Fire/Electric/MRI Safety

Question 1

Fire Triangle Components

Answer 1

Oxidizer, ignition source, fuel

Question 2

Oxidizers in the OR

Answer 2

oxygen, nitrous oxide, room air- closed or semi-closed breathing systems (inside the airway devices) or under the drapes

Question 3

Ignition source in the OR

Answer 3

electrical surgical unit, lasers, fiberoptic light sources, cautery, heated probes, drills & burrs, argon bean coagulators, defib pads, static electricity

Question 4

Fuel in the OR

Answer 4

alcohol-based skin preps, surgical drapes, patient, airway device (PVC tubes), packaging materials, intestinal gas

Question 5

How to minimize oxygen concentration with MAC

Answer 5

hook up to the common gas outlet so you can use lower oxygen concentration, configure drapes to minimize accumulation of oxygen

Question 6

Anesthesia’s role in fire

Answer 6

If airway- pull ETT immediately and stop all flow of gases, if not airway fire stop flow of gases and monitor airway. After fire: re-establish ventilation, avoid oxidizer rich environment and examine airway

Question 7

Anesthesia’s role in fire

Answer 7

If airway- pull ETT immediately and stop all flow of gases, if not airway fire stop flow of gases and monitor airway. After fire: re-establish ventilation, avoid oxidizer rich environment and examine airway

Question 8

Ohm’s triangle

Answer 8

V=IR (voltage = current x resistance)

Question 9

Sources of electrical hazards in OR

Answer 9

Batteries (laryngoscope handles, portable pumps, back up batter in anesthesia machine), generators

Question 10

Effects of electrical shock (mA and what it causes)

Answer 10

1 maA = perception, 10 mA = let go, 15 mA= muscle freeze, 30 mA= breathing difficulty (fibrillation in kids), 50 mA-100 mA = possible V Fib, 100 mA = certain VFib, 4A and over serious tissue & organ burning, cardiac paralysis

Question 11

What levels of current are dangerous

Answer 11

1,10,100 macro/100 micro (V Fib by 100 mA of macro, 100 microamperes of micro)

Question 12

Microshock

Question 13

Line Isolation Transformer

Answer 13

Isolates the live wire - if someone touches faulty electrical thing they will not get shocked because they cannot complete the circuit

Question 14

Line Isolation Monitor

Answer 14

Monitors the integrity of the system because isolated systems can become accidentally grounded through equipment fault. These measure the leakage current and will alarm at 2 or 5 mA– a shock may happen if someone on the ground touches faulty equipment

Question 15

Electrical safety tips

Answer 15

Inspect cords for breaks in insulation or exposed wires, take care not to run wires over or knot them, keep surfaces and patients dry, wear insulated shoes, keep defib pads away from pacemakers, avoid use of extension cords, plan for loss of electricity

Question 16

Electrical safety tips

Answer 16

Inspect cords for breaks in insulation or exposed wires, take care not to run wires over or knot them, keep surfaces and patients dry, wear insulated shoes, keep defib pads away from pacemakers, avoid use of extension cords, plan for loss of electricity

Question 17

Guidelines for non-operating room anesthetizing locations

Answer 17

Reliable oxygen source with backup, suction source, waste gas scavenging (may be charcoal), adequate monitoring, self-inflating resuscitator bag, sufficient safe electrical outlets, adequate light & battery powered backup, sufficient space, emergency cart, reliable 2-way communication, compliance with safety & building codes

Question 18

What to avoid bringing in to the MRI room

Answer 18

Any ferromagnetic items (scissors, pens, keys, magnetic strips) & anyone with SWAN, pacemaker, clips, etc

Question 19

What is the yellow line called that cannot be crossed with ferromagnetic materials

Answer 19

5 gauss line