines Risikomanagements näherbringen. Darüber hinaus soll die Demonstration der Machbarkeit eines solchen Projektes Therapeuten dazu anregen, sich näher mit den Risiken unseres Berufes auseinanderzusetzen.
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Literatur
Andersen BM, Lindemann R, Bergh K, Nesheim BI, Syversen G, Solheim N, Laugerud F (2002) Spread of methicillin-resistant Staphylococcus aureus in a neonatal intensive unit associated with understaffing, overcrowding and mixing of patients. J Hosp Infect 50(1):18–24
Artho PA, Thyne JG, Warring BP, Willis CD, Brismée LNS (2002) A calibration study of therapeutic ultrasound units. Phys Ther 82:257–263
Atkins T, Duck F (2003) Heating caused by selected Doppler and physiotherapy ultrasound beams measured using thermal test objects. Eur J Ultrasound 16:243–252
Barkana Y, Belkin M (2000) Laser eye injuries. Surv Ophtalmol 44:459–478
Broex EC, van Asselt AD, Bruggeman CA, van Tiel FH (2009) Surgical site infections: how high are the costs? J Hosp Infect 72(3):193–201
Carlsson T, Andrell P, Ekre O, Edvardsson N, Holmgren C, Jacobsson F, Mannheimer C (2009) Interference of transcutaneous nerve stimulation with permanent ventricular stimulation: a new clinical problem? Europace 11:364–369
Carlton G, Blegen MA (2006) Medication-related errors: a literature review of incidence and antecedents. Annu Rev Nurs Res 24:19–38
Carpenter RL, Van Ummersen CA (1968) The action of microwave radiation on the eye. J Microw Power 3(1):3–19
Castelain PY, Chabeau G (1986) Contact dermatitis after transcutaneous electric analgesia. Contact Dermatitis 15:32–35
Clarke SP, Sloane DM, Aiken LH (2002) Effects of hospital staffing and organizational climate on needlestick injuries to nurses. Am J Public Health 92(7):1115–1119
Corazza M, Maranini C, Bacilieri S, Virgili A (1999) Accelerated allergic contact dermatitis to a transcutaneous electrical nerve stimulation device. Dermatology 199:281
Crevenna R, Quittan M, Wiesinger GF, Nuhr MJ, Nicolakis P, Pacher R, Fialka-Moser V (2001) Elektrostimulationstherapie bei Patienten mit Herzschrittmachern. Phys Med Rehab Kuror 11:159–164
Crevenna R, Stix G, Pleiner J, Pezawas T, Schmidinger H, Quittan M, Wolzt M (2003) Electromagnetic interference by transcutaneous neuromuscular electrical stimulation in patients with bipolar-sensing implantable cardioverter defibrillators. Pace 26:626–629
Crowcroft N, Maguire H, Fleming M, Peacock J, Thomas J (1996) Methicillin-resistent Staphylococcus aureus: investigation of a hospital outbreak using a case-controll study. J Hosp Infect 34:301–309
Cutz A (1989) Effects of microwave radiation on the eye: the occupational health perspective. Lens Eye Toxic Res 6(1–2):379–386
Daniel DM, Rupert RL (2003) Calibration and electrical safety status of therapeutic ultrasound used by chiropractic physicians. J Manipulative Physiol Ther 26(3):171–175
Doyle JR, Smart BW (1963) Stimulation of bone growth by short-wave diathermy. J Bone Joint Surg Am 45:15–24
Draper DO (2011) Injuries restored to ROM using PSWD and mobilizations. Int J Sports Med 32(4):281–286
Draper DO, Castel CJ, Castel D (2004a) Low-watt pulsed shortwave diathermy and metal-plate fixation of the elbow. Athl Ther Today 9(5):28–32
Draper DO, Castro JL, Feland B, Schulthies S, Eggett D (2004b) Shortwave diathermy and prolonged stretching increase hamstring flexibility more than prolonged stretching alone. J Orthop Sports Phys Ther 34(1):13–20
Dwyer CM, Chapman RS, Forsyth A (1994) Allergic contact dermatitis from TENS gel. Contact Dermatitis 30:305
Ford KS, Shrader MW, Smith J, Mclean TJ, Dahm DL (2005) Full-thickness burn formation after the use of electrical stimulation for rehabilitation of unicompartemental knee arthroplasty. J Arthroplast 20:950–953
Foti C, Cassano N, Conserva A, Vena GA (2004) Allergic contact dermatitis due to diclofenac applied with iontophoresis. Clin Exp Dermatol 29:91
