Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Open-Chest Cardiac Massage


Specialists

  • Anesthesiologist
  • Cardiologist, Cardiovascular Physician
  • Critical Care Internist
  • Critical Care Surgeon
  • Emergency Medicine Physician
  • Thoracic Surgeon

Comorbid Conditions

  • Chronic obstructive pulmonary disease (COPD)
  • Ischemic heart disease
  • Obesity

Factors Influencing Duration

Length of disability is influenced by the effectiveness of the procedure and any complications. The customary recovery time for the original surgery or trauma is normally 6 to 8 weeks, but it may be extended due to complications. The attending physician may want to have the individual stay under close electronic monitoring to guard against a recurrence of cardiac arrest.

Medical Codes

ICD-9-CM:
37.91 - Open-chest Cardiac Massage

Overview

Open-chest cardiac massage is an emergency procedure for managing a heart that is not beating or beating ineffectively (cardiac arrest). It is done in conjunction with the administration of drugs directly into the heart or vein and the use of direct electrical defibrillation.

Source: Medical Disability Advisor



Reason for Procedure

Open-chest cardiac massage is usually done on an individual undergoing surgery whose chest is already open and whose heart stops beating effectively. On occasion, if a cardiac arrest occurs a few hours or days after chest surgery, the chest is reopened to institute open-chest cardiac massage. The procedure may also be used in an individual with gunshot or stab wounds to the chest (penetrating trauma) whose heart stops beating in the emergency department.

The cause of cardiopulmonary arrest is usually an intraoperative event, such as a reaction to anesthetics or other drugs, massive hemorrhage, a pulmonary embolus, high potassium, or an air embolus. A trauma-related arrest is due to an injury of a major blood vessel, the lungs, or the heart.

Source: Medical Disability Advisor



How Procedure is Performed

The heart is compressed with one or both hands (preferably both) at a rate of 60 to 70 times a minute. Lungs are easily inflatable through a tube (endotracheal tube) inserted before the surgery or in the emergency department. Several individuals are needed to perform compressions in rotation to prevent hand fatigue. At the same time, drugs are administrated directly into the heart or intravenously. One or more attempts are made to defibrillate the heart with sterile paddles applied directly to the heart. The amount of electrical energy delivered via the paddles is much less than the amount delivered when the paddles are placed on the chest wall to deliver the electrical shock. If the cardiac arrest occurs in the recovery room or later in the surgical ward, the chest is reopened through the original incision. If the arrest occurs in the emergency department, the incision is made between ribs five and six on the side of the chest, and the ribs are spread apart.

Source: Medical Disability Advisor



Prognosis

Open-chest cardiac massage is an emergency, life-saving procedure. Success means that the individual lives through the arrest. Failure results in death.

Source: Medical Disability Advisor



Complications

Open-chest cardiac massage may be complicated by perforation of the heart. This may occur if the individual has had a recent heart attack. Other complications include an air embolus in the brain and laceration of the lung. Other possible delayed complications include a heart attack or brain damage.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Work restrictions and accommodations depend on the degree of cardiac and neurologic damage (if any) caused by the procedure. Lifting restrictions are necessary for 6 to 8 weeks.

Source: Medical Disability Advisor



References

General

Galler, David, and Adrian Skinner. "Critical Care Considerations in Trauma." eMedicine. Eds. Lewis J. Kaplan, et al. 3 Mar. 2004. Medscape. 23 May 2005 <http://emedicine.com/med/topic3218.htm>.

Source: Medical Disability Advisor






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