Exam 1 Material Pt 2 (Occupational Hazards)

Question 1

Substance abuse, depression, and suicide are frequent ____

Answer 1

Occupational hazards

**Access to drugs biggest issue

Question 2

Positive state of mind, body, and spirit reflecting a balance of effective adaptation, resilience, and coping mechanisms in personal and professional environments that enhance quality of life

Answer 2

AANA’s definition of wellness

Question 3

Second victim

Answer 3

Following an adverse event, the CRNA/SRNA becomes anxious and fearful

Question 4

Third victim

Answer 4

Following an adverse event, the patient can become the “third victim” when the CRNA/SRNA is so stressed it affects the patient negatively

Question 5

Emotional considerations include emotional ____ and stress ____

Answer 5

Emotional burnout
Stress syndrome

Question 6

WAG (waste anesthesia gas) evacuated via ____

Answer 6

Scavenging systems

Question 7

Medical and Anesthetic Gases include: (7)

Answer 7

Oxygen
Air
Carbon dioxide
Bone cement
Inhalation agents
Nitrous Oxide
Nitrogen

Question 8

NIOSH limits on recommended exposure:

Answer 8

2 ppm (parts per million) for halogenated anesthetic agents when used alone

0.5ppm (parts per million) for a halogenated agent and 25 ppm of N2O when used together

Question 9

Elevated levels of WAG have also been identified in the ____

Answer 9

PACU

Question 10

Factors that increase anesthetic gas concentration in room:

Answer 10

Flushing circuit
Filling vaporizer
Poorly fit facemasks
Uncuffed ETT
Failure to turn gas vaporizer off at end of case
Use of semi-open circuits (difficult to scavenge)

Question 11

Air in OR should be exchanged AT LEAST _____

Answer 11

15-20x/hr

Question 12

OSHA limit on radiation:

Answer 12

5 REM/50 mSv annually

Question 13

Unit for measurement of radiation exposure

Answer 13

REM

Question 14

OR average noise level is ___
What is recommended?

Answer 14

77 dB
35-45 dB recommended

Question 15

Monitor should be at least ____ in order to hear properly

Answer 15

≥ 20 dB

Question 16

24 hours awake is equivalent to a BAC of ____

Answer 16

0.1% (LEGALLY impaired to drive @ 0.08%)

Question 17

____% of all anesthesia providers misuse drugs/alcohol at some point

Answer 17

10-15%

Question 18

Recurrent use of substances

Answer 18

Substance Use Disorder

Question 19

Psychological need/craving for a substance

Answer 19

Addiction

Question 20

Inability to safely participate in activities

Answer 20

Impairment

Question 21

More of the substance required

Answer 21

Tolerance

Question 22

Syndrome when the abuse is halted/stopped

Answer 22

Withdrawal

Question 23

Signs of misuse:

Answer 23

Frequent/unexplained tardiness, absences, confusion, memory loss, mood swings, refusing drug screening

Question 24

What do you do if you suspect current impairment?

Answer 24

Follow institutional policy, do not let the impaired person out of your sight or determine treatmetn

Question 25

Re-entering practice after misuse of drugs: must participate in a monitoring program for at least ____

Answer 25

5 years in length with random drug testing

Question 26

Some diversion programs report success rates of ____%, but recurrence rate of ____%

Answer 26

70 25

Question 27

Operating room environment temperature:

Answer 27

68-75º F (usually lower)

Question 28

Operating room environment humidity:

Answer 28

50-55% 20-60% is acceptable

Question 29

Operating room environment ventilation:

Answer 29

20 air volume exchanges per hour +/- HEPA filters

Question 30

Operating room environment noise:

Answer 30

70-80 dB or >

Question 31

OSHA recommendation max whole body exposure (radiation)

Answer 31

5 rem/yr (roentgen equivalent man)

Question 32

Inverse square law: Beam intensity calculation

Answer 32

1/(distance) 2 (squared) **Inverse relationship-- if one goes up, the value will go down (Further you get away, less radiation)

Question 33

OR's account for ____% of all hospital electrical accidents

Answer 33

40%

Question 34

ORs must be protected by either ____ or _____

Answer 34

Isolated power (IPS) Ground fault circuit interrupters

Question 35

Residential power is a ____

Answer 35

Grounded system

Question 36

OR power is a(n) ____

Answer 36

UNgrounded system (isolated from ground potential)

Question 37

Electricity travels the path of ____

Answer 37

Least resistance

Question 38

To get shocked in the OR:

Answer 38

You must come in contact with 2 circuits to make you a part of the circuit (bc it is ungrounded)

Question 39

EQUIPMENT in the OR is ___

Answer 39

Grounded (Round plug is the safety ground) **System is ungrounded, but if equipment becomes faulty = GROUNDED

Question 40

Macroshock =

Answer 40

100-300 milliamps (mA)

Question 41

Microshock =

Answer 41

50-100 microamps (uA)

Question 42

Ungrounded OR power system is achieved by the use of ____

Answer 42

Isolation transformer

Question 43

Ungrounded OR system is monitored by a ____

Answer 43

Line isolation monitor

Question 44

LIM monitors ___

Answer 44

Integrity of isolated system in case of faulty equipment (will alarm)

Question 45

Cautery tip/bovie & return pad

Answer 45

Circuit starts at bovie, localized to tip and then dispersed to return pad **Can get deeper in tissue

Question 46

Bipolar is similar to

Answer 46

think of jumper cables (2) Set of tweezers **Can only work in between two tweezers

Question 47

Current on bovie can cause interference and look like artifact-- Special consideration

Answer 47

Keep magnet nearby to potentially need to deactivate AICD

Question 48

Vfib is prevented by the use of ____

Answer 48

Ultrahigh electrical frequencies which decrease tissue penetration

Question 49

Fire triad =

Answer 49

Fuel, oxidizer, ignition source

Question 50

What part of the fire triad do anesthesia control?

Answer 50

Oxidizer

Question 51

ANY time surgery is above the level of ______ there is a(n) ____

Answer 51

Xiphoid/AC Increased risk for fire

Question 52

If fire triad might become an issue, you should

Answer 52

Titrate oxygen to lowest concentration necessary for patient oxygenation

Question 53

To reduce the risk of fire: you can discontinue O2 for at least ______

Answer 53

One full minute prior to cautery or laser use *** Reduce to ≤ 30% FiO2

Question 54

True or false: Monopolar ESU is preferred over bipolar electrosurgical unit

Answer 54

FALSE Bipolar > monopolar in preference

Question 55

IF fire occurs:

Answer 55

Stop FGF ETT needs removed Sterile water/saline can be poured

Question 56

Laser safety:

Answer 56

Eye goggles Special ETT (methylene blue) Avoid petroleum ***Just bc you use laser resistant ETT, the cuff is NOT laser protected

Question 57

All medical lasers are class

Answer 57

IV

Question 58

Lasers in dark room can damage your eye bc

Answer 58

Pupils are dilated and can get to retina easier