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HAND INJURIES
Published: 1 December 2018
The hand is one of the most complicated parts of the body – there are 27 Bones in the hand, including the 8 bones in the wrist. Combined with the Tendons, bones, tissues and nerves, they all allow the hand to do a wide Variety of highly complex tasks. When just one of these elements is Injured, the effect can be enormous.
Even quite minor injuries to a hand may prevent it being fully functional – with loss of motion, dexterity and grip. To give a simple example, try tucking your thumbs into the palms of your hands and then try to tie your shoes – it is not easy!
We have been looking at hand injuries reported to the Club over the past 3 years (from December 2018). There have been 55 cases of amputation (usually of finger tips but in rare cases, the whole hand), 129 cases of fractures or breaks and 102 serious lacerations. There are also many examples of bruising, burns or dislocation.
The most common causes of hand injuries are:
- Carelessness
- Lack of awareness
- Boredom
- Ignoring safety procedures
- Distractions
GLOVES
Personal protective equipment (PPE) should be your last line of defence against injury, not your first. A thorough assessment of the nature of the task and the risks involved should always be your first step. But this does not mean that gloves are not essential – in a recent study in the US it was found that 70% of workplace hand injuries occur because people are not wearing gloves (or the correct gloves) at the time of the injury.
Always consider which gloves are best for the task. For example, use leather gloves for equipment handling and general construction tasks, and specialist rubber and other synthetic gloves when handling chemicals and other corrosive substances. Do make sure that the gloves are the correct material for the type of chemical or substance you are working with. Whatever gloves you choose, always make sure you check them for tears, excessive wear and any holes. Dispose of leather and cloth gloves if they are covered in oil or other chemicals. Check chemical gloves for leaks by sealing the wrist and filling the glove with air (using a clean plastic tube or air line – not your mouth). Lastly make sure that they fit, as loose or poorly fitting gloves have been shown to be the cause of several accidents. Using gloves of an excessive size can make work more complicated and also reduce your grip. If working close to rotating machinery wrongly worn or fitting gloves can increase the risk of getting them caught.
HAND EXERCISES
If you do a few exercises before carrying out even simple tasks, you will build hand strength, improve mobility and dexterity and do much to avoid repetitive strain injuries:
- Stretch fingers by spreading them wide for a few seconds – repeat 3 times with each hand
- Stretch your thumb by holding it down gently for 5 seconds – repeat 3 times with each hand
- Stretch your wrist by making circles with your hands – repeat 10 times for each hand
FIRST AID
If injuries do occur, there are some steps that you can take straight away while waiting for medical assistance.
CUTS: apply pressure to the wound to stop the bleeding, wash any dirt or debris from the wound, cover with a clean cloth to prevent further contamination.
BROKEN BONES: keep the hand still, in a splint if possible. If an open fracture cover with a clean cloth. Apply ice to help the pain, but never for more than 20 minutes at a time and never apply directly to the skin.
AMPUTATIONS AND SOFT TISSUE INJURY: apply pressure to stop the bleeding and cover with a clean damp bandage. Elevate the hand above the heart to reduce bleeding. Retrieve the amputated part if possible and keep it damp and cool (but not in direct contact with ice).
BURNS: if caused by heat then cool with water (not ice) and then cover. For chemical burns, flush the area with lots of water and then cover.
CASE STUDIES
Some examples of hand injuries that have been dealt with by our people risks team.
Case study one
The ship’s crew were preparing for departure and the third engineer was carrying out his daily routine which included wiping away traces of oil around the engine. While wiping some oil traces on the alternator casing near the flywheel, a rag from his left hand was caught by the rotating flywheel and this dragged his finger in between the cover and the flywheel. The top part of his small finger was amputated and there were serious cuts to his ring finger.
Case study two
A group of officers and crew were working on a hatch cover to renew the oil seal hydraulic motor. The bosun was instructed to move the hatch cover but by mistake he operated the lever that raises the jack and the hatch cover moved upwards from its secured position. While attempting to secure the hatch cover, the hatch cover moved and the wire sling broke, breaking and crushing 3 fingers on the right hand of the A/B.
Case study three
An A/B was closing a watertight door and realised that his finger was inside the padlock securing ring. He tried to remove his finger but it was too late as the door swung closed, severing the tip of his little finger.
Case study four
An A/B was on the deck of a tanker preparing to secure the reducers which were being lowered by a crane and a sling (reducers are used to align ship and shoreside cargo lines). All went well until the A/B tried to turn the reducer by hand to align the holes on the reducers with the ones on the securing guides. The reducer suddenly slipped and tilted and, as the reducers were stacked very close to each other, the fingers of the A/B were trapped between 2 reducers and were severely crushed.
Key learning points
In all of the above cases, the crewmembers sustained traumatic and potentially life changing injuries in accidents that were all preventable. Although the circumstances were different in each scenario, the underlying issues are depressingly familiar:
- The need to maintain situational awareness, paying full attention to the surroundings and taking adequate care.
- Avoiding any distractions to ensure that the operator remains fully focussed and the task is carried out in a controlled manner.
- The importance of carrying out an effective risk assessment which should be task-specific and include meaningful and practical control measures that are then actually put in place.
- Eliminate the danger of complacency by never just assuming that everything is OK, particularly while carrying out what might be regarded as a routine task.
- For activities involving teamwork, ensure that a comprehensive toolbox talk or safety briefing is conducted with all team members before commencing the job, looking at the hazards, roles and responsibilities and safe work practices.
- Finally, always ensure that there is an adequate and effective protocol for communication between members of the team to coordinate and control the activity at all times.