Frye JL, Johns LD, Tom JA, Ingersoll CD (2007) Blisters on the anterior shin in 3 research subjects after a 1-MHz, 1.5W/cm2, continuous ultrasound treatment: a case series. J Athl Train 42(3):425–430
Gaillot O, Maruéjouls C, Abachin E, Lecuru F, Arlet G, Simonet M, Berche P (1998) Nosocomial outbreak of Klebsiella pneumoniae producing SHV-5 extended-spectrum beta-lactamase, originating from a contaminated ultrasonography coupling gel. J Clin Microbiol 36(5):1357–1360
Green T, Pye RJ (1991) Skin reactions to TENS equipment used for pain relief. Br J Dermatol 125(suppl 38):35
Guirro R, Britshcy Dos Santos SC (2002) Evaluation of the acoustic intensity of new ultrasound therapy equipment. Ultrasonics Jun;39(8):553–557
Halwani M, Solaymani-Dodaran M, Grundmann H, Coupland C, Slack R (2006) Cross-transmission of nosocomial pathogens in an adult intensive care unit: incidence and risk factors. J Hosp Infect 63(1):39–46. https://doi.org/10.1016/j.jhin.2005.10.012. Epub 2006 Mar 3
Heick A, Espersen T, Pedersen HL, Raahauge J (1991) Is diathermy safe in women with copper bearing IUDs? Acta Obstet Gynecol Scand 70:153–155
Holcomb WR, Joyce CJ (2003) A comparison of temperature increases produced by 2 commonly used ultrasound units. J Athl Train 38:24–27
Holmgren C, Carlsson T, Mannheimer C, Edvardsson N (2008) Risk of interference from transcutaneous electrical nerve stimulation on the sensing function of implantable defibrillators. Pace 31:151–158
Ketscher KD, Retschke U, Kindt J (1985) Die transkutane elektrische Nervenstimuation zur Behandlung der Plazentainsuffzienz. Methodenprinzip und Gerätekombination. Zbl Gynaekol 107:500–502
Ketscher KD, Retschke U, Kindt J (1987) Die transkutane elektrische Nervenstimuation zur Behandlung der Plazentainsuffzienz. Ergebnisse der Behandlung im Vergleich zu einer speziellen Infusionsbehandlung. Zbl Gynaekol 109:850–853
Lambert I, Tebbs SE, Hill D, Moss HA, Davies AJ, Elliott TSJ (2000) Interferential therapy machines as possible vehicles for cross-infection. J Hosp Infect 44:59–64
Lerman Y, Jacubovich R, Green MS (2001) Pregnancy outcome following exposure to shortwaves among female physiotherapists in Israel. Am J Ind Med 39:499–504
Lyon R, Liu X, Meier J (2003) The effects of therapeutic vs. high-intensity ultrasound on the rabbit growth plate. J Orthop Res 21:865–871
Macchia L, Caiaffa MF, Vacca A (2002) General adverse reaction to aspirin administered by transdermal iontophoresis. Eur J Pharmacol 58:641–642
Mackey AL, Bojsen-Moller J, Qvortrup K, Langberg H, Suetta C, Kalliokoski KK, Kjaer M, Magnusson SP (2008) Evidence of skeletal muscle damage following electrically stimulated isometric muscle contractions in humans. J Appl Physiol 105:1620–1627
Mars Climate Orbiter Mishap Investigation Board Phase I Report. 10.09.1999. ftp://ftp.hg.nasa,gov./pub/pao/reports/1999/MCO report
Mattei E, Censi F, Calcagnini G, Falsaperla R, Genovese E, Napolitano A, Cannatà V (2016) Pacemaker and ICD oversensing induced by movements near the MRI scanner bore. Med Phys 43(12):6621
Medizinprodukte-Betreiberverordnung in der Fassung der Bekanntmachung vom 21. August 2002 (BGBl. I S. 3396), zuletzt geändert durch Artikel 386 der Verordnung vom 31. Oktober 2006 (BGBl. I S. 2407) 27 http://bundesrecht.juris.de/mpbetreibv/BJNR176200998.html
Medizinprodukteverordnung (MepV) Schweiz vom 1. Juli 2020., https://www.fedlex.admin.ch/eli/oc/2020/552/de
Medizinprodukteverordnung Österreich, Fassung vom 19.02.2021, StF: BGBl. II Nr. 129/2003 https://www.ris.bka.gv.at/GeltendeFassung.wxe?Abfrage=Bundesnormen&Gesetzesnummer=20002557
Nielsen NC, Hansen R, Larsen T (1979) Heat induction in copper-bearing IUD’S during short-wave diathermy. Acta Obstet Gynecol Scand 58(5):495
Nutt JG, Anderson VC, Peacock JH, Hammerstad JP, Burchiel KJ (2001) DBS and diathermy interaction induces severe CNS damage. Neurology 56:1384–1386
Occhetta E, Bortnik M, Magnani A, Francalacci G, Marino P (2006) Inappropriate implantable cardioverter-defibrillator discharches unrelated to supraventricular tachyarrhythmias. Europace 8:863–869
Ouellet-Hellstrom T, Stewart WT (1993) Miscarriages among female physical therapists who report using radio- and microwave-frequency electromagnetic radiation. Am J Epidemiol 138:775–786
Paula H (2007) Patientensicherheit und Risikomanagement im P ege- und Krankenhausalltag. Springer Medizin Verlag Heidelberg: ISBN-10 3-540-33726-1
Pyatt JR, Trenbath D, Chester M, Connelly DT (2003) The simultaneous use of a biventricular implantable cardioverter defibrillator (ICD) and transcutaneous electrical nerve stimulation (TENS) unit: implications for device interaction. Europace 5:91–93
Pye S (1996) Ultrasound therapy equipment: does it perform? Physiotherapy 82:39–44
Pye S, Milford C (1994) The performance of ultrasound physiotherapy machines in Lothian Region, Scotland, 1992. Ultrasound Med Biol 4:347–359
Quick-Alert No 5 (2008) Kontaminiertes Ultraschallgel. Stiftung für Patientensicherheit, Schweiz. Zugriff Dezember 2009 https://www.patientensicherheit.ch/publikationen/quick-alert/?tx_news_pi1%5B%40widget_0%5D%5BcurrentPage%5D=3&cHash=a5976491d6b3fb10d930e813b265feb1
Reason JT (1997) Managing the risks of organizational accidents. Ashgate Publishing Limited, Aldershot England ISBN: 978-1-84014-105-4
Reason JT (2008) The human contribution: unsafe acts, accidents, and heroic recoveries. Ash- gate Publishing Limited, Surrey England ISBN: 978-0-7546-7402-3
Roark C, Whicher S, Abosch A (2008) Reversible neurological symptoms caused by diathermy in a patient with deep brain stimulators: case report. Neurosurgery 62:E256
Ruggera PS, Witters DM, von Maltzahn G, Bassen HI (2003) In vitro assessment of tissue heating near metallic medical implants by exposure to pulsed radio frequency diathermy. Phys Med Biol 48:2919–2928
Samuels JM, Overbey DM, Wikiel KJ, Jones TS, Robinson TN, Jones EL (2020) Electromagnetic interference on cardiac pacemakers and implantable cardioverter defibrillators during endoscopy as reported to the US Federal Drug Administration. Surg Endosc. https://doi.org/10.1007/s00464-020-07872-2. Epub ahead of print. PMID: 32804270
Satter E (2008) Third-degree burns incurred as a result of interferential current therapy. Am J Dermatopathol 30:281–283
Schabrun S, Chipchase L, Rickard H (2006) Are therapeutic ultrasound units a potential vector for nosocomial infection? Physiother Res Int 11(2):61–71
Seiger C, Draper DO (2006) Use of pulsed shortwave diathermy and joint mobilization to increase ankle range of motion in the presence of surgical implanted metal: a case series. J Orthop Sports Phys Ther 36(9):669–677
Taskinen H, Kyyrönen P, Hemminki K (1990) Effects of ultrasound, shortwaves, and physical exertion on pregnancy outcome in physiotherapists. J Epidmiol Community Health 44:196–201
Valtonen EJ, Lilius HG, Tiula E (1975) Disturbances in the function of cardiac pacemaker caused by short wave and microwave diathermies and pulsed high frequency current. An Chir Gynaecol Fen 64:284–287
Vlay SC (1998) Electromagnetic interference and ICD discharge related to chiropractic treatment. Pace 21:2009
Weitz SH, Tunick PA, McElhinney L, Mitchell T, Kronzon I (1997) Pseudoatrial flutter: artifact simulating atrial flutter caused by a transcutaneous electrical nerve stimulator (TENS). Pace 20:3010–3011
Zeqiri B (1997) Calibration and safety of physiotherapy ultrasound equipment. Physiotherapy 83:559–560
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van Kerkhof, P. (2022). Risikomanagement. In: Evidenzbasierte Elektrotherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-63536-0_10
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