Chapter 21 - Safety and Infection Control

Question 1

Three components must be present for a fire to burn:

Answer 1

a flammable substance (fuel), oxygen, and heat

Question 2

first step toward prevention

Answer 2

An awareness of potential hazards is the first step toward prevention.

Question 3

Most accidental fires are traceable to one of four causes:

Answer 3

(1) spontaneous combustion, (2) open flames, (3) smoking, and (4) electricity

Question 4

Spontaneous combustion

Answer 4

occurs when a chemical reaction in or near a flammable material causes sufficient heat to generate a fire.

Question 5

Electric Safety Rules

Answer 5

*All electric equipment and appliances must be approved for their intended use and used as intended.
*Follow equipment manufacturers’ instructions.
*Equipment used on or near patients or near water must have grounded plugs.
*Inspect equipment regularly, paying attention to cords and plugs. Arrange for repairs as necessary.
*Do not overload circuits by connecting too many devices to a single outlet or outlet group.
*Unplug or turn off electric equipment before exposing internal parts.
*Do not attempt to repair equipment unless you are trained to do so.
*Do not use extension cords. If necessary, use an approved power strip that is equipped with a circuit breaker.
*In case of electric fire, use a class C or carbon dioxide fire extinguisher.

Question 6

According to professional fire marshals, the most frequent infractions of fire safety rules include the following:

Answer 6

*Blocked fire exits
*Doors blocked open
*Equipment stored in corridors
*Improper storage of flammable items
*Improper use of extension cords

Question 7

In Case of Fire

Remain calm and remember the acronym RACE.

Answer 7

R—Rescue

*Remove patients from danger by moving them to a safe area. In large buildings, move patients past at least two fire doors within the facility.
*For larger fires, follow the instructions of coordinating personnel.

A—Alarm

*Activate the alarm system directly or use the established code for fire.
*Make sure that all personnel in the area are aware of the fire, being careful not to alarm patients.

C—Contain

*Close any open doors to limit the oxygen supply to the fire and to prevent the spread of smoke and heat.
*Check to make sure oxygen valves and electric circuit breakers are turned off.
*In inpatient facilities, close the doors to patient rooms. If a patient is still in a room, place the room’s trash can in front of the door.

E—Extinguish/Evacuate

*For small fires, use the available fire extinguisher to put out the fire or smother the fire with a blanket.
*For larger fires, evacuate the area of all personnel and wait for fire personnel.

Question 8

Fire extinguishers

Answer 8

*Class A fires involve combustibles, such as paper or wood.
*Class B fires involve flammable liquids or gases.
*Class C fires involve electric equipment or wiring.

Question 9

To use the fire extinguisher correctly, remember the acronym PASS:

Answer 9

Pull the pin.
Aim the nozzle.
Squeeze the handle.
Sweep. Use a sweeping motion from side to side.

Question 10

Fire extinguishers must be inspected regularly and recharged periodically.

Answer 10

A tag attached to the unit should indicate the date of the last inspection and the last recharge. The last inspection should have been no longer than 1 year earlier.

Question 11

The following steps will help to ensure safety when a spill occurs:

Answer 11

*Limit access to the area.
*Evaluate the risks involved.
*Obtain both the information and the equipment to clean up the spill safely.
*Clean up the spill.
*If you lack the necessary skill or equipment, call your supervisor.

Question 12

The most common injuries reported by health care workers are

Answer 12

musculoskeletal disorders (MSDs). Subcategories of MSDs as classified by OSHA include repetitive motion injuries, repetitive strain injuries, and cumulative trauma disorders (CTDs).

Question 13

body mechanics

Answer 13

The principles of proper body alignment, movement, and balance

Question 14

The three following concepts are essential to understanding the principles of body mechanics (Fig. 21.4):

Answer 14

1.Base of support—This is the portion of the body that is in contact with the floor or other horizontal surface. A broad base of support provides stability for body position and movement.
2.Center of gravity, or center of body weight—This is the point around which body weight is balanced. It is usually located in the midportion of the pelvis or lower abdomen, but the location may vary somewhat depending on body build. The body is most stable when the center of gravity is nearest the center of the base of support.
3.Line of gravity—This is an imaginary vertical line passing through the center of gravity. The body is most stable when the line of gravity bisects the base of support.

Question 15

Rules of Body Mechanics

Answer 15

1.Provide a broad base of support.
2.Work at a comfortable height.
3.When you are lifting, bend your knees and keep your back straight.
4.Keep your load well balanced and close to your body.
5.Roll or push a heavy object. Avoid pulling or lifting.

Question 16

Bending and twisting the back while lifting

Answer 16

is the most common cause of back strain (Fig. 21.5).

Question 17

A broad and stable base of support is ensured by

Answer 17

standing with feet apart and one foot slightly advanced.

Question 18

A support under the knees of a supine patient

Answer 18

relieves lumbosacral stress by straightening the lordotic lumbar curve. This is especially comforting to arthritic and kyphotic patients and to most elderly persons.

Question 19

dyspnea

Answer 19

difficulty breathing

Question 20

orthopnea

Answer 20

inability to breathe lying down

Question 21

emesis

Answer 21

vomit

Question 22

To help a seated patient stand up, stand facing the patient.

Answer 22

Reach around the patient’s upper body and place your hands firmly over the scapulae. The patient’s hands may rest on your shoulders. If the patient has weakness on one side of the body, position yourself to brace the patient’s weak leg with your knee as the patient stands. This will help to keep the patient’s leg from bending and giving way with weight bearing. On your signal, lift upward while the patient rises to a standing position (Fig. 21.7). Remember to use a broad base of support and keep your back straight. This method may be reversed when you are helping a standing patient to sit down. Be certain that the seat is secure and will not move as the patient sits.

Question 23

Patients seated on the edge of the radiographic table often find it easier to lie down with some help.

Answer 23

Place one arm under the knees and the other around the patient’s shoulders. Lift the legs as you pivot the patient and rest the legs on the table (Fig. 21.8). At the same time, ease the shoulders down so that the patient is supine. This method is reversed when a supine patient is being helped to sit up. It is much easier to sit up when the legs have been lowered somewhat than when they are extended on the table.

Question 24

orthostatic hypotension

Answer 24

This is a temporary state of low blood pressure that causes patients to feel lightheaded or faint when they first sit up.

Question 25

gait belt, also called a transfer or walking belt

Answer 25

should be used when patients who are weak or unsteady are being helped. They should not be used for patients who cannot bear any weight on their legs. These belts are heavy fabric straps with strong buckles. When placed snugly around the patient’s waist, the belt provides a secure handhold for you to use in helping the patient to stand and walk.

Question 26

process of helping a patient to or from a wheelchair

Answer 26

Start with the patient seated. Position the wheelchair beside the patient with wheels locked and footrests out of the way. At this point, competent patients are able to stand and move to the wheelchair with little assistance, although a steadying hand at the patient’s elbow is a good practice. With the patient standing next to the wheelchair, instruct and assist the patient to pivot a quarter turn so that the edge of the wheelchair is touching the back of the patient’s knees; then ease the patient into a sitting position in the chair. Position the footrests and leg rests and cover the patient’s lap and legs with a sheet or bath blanket to provide warmth and comfort and protect the patient’s modesty.

Question 27

To move the patient from wheelchair to x-ray table,

Answer 27

place the wheelchair parallel to the table, lock the brakes, and move the footrests out of the way. At this point the procedure will vary depending on whether you are fortunate enough to have an x-ray table that is adjustable in height.

If the height of the x-ray table is adjustable, lower the table to chair height.

Question 28

Helping Patients to Change Positions,

Answer 28

help the patient to stand and pivot with the patient’s back to the table. Then ease the patient into a sitting position on the edge of the table.

Question 29

The most common type of fall associated with wheelchair transfer occurs

Answer 29

when the patient backs into the wheelchair to sit down. The patient may miss the edge of the seat or tip the chair by sitting too near the edge.

Question 30

cycle of infection

Answer 30

For infections to be transmitted, there must be an infectious organism, a reservoir of infection, a susceptible host, and a means of transporting the organism from the reservoir to the susceptible individual.

Question 31

Infectious agents include

Answer 31

microorganisms and infectious proteins called prions.

Question 32

Microorganisms or microbes

Answer 32

are referred to in lay terms as germs. They are living organisms too small to be seen with the naked eye and include bacteria, viruses, protozoa, and fungi.

Question 33

normal flora

Answer 33

Some microorganisms live on or within the body without causing disease. They aid in skin preservation and digestion and protect us from infection.

Question 34

pathogens

Answer 34

Microorganisms that cause disease

Question 35

Prions

Answer 35

are infectious protein particles that are not living organisms; they are similar to microorganisms in that they can cause disease and can replicate within the human body.

Question 36

Bacteria

Answer 36

are very small single-cell organisms with a cell wall and an atypical nucleus that lacks a membrane (Fig. 21.18). Bacteria grow independently and do not need a host cell to reproduce. They are classified according to shape.

Question 37

Most bacteria have one of three distinct shapes:

Answer 37

spherical bacteria are called cocci; rod-shaped bacteria are called bacilli; and spiral-shaped bacteria are called either spirilla or spirochetes

Question 38

Viruses

Answer 38

Viruses are subcellular organisms. They are among the smallest known disease-causing organisms.

Examples of viruses include influenza virus, HIV, herpesvirus, hepatitis virus, and rhinovirus. Rhinoviruses cause the common cold. Other common viruses are Epstein-Barr virus, which causes infectious mononucleosis, and varicella zoster virus, which causes chickenpox.

Question 39

Protozoa

Answer 39

Protozoa are complex single-cell animals that generally exist as free-living organisms. Most parasitic protozoa produce some type of resistant form, such as a cyst, to survive in the environment outside the host. Other protozoa have complicated life cycles involving alternate existence in the human body and in insects. This is true of the protozoan that causes malaria.

Question 40

Fungi

Answer 40

Fungi (singular, fungus) occur as single-celled yeasts or as filament-like structures called molds that are composed of many cells. In humans, fungi can cause skin infections such as athlete’s foot and ringworm; respiratory infections, such as histoplasmosis; and infections in individuals with compromised immune systems.

Question 41

Prions

Answer 41

The smallest and least understood of all infectious agents is the prion, which was discovered in 1983. Scientists believe that prions are infectious protein particles. Prions also cause mad cow disease and a human variant called Creutzfeldt-Jakob disease, a disorder that causes brain damage with a rapid decrease of mental function and movement.

Question 42

six main routes of transmission, including direct and indirect routes.

Answer 42

Indirect routes may involve transport of organisms by fomite, vectors, vehicles, and airborne particles or droplets.

The first route is by means of direct contact.

Question 43

fomite

Answer 43

An object that has been in contact with pathogenic organisms. Examples of fomites in the radiology department are the x-ray table, upright Bucky, image receptors, calipers, and positioning sponges that have been contaminated with infectious body fluids.

Question 44

Vectors

Answer 44

A vector is an arthropod (insect, spider, or similar form) in whose body an infectious organism develops or multiplies before becoming infective to a new host. Some examples of vectors are mosquitoes that transmit malaria and dengue fever, fleas that carry bubonic plague, and ticks that spread Lyme disease and Rocky Mountain spotted fever. In these examples, the bites of infected insects transmit diseases to humans.

Question 45

vehicle

Answer 45

A vehicle is any medium that transports microorganisms. Examples include contaminated food, water, drugs, and blood.

Question 46

Airborne contamination

Answer 46

Airborne contamination is spread by dust containing either endospores or droplet nuclei (tiny infectious particles from evaporated droplets that contain microorganisms).

TB, rubeola (measles), and varicella (chickenpox) are examples of infections spread by airborne particles.

Question 47

Droplet contamination

Answer 47

Droplet contamination often occurs when an infectious individual coughs, sneezes, speaks, or sings in the vicinity of a susceptible host. Droplet transmission involves contact of the mucous membranes of the eyes, nose, or mouth of a susceptible person with droplets containing microorganisms. These particles are relatively large and do not remain suspended in the air. They travel only short distances, usually 3 feet or less. Influenza, meningitis, diphtheria, pertussis (whooping cough), and streptococcal pneumonia are examples of illnesses spread by droplet contamination.

Question 48

Bacteria that are capable of forming endospores

Answer 48

may live in this form for many years.

Question 49

Research has shown that some viruses

Answer 49

can resist drying, remaining infectious for weeks. This is true of the viruses that cause herpes, both oral and genital.

Question 50

Medical asepsis

Answer 50

Medical asepsis is the process of reducing the probability of infectious organisms being transmitted to a susceptible individual.

Question 51

microbial dilution

Answer 51

The process of reducing the total number of organisms is called microbial dilution and can be accomplished at several levels.

Question 52

disinfection

Answer 52

The second level is disinfection and involves the destruction of pathogens by chemical agents.

Question 53

sterilization

Answer 53

The third stage is surgical asepsis, or sterilization. This involves treating items with heat, gas, or chemicals to make them germ free.

Question 54

Bleach

Answer 54

Dilute the bleach by mixing 1 part bleach with 10 parts water. Mix fresh bleach daily because its effectiveness declines rapidly when diluted.