WorkSafeBC recently introduced regulations that “safety engineered scalpels” have to replace conventional scalpels—though there is no evidence that they reduce injuries. This regulation was recently implemented across the Interior Health Authority and will soon be coming to the other health authorities.
Contrary to their name, these devices are actually more dangerous. First, the protective plastic sheath is very difficult to manipulate back and forth, especially with greasy gloves on, risking injury to physicians and nurses. Second, the sheath has to be advanced and retracted multiple times during an operation, distracting the surgeon from the patient’s operation. Last, and most importantly, visualization of the blade is unacceptably obscured by the plastic sheath. This is illustrated in the accompanying pictures. The picture on the left is the visualization of the carpal ligament with a standard scalpel; and on the right with the so-called safety scalpel. Both scalpels are placed with the blade at the same level on the tissue and at the same angle of inclination.
WorkSafeBC has indicated that these scalpels do not have to be used if they are deemed “not clinically appropriate.” These will soon be coming to your health authority. For the sake of your patients and colleagues, be sure to be proactive in the process of establishing “clinical appropriateness” (or lack thereof) of these dangerous devices.
—Hamish Hwang, MD
Vernon Jubilee Hospital, Deputy Chief of Surgery
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
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For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org