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Basic Clinical Laboratory Techniques > Lab Safety > Flashcards

Lab Safety Flashcards

1
Q

What to know before working in the lab (8)

A 
hazardous properties of materials and agents, 
safe handling and storage procedures (MSDS),
proper use of equipment,
emergency telephone number,
reporting procedure,
emergency response procedure,
designated escape route,
location and use of emergency equipment
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2
Q

While in the lab, perform procedures involving possible release of volatile toxic or flammable chemicals in a ___________________

A

chemical fume hood

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3
Q

Perform procedures involving the possible release of biohazardous aerosols in a ___________________

A

biological safety cabinet

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4
Q

Due diligence

A

doing everything reasonable to protect the health and safety of workers to prevent injuries or accidents in the workplace
ie. policies regarding health and safety, train workers to ensure awareness and competence in safe work practices

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5
Q

Types of hazards in medical laboratory (5)

A

physical hazards, chemical hazards, insidious/radiation hazards, biological hazards, psychological hazards

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6
Q

Physical hazards properties

A

volatility, density

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7
Q

chemical hazard properties

A

flammability, corrosivity, solubility, carcinogenicity, neurotoxicity

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8
Q

biological hazards properties

A

viability, pathogenicity, infectivity

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9
Q

psychological hazards

A

stress, abuse, working alone

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10
Q

Possible sources of physical hazards

A

fire, electricity, sharp objects, heavy objects and wet floor

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11
Q

Classifications of Fire extinguishers

A 
Class A(green): puts out fires such as wood and paper
class B (red): used on fires involving flammable liquids such as grease, gasoline, oil
class c (blue): for use on electrically energized fire-is non-conductive
class d(yellow): designed for use on flammable metals
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12
Q

fire requires three factors to burn:

A

heat, oxygen and fuel

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13
Q

scald

A

caused by moist heat in the form of hot vapor or liquid

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14
Q

burn

A

caused by radiation, chemicals or electric

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15
Q

how to handle sharp objects such as needles (4)

A

handle all needles and lancets carefully,
never lay down an uncapped needle,
uncap needle just prior to use, never recap, bend or break a used needle
and discard used needle or lancet biohazard container immediately after use,

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16
Q

cryogenics

A

-fluids that are liquified at a very low temperature -73.3 degrees celsius
, potential for pressure buildup in container
-most common cryogenic is liquid nitrogen

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17
Q

corrosive

A

aka caustic.
common corrosives are strong acids and strong bases;
these chemicals will injure body tissues by contact or corrode metal
ie. hydrochloric acid, sulfuric acid

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18
Q

caustic

A

aka corrosive by contact, these chemicals can burn or destroy tissue
ie. acetic acid and ammonia

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19
Q

poisonous

A

chemicals that cause immediate death if ingested (bromine ampules)

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20
Q

carcinogenic

A

chemicals known to cause cancer to humans or lab animals

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21
Q

mutagenic

A

aka crystal violet, cause genetic mutations, are typically carcinogenic

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22
Q

flammable chemical hazards and how to store

A

can catch fire easily, ignite at 37.8 degrees Celsius;
must be stored in a safety can or cabinet,
can only be heated by ether, methanol, ethanol, xylene, benzene and chloroform

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23
Q

what is the flash point for combustible chemicals and how should it be stored

A

has a flash point above 37.8 degrees Celsius; must be stored in a safety can or cabinet

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24
Q

PH

A

indicates the strength of many corrosives, the pH scale ranges from 0-14. pH 7 is considered neutral, acid is below 7 and alkalis bases are above 7. The more corrosive the substance the farther the pH from 7

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25
Q

hydrochloric acid

A

corrosive can cause burns on skin , vapour inhalation should be avoided

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26
Q

nitric acid

A

corrosive, releases yellow fumes, which are extremely toxic and damaging to tissue, overexposure can cause death, loss of eyesight. if ingested it causes extreme burns, may perforate stomach wall and cause death

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27
Q

sulfuric acid

A

corrosive, may cause blindness, if ingested may cause severe burns

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28
Q

acetic acid

A

severely caustic, continuous exposure to vapours can lead to chronic bronchitis, must be stored at room temperature in safety cabinet

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29
Q

Storing of acids

A
  • in glass stoppered bottles
  • if stored on shelves must not exceed capacity greater than 500 mL.
  • large capacity bottles must be kept on floor.
  • when transporting large bottles must be carried with rubber acid bottle carriers
  • must not be stored with alkalis or other reactive chemicals
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30
Q

what is the rule when diluting acid with water

A

pour acid into water NOT water into acid

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31
Q

never place glacial _______________ in _____________ as it will freeze and the bottle will break

A

acetic acid, refrigerator

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32
Q

examples of bases

A

sodium and potassium hydroxide, ammonia, phenol, bromine ampules, iodine

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33
Q

sodium and potassium hydroxide

A

-alkalis
extremely hazardous even in low concentrations. may cause chemical caustic burns, permanent injury or scarring and blindness

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34
Q

ammonia or ammonium hydroxide

A

-alkalis

in concentrated form is caustic and can cause burns, they cause upper respiratory tract damage when inhaled

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35
Q

phenol

A

-an alkalis
liquid phenol causes burns with a blanching of the skin. do not use water to wash off phenol from the skin, use ethyl alcohol (absolute), which neutralizes the phenol by forming an ester

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36
Q

bromine ampules

A
  • alkalis
  • very common in laboratories
  • poisonous and causes burns
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37
Q

Iodine

A
  • alkalis

- does not react violently, but one should wear protective gloves when handling

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38
Q

storing and handling of bases

A

store in plastic containers, not glass (they form silicates). Do not store with acids or other reactive chemicals. they react violently with water, follow same guidelines for using acids

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39
Q

examples of explosives

A

picric acid, benzoyl peroxide, sodium azide

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40
Q

picric acid

A

handle with extra care because very explosive when dry, should be stored under water; found in brazil fixative

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41
Q

pyrophorous

A

substances that ignite and burn when exposed to air

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42
Q

General storage rules of chemicals

A

Chemicals should be arranged alphabetically

  • store strong oxidizers and strong reducing agents separately,
  • organic solvents should be kept in small quantities only.
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43
Q

How should Ether be stored?

A

should be stored in full, air tight, amber glass bottes or safety cans in the dark; because Ether can form explosive peroxides when exposed to air and sunlight. Also do not store in refrigerator.

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44
Q

How to store Sodium and Potassium metals and their hydroxides?

A
  • store in plastic not glass bottles

- they must be kept dry and stored away from any water source; otherwise may catch fire spontaneously when wet

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45
Q

How to store Picric acid?

A
  • it should be stored under water in a bottle with a stopper that is moistened before removal and on replacement.
  • explosive when dry
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46
Q

How to store Mercury?

A
  • stored in airtight containers away from direct sunlight and kept as cold as possible
  • forms toxic vapor at room temperature
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47
Q

How should acids be stored?

A
  • in glass stopper bottles in a glass drip tray
  • must not contain more than 500 mL on shelf.
  • larger volumes kept on floor
  • Not stored with alkalis or other reactive chemicals
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48
Q

Ammoniacal Silver

A

forms explosive precipitates upon standing. do not store this compound

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49
Q

How to open acids or bases bottle?

A

-wear goggles, safety gloves and rubber apron

place bottle in sink, wrap absorbent towel or cloth over neck, then open carefully.

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50
Q

How to measure a dangerous chemical?

A

use a cylinder, automatic pipette or pipette and safety bulb. never mouth pipette.

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51
Q

How to pour dangerous chemicals?

A

keep the bottle below eye level

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52
Q

How to mix dangerous chemicals?

A

always add acid to water not water to acid.

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53
Q

How to transport large bottles of dangerous chemicals?

A

must be transported in acid bottle carriers to reduce the chance of accidental breakage.

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54
Q

How to handle carcinogenic substances?

A

wear disposable gloves, handle substances in a laminar flow hood. rinse hands in cold water before using soap after procedure is complete. Cold water closes pores and rinses carcinogenic away.

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55
Q

Drabkin’s reagent

A

used in hematology is extremely toxic (contains cyanide)

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56
Q

Ether

A

fumes are flammable. never use near an open flame

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57
Q

crystal violet

A

used in gram staining is clastogenic (causes breaks in chromosomes.) wear gloves when handling and do not mouth pipette

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58
Q

General Rules of disposing hazardous chemicals

A
  • Never dispose several chemicals at the same time, in the same container or sink before checking their reactivity data
  • rapidly flowing water must be used to flush the pipes when disposing chemicals down the drain
  • spills are dangerous, isolate the spill with absorbent material, neutralize if necessary, mop up and dispose of all materials in a properly labelled disposal bag. ventilate area of spill
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59
Q

insidious and an example

A

aka hidden ie. aerosols

60
Q

aerosol

A

the vaporization of the dispersion of