Advanced precautions for today’s O.R.

preface. Perhaps NAF chose to keep a low profile, but it seems curious then that its logo is prominently displayed. In any event, NAF’s support adds to the text’s authority on this topic. In summary, this excellent text promises to become an essential reference as well as the primary teaching guide on abortion for all professionals who incorporate these procedures in their practice and strive to provide optimal women’s reproductive health care. Advanced Precautions for Today’s O.R. The Operating Room Professional’s Handbook for the Prevention of Sharps Injuries and Bloodborne Exposures. By Mark S. Davis. Atlanta, GA: Sweinbinder Publications, 1999. 158 pages, $14.95, paperback. Reviewed by: Emalie Gibbons-Baker, CNM, Bronx Lebanon Hospital Center, Bronx, New York. Although this book is primarily written for operating room (OR) professionals, its scope encompasses the expanding practice of midwifery that now includes first assist for cesarean sections. The author logically addresses protective measures that the practitioner can take to avoid unnecessary injury in the OR setting. Appendixes provide the most current recommendations for managing occupational exposures and include a summary of the Occupational Safety and Health Administration (OSHA) regulations relevant to surgical procedures, as well as a detailed safety checklist intended for daily use. The chapter on obstetrical procedures carefully looks at vaginal deliveries, fetal scalp electrode application, laceration and episiotomy repair, cesarean section, umbilical cord blood samples, and newborn circumcision with suggestions on how to decrease exposure risks. The use of personal protective equipment and optimal placement of sharps disposal containers are discussed. The authors wisely suggests that a copy of this book be kept readily accessible for reference. Mark Davis, MD, describes his first-hand experience with a sharp instrument injury. In the late 1980s, he was severely cut in the OR, right around the time that the medical community was becoming aware of the magnitude of the silently spreading HIV/AIDS epidemic. His book is a self-professed plea for all OR workers to adopt safer methods in the surgical environment. Davis points out that administrators have become custodians of the well-being of an extended group of people beyond the client, as they are responsible for the choices of safer devices and stricter hospital protocols. The author describes how the epidemic spread of HIV and hepatitis C in the 1990s has created a new era in surgical infection control, requiring the protection of both clients and care providers. By the end of 1997, an estimated 30 million people worldwide were infected with HIV alone, and a substantial number of these

individuals are unaware of their condition. Advanced Precautions for Today’s O.R. addresses the very real fear faced by healthcare workers today that they are at risk for becoming infected with a bloodborne disease via an accidental needlestick or other sharps injury. The author states that millions of blood and body fluid exposures occur annually, at a cost of $500 per incident, not to mention the incalculable personal hardships. The author’s simple approach, in which he identifies dangerous and safe ways to function in the operating room, encompasses practices that have been available for years but have been either underutilized or ignored. These practices pertain to delivery procedures as well. By simply using blunt-tipped suture needles for surgical repairs and using greater caution, he explains how safety in the OR birthing room can be increased dramatically for clients as well as the practitioner and assistants. His suggestions can be easily carried out in the out-ofhospital birth setting also. Based on his own observations, as well as information gathered from the current literature and discussions with respected surgical colleagues, Davis describes approaches that have been extremely helpful in increasing safety. Issues of inertia, denial, and cost containment within institutions are also addressed. The author is optimistic that these problems can be overcome by sufficient teamwork and staff education. This book not only makes a compelling argument for taking exposure prevention to a higher level, it also details how to do it. Midwives’ lives are dedicated to the health care of women. They continually seek knowledge and skills to enhance and define their practice. Many midwifery practitioners walk a fine line between being hands on with women during labor and birth and complying with OSHA guidelines. This is a book that delineates thoughtful and well-researched ways to protect medical professionals who dedicate their lives to others. This reviewer recommends Mark Davis’ book to her colleagues in practice. Breath of Life: Parts 1 & 2. VHS tape, color, 40 minutes, 1992. Produced by Eve Muir for Chip Taylor Communications, 15 Spollett Drive, Deny, New Hampshire, 03038-5728. (800) 876-CHIP. Fax: (603) 4322723. $29.95 (for personal use) plus $5 for shipping and handling. Reviewed by: Polly Ann Bennett, CNM, MS, NurseMidwifery Service of St. Bernard Hospital, Chicago, Illinois. Breath of Life: Parts 1 & 2 is a video designed to show prospective parents and others what to expect during a home birth. The packaging identifies the intended audience as those high school age or older. It begins with an exercise class of women in late pregnancy and later focuses on the home birth experience of two couples.

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