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Promoting Practitioner Wellness in the Neurotology Clinic -- An Ergonomic Assessment of the Dix-Hallpike's Test.
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  • Sanjay Nair,
  • Tareq Ammari,
  • Rohit Gohil,
  • Alex Bennett
Sanjay Nair
The University of Edinburgh College of Medicine and Veterinary Medicine

Corresponding Author:[email protected]

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Tareq Ammari
Stoke Mandeville Hospital
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Rohit Gohil
Royal Hampshire County Hospital
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Alex Bennett
NHS Lothian
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Abstract

Objectives: Numerous tasks carried out in the otolaryngology clinic increase the chances of developing injury among practitioners. To mitigate this, we aim to observe the risk of musculoskeletal injury in practitioners when carrying out common procedures. We observe the performance of the Dix-Hallpike manoeuvre, deducing whether technique has an impact on the likelihood of developing injury. Design: Participants were asked to perform the Dix-Hallpike manoeuvre as they normally would in clinic, on departmental colleagues. Data that was collected included chosen preference of position when carrying out manoeuvre, level of seniority of practitioner and risk of musculoskeletal injury to practitioner. Setting: Simulated outpatient department; St John’s Hospital, Edinburgh. Participants: Otolaryngology consultants and trainees with clinic commitments, having regularly performed the Dix-Hallpike manoeuvre. Main outcome measures: Risk of musculoskeletal injury was measured using the validated Rapid Upper Limb Assessment (RULA) tool. Results: 3 consultants and 7 trainees were included in this study performing on average 4 Dix-Hallpike’s during the study period – totalling 40 attempts. The median RULA score was 4 for the sitting position, compared to 6 for standing (p<0.0001). There was similar statistical significance when consultants and trainees were evaluated separately. Conclusions: A doctor’s wellness is of great importance to facilitate long-term job satisfaction and productivity. It is important to improve conditions for the practitioner in the otology clinic, and one factor is procedural technique. Further work is needed to raise ergonomic awareness amongst otolaryngology surgeons.