As long stressful hours, time pressure and self-driven passion add to the risk of injuries of cuts, burns and falls, Dr Vijay Patil highlights on the dos and dont’s while in the kitchen
I will prevent disease whenever I can, for prevention is preferable to cure. (Hippocratic Oath)
A modern kitchen in a good restaurant bustles with passion and creativity on one hand and battles with the dangers of risk of injuries like cuts, burns and falls on the other. Stressful long hours, immense time pressure and self-driven passion only add to the risk. Consequences of injuries can be devastating to the injured and may affect the quality of service and reputation of the business.
Prevention Cuts
One must take utmost care with sharp instruments. Knives must be stored safely in a block to allow easy and safe grip of the handle. The storage must be separate from the utensil drawer. The health and safely executive in the UK highlight some of these recommendations. Knives should be used only for one purpose- ‘To Cut’. Use of dull knives or fresh use of an unaccustomed sharp knife is particularly dangerous as the force required is unpredictable.
Movement of the knives should always be away from the body and the cutting platform should be clean and stable. The use of meshed knife gloves is becoming popular in modern kitchen today. While placing knives in a dishwasher, the pointed end must face downwards and one must never attempt to catch a falling knife.
Fruits like avocado can pose as a serious risk when a chef tries to remove its seed with a knife. The opposite hand is at risk of injury when the knife suddenly penetrates the fruit with a jerk. A small external wound may easily hide a sinister tendons, arteries or nerves injury delaying the need to seek medical attention. Many companies routinely train their employees about the use of knives. Fingers should be kept away from the blades of food processors at all times. Broken glass pieces on the floor should be swept into a dustpan rather than use bare hands and wipe the floor with damp cloth.
Thermal injury
Thermal injuries occur due to scalding liquids, spattering grease, hot utensils, electric connections or malfunctioning appliances. Use of appropriate safety equipments is essential when handling hot surfaces and putting hands in oven. Clearly labelled fire blankets should be available in the kitchen for any fire-related eventualities.
Always turn handle of cookware inwards on the range and open the pan lids away from the body to prevent steam burns. Small appliances must be disconnected when not in use and there must be provision of smoke detectors in the kitchen.
Falls
Liquid fallen on the floor is an accident waiting to happen. Walking surfaces must be clean, dry, well lit and with minimum obstruction. Never store heavy items in higher shelves and when reaching for them, the elevated platform or ladder must be firm and non slippery.
Ergonomics
Efficient and safe interaction between people and things is key towards maintaining safety. Compliance to the safety regulations is not optional anymore and many governments are becoming strict in reviewing standards before awarding certification of quality. Proper safety training of staff must be ensured to minimise accidental injuries.
Treatment
Some accidents are due to ignorance but most are due to carelessness and can be avoidable. When accidents happen, it is important to avoid panic and remain calm. There must be provision of a first aid kit and a qualified first aider with guidelines set for seeking medical advice. With cuts, exact nature and depth of the injury may not be established until seen by a specialist hand surgeon. Similarly, with burns and falls, there should be low threshold in seeking medical help.
In case of cuts, clean the area with running water and apply clean gauze and bandage with moderate compression. Commonly the bleeding is venous and compression and elevation above heart level is all that it takes to control the bleeding. Superficial skin lacerations may need simple surgical suturing. However deeper injuries to nerve, arteries, tendons or joints may require formal exploration and repair. Any delay in seeking advice may compromise long-term function. Return to work after surgery should be guided by the treating surgeon and one must resist the temptation to return early as it may compromise healing process, interfere with therapy and risk contamination of both wound as well as food.
In case of burns, cessation of further exposure of the body to the burning agent is a priority. Local guidelines must be followed to control the fire. A burnt area should be cooled under running tap water and the area covered with non-adhesive dressing followed by urgent medical referral.
Subsequent to falls, the initial approach should be ensuring patient’s safety. It is important to establish consciousness level and respond to commands. Pain initially is masked with the rushing endorphins in the blood and the localisation of exact site of injury may be poor. There should be no rush to pick the person up and priority should be to establish and maintain airway and ensure that there is no obvious bleeding. The neck should be well protected from any further injury and urgent medical attention needs to be obtained.
Errare humanum est
To err is human. Mistakes will continue to happen around us but lessons must be learnt from them and preventative measures taken. A good restaurant must have a system to audit near-miss incidences and accidents with periodical review process to ensure safety and accountability. Setting up strict safety guidelines and appropriate training and implementation will undoubtedly help transform the image of a modern professional kitchen from a dangerous place to a healthy and stress free environment.
(The writer is a hand, wrist and microsurgeon at Nanavati Super Speciality Hospital (NSSH) Vile Parle, Mumbai)