Electrical Laser Radiation and Fire Safety Flashcards
Who is the Electrical safety cartoon?
Reddy Kilowatt
An open circuit is what?
A circuit in which no path is available for the current to return to the battery
What are the electrical hazards for patients?
Burns, Microshock, Macroshock
Burns may be associated with what?
Pressure ischemia
True or false: macroshocks can only be detected on a conscious patient
True
Which are more difficult to detect, micro shock or macro shock?
Microshock
Ventricular fibrillation occurs in 5% of patients at what milliampere?
100 ug
An awareness of or a reflex response to a passage of electric current through the body is known as what?
Electric shock
What makes electrical currents passing through the body so dangerous?
The currents interfere with signals produced by body
What is the worst frequency that that can pass through the human body?
50 - 60 Hz
What are the two parts of the human body that you do not want a current to go through?
The heart and the brain
The heating effect from electrical burns comes from what kind of heating?
Joule heating
For a constant current density, burns will result from what size area of contact?
Large areas of contact equate to no burns Small areas of contact equate to Burns
Temperatures above what degrees Celsius may cause skin injury?
45*C
What does a GFCI outlet stand for?
Ground fault circuit interference
What class electrical wires is grounded?
Class 1
What class of electrical wires is double insulated?
Class IIThat is they have 2 walls of insulation
Class III type of electrical wires contain what?
Internal power sourceIe. transport monitors
Shock is known as what?
An awareness or reflex response to a stimulus
A risk of micro shock can come from what?
An indwelling catheter
What are some types of indwelling catheters?
Pulmonary artery catheter Central line
What are some examples of safety power systems?
Isolation transformers line isolation monitors (LIM)ground fault circuit interrupters (GFCI)
How do line isolation monitors work?
When a faulty piece of equipment is plugged into the isolated power system, it will markedly decrease the impedance from line 1 or line 2 to the ground. This will be detected by the LIM which will sound an alarm
How do isolation transformers work?
They isolate the power from the ground
What does laser mean?
Light amplification stimulated emitted mediated radiation
When measuring radiation, the amount of radiation being given off or emitted is measured by what?
Curie (Ci)Becquerel (Bq)
When measuring radiation what does the rad or the gray (Gy) unit measure?
The radiation dose absorbed by person, (that is the amount of energy deposited in human tissue by radiation)
The biological risk of exposure to radiation is measured by what?
RemSievert (Sv)
True or false, the beta particle that is emitted is also the electron
True
What are two types of radiation counters?
The Geiger-Muller counter the scintillation counter
Radiation follows what law?
The inverse square lawE € d^-2
True or false if the radioactive substances within the body of the patient, all or part of this energy must be absorbed by the tissues
True
True or false, the energy of the alpha and beta particles absorbed in the surrounding tissues do not cause damage
False
True or false, in the case of gamma rays a proportion of the radiation escapes from the body
True
Actively dividing cells such as tumor cells are particularly vulnerable for what?
Any alpha or beta particles or radiation that caused damage or death to cells
ALARA means what
As low as reasonably achievable
What are some common types of lasers?
Gaseous lasing medium
solid lasing median
liquid dyes or semi conductors
Most medical lasers including CO2 and KTP lasers are what type of class?
Class 4
What is the American national standards Institute for laser and laser hazards class 4 description?
Hazardous if viewed directly or from diffuse reflection. these lasers also produce fire hazards and skin hazards
Which lasers are most often used for surgery?
ExcimerCO2Nd: YAG
What are some common laser hazards?
Laser plume
perforation of a vessel or structure
embolism
inappropriate energy transfer
What hazards do laser plume present?
Atmospheric contamination
Vector for viral infection bacterial spores
Produces particulate matter 0.3 µ that is efficiently transported into the alveoli
Mutagenic and teratogenic
What is an inappropriate energy transfer laser hazards?
Ignition of surgical drapes
When using lasers In the OR, what should you do to your Fi 02?
Keep as low as possible perhaps less than 0.3
What are the steps to do in case of a laser fire in the airway?
- Disconnect oxygen source at y piece and remove burning objects from the airway
- Irrigate site with water fire is still smoldering
- Ventilate the patient by mask or reintubate the trachea and ventilate with as low FI O2 as possible
What type of lens will work for CO2 lasers?
Plastic or glass lens
What is the bare minimum eye protection for the patient when using lasers near the face?
Tape the patient’s eyes and cover with saline soaked knit or metal shield
What color Eye filter must be used for the argon and krypton lasers?
Amber / orange filter
What type of laser requires the green filter for eyewear?
Nd: YAG
What kind of lasers requires a red filter for eyewear?
KTP:Nd:YAG
What is the Firedog for fire safety’s name?
Sparky
What three things must be present to have a fire?Name examples of each:
An oxidizer: oxygen
ignition source: heat
fuel: sheets
A tincture of something means what
It is dissolved in alcohol
What are some combustible substances in the OR?
Endotracheal tubes Tape
Plastic tubing
Hair
Gauze
Surgical drapes
Gastro intestinal gases
Alcohol and acetone
Tincture of benzoin and oils
What are some of the combustible gases in anesthesia?
Ethers halothaneisofluraneEnflurane(Lowest limits needed for combustion of each are found only inside the bottle)
What are some of the combustion supporting gases?
Oxygen nitrous oxide air
Is oxygen flammable?
It is nonflammable, but feeds and oxidizes everything else to the flame
Why is N2O such a combustion supporting gas?
Releases the O2 molecule very readily thus providing the oxidizer the fire needs
What are some combustion squelching gases?
Nitrous
carbon dioxide
helium
Why is carbon dioxide a squelching gas when it has an O2 molecule available?
The CO2 molecule does not release the O2 molecule very well
What are some ignition sources used in anesthesia or in the operating room?
Lasers
Hot filaments : bairhugger\fluid warmer\Drager flow reading on anesthesia machine
sparks and arcs : bovie
gas compression
Conditions of a fire are what Compared to an explosion?
1 bar of pressureTemperature between 200 and 500°CBurns very slowly
Conditions of an explosion compared to fire are what?
25 bar of pressureTemperature around 3000°CFlame front is faster than speed of sound
What is the rule of Arrhenius?
The rate of a reaction is doubled when the temperature of the initial mixture is raised by 10°C
In layman’s terms describe the rule of Arrhenius.
It is more likely for fire to occur around something hot
True or false 70% of surgical fires in the operating room are in the patient’s airway
False, only 21% of fires are actually in the airway
True or false around 50% of surgical fires in the operating room are located on the patient’s head neck or upper chest
True
What are some of the early warning signs of a fire?
A pop, a flash, or smoke
What was Biggs number one risk management objectives if you are at fault for causing a fire
Destroy and mess up the scene of the crime as much as possible, throw away all damaging/incriminating evidence (This is obviously a joke)
What is the type of fire extinguisher that most hospitals have in the operating room’s
An a, B, C fire extinguisher that contains pressurized water
What type of class fire are those that are fueled by materials that when they burn they leave a residue in the form of ash
Class a
What is classified as a class B fire?
They involve flammable liquids and gases such as gasoline propane and paint thinner
Class C fires involve what?
They involve energized electrical wiring or equipment
What type of fires will we never see in the operating room and are most often caused by things such as phosphorus
Class D
I recommend highly looking at the prevention and management of operating fires list
Biggs had it on about 4 slides so look at each one of them
Most sensitive organs/tissue to radioactive activity: (5)
gonads
bone marrow
colon
lung
stomach
Tissue sensitivity depends on tissue _____ factor.
weighting
X ray protection
Which provides the better and least protection?
Indicate the curves on the graph.
d-composite is least, top solid line
lead is most protective, bottom solid line
Wall that protects someone from x ray protection:
composite shield
symbol for laser radiation
ionizing radiation
laser shield
laser-flex tube with dual cuff
The accepted maximal harmless current: ___ mA
5
“Let-go” current. Threshold of tetanic contraction of skeletal muscle. The point person can let go of current conductor is: ______ mA
10-20
Pain, fainting, mechanical injury is ____ mA.
50
Current that induces ventricular fibrillation, respiration remains intact at _____ mA.
100-300
Current resulting in sustained ventricular contraction, has defibrillation effect, and burns if the current is high enough is _____ mA.
6000
1 - 6000 mA current is defined as ______.
macroshock
Recommended safe current limit for directly applied cardiac equipment is ____ microAmp.
10
Maximum fault condition current for cardiac equipment is _____ microAmps.
50
Ventricular fibrillation is induced when current directly applied to myocardium at _____ microAmps.
100
