FLUID POWER SAFETY INSTITUTE™ - Director's Reports - High-Pressure Injection Injuries

Everything You AND Your Company Need To Know About Effectively Managing Oil Injection Injuries!

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Hydraulic Safety Videos and CD's
by Rory S. McLaren

Introduction -
For many years, I have traveled around the country talking to people about hydraulic safety. So many of you have asked me to make my safety topics available in video and/or CD format.

The Fluid Power Safety Institute is planning to develop the first in a series of safety videos and CD’s aimed specifically at preventing accidents associated with hydraulic systems.

Our first planned masterpiece, titled “The Lethal Strike,” will cover everything people need to know about preventing debilitating, high-pressure injection injuries.

High Pressure Injection Injuries -
While all evidence indicates that high-pressure injection injuries are few and far between, there is certainly no reason to believe that the evidence accurately reflects the situation.

According to an extensive study conducted by the FPSI, over 99% of the people who service, repair, and troubleshoot hydraulic systems have been subjected to the exact dynamics that trigger a high-pressure injection injury.

However, the “liquid bullet” either missed or deflected off its target.

In other words, if “hydraulics” was a recognized occupational hazard, and thus fell into a category for near miss reporting, the statistics on high-pressure injection injuries might differ substantially from current data.

In short, with respect to hydraulic “accidents,” if a person does not suffer a lost-time injury, that person simply did not have an accident!

Ignorance and Oversight – the Ingredients for a High-Pressure Injection Injury -
The potential for high-pressure injection injuries to occur is elevated due to two factors:

The vast majority of people who work on and around hydraulic systems are not properly trained in hydraulics to avoid the hazard.
Less than 1% of hydraulic systems can be safely de-energized after lockout, which leaves people susceptible to injection injuries while performing minor service and repair tasks.

To add insult to injury, even if a manufacturer claims that a system is “self de-energizing,” de-energization on over 99% of those systems is not independently verifiable.

A Perspective on High-Pressure Injection Injuries -
It is reported that 1 in 600 injuries treated in emergency facilities is caused by high-pressure injection. Granted, they are not all associated with hydraulic systems.

In one study of 25 patients that were injected, 8 were injected with hydraulic fluid, and 5 were injected with grease. The other commonly injected materials are paint and paint thinners.

In a separate 10-year review of high-pressure injection injuries to the hand, which studied 28 cases, 17 of the victims were injected with hydraulic fluid.

However, every person who works on and around hydraulic systems or operates a grease gun is susceptible to this type of injury. Accordingly, they should be acutely aware of the physics associated with hydraulics so they know what set of conditions must exist for this type of injury to occur.

It is important to avoid an injection injury. However, it is equally as important to know precisely what to do if one gets injected.

Most doctors agree that high-pressure injection injuries should be considered a potential surgical emergency.

The reason why a person may overlook the gravity of this type of injury is that, due to the innocuous appearance of the wound, it may hide the severity of the injury.

Management of a High-Pressure Injection Injury -
This is a picture (illustration 1) of an injection injury. As you can see, it has the appearance of a minor superficial wound, and that’s why its severity is oftentimes undermined.

Illustration 1

According to most doctors, surgical exploration should be the benchmark of management for an injection injury.

Usually, a hand-surgeon will plan surgical incisions (illustration 2) that will allow proximal (situated toward the point of origin or attachment of the bone), and distal (situated away from the point of origin or attachment of the bone) exploration.

Illustration 2

The entry wound should be excised (illustration 3) and all areas permeated by the injected materials must be exposed to decompress the affected tissue and perform extensive exploration.

Illustration 3

Don’t Overlook the Collateral Hazards Associated with Oil Escaping to Atmosphere -
Oil escaping to atmosphere presents a considerable burning hazard. In addition, it can cause severe eye injury or total eye loss.

Prevention of High-Pressure Injection Injuries – Our First Priority -
The following key factors prompted the FPSI to make the prevention of high-pressure injection injuries our first priority:

Susceptibility of hydraulic maintenance personnel to this type of injury,
The gravity of the injury.
Ignorance associated with this type of injury.

"The Lethal Strike!" - AVAILABLE NOW!
“The Lethal Strike!” covers the following topics:

	The Hand – an extraordinary machine.
	What is an injection injury?
	Basic hydraulics principles and laws that apply to the physics associated with an injection injury.
	Injection injury risk factors.
	How to avoid injection injuries.
	Burn injuries.
	How to prepare for an emergency: The role of the supervisor. The role of the safety personnel. Is your local clinic or hospital prepared for this type of injury?
	You have been injected: The role of the victim. The role of the supervisor. The role of the safety personnel. The role of the physician.

Training Methodology -
The most powerful tool for preventing accidents is clear, straightforward, and concise communication which is presented at a level that everyone can understand. It must also be delivered in a time efficient manner.

The important message that the CD is designed to convey is presented in a manner that makes it ideal for a short, highly effective, pre-work safety topic.

We also understand that the information flow must be properly directed. For example, the supervisor must understand the subject matter at the same level that the maintenance person does. However, the maintenance person does not necessarily need to know the supervisor’s role in handling an emergency situation.

Accordingly, our CD’s are designed to provide a common insight for everyone regarding the subject matter. However, the roles of the individual departments in handling an emergency situation are divided into individual training elements.

The FPSI believes that it is critical for students to understand the information presented in a safety presentation. In addition, it is important for a company to have a record of the safety training each person receives.

There will be a downloadable test included with the CD. The test will be simple and straightforward using the multiple-choice answer approach.

Your comments are welcome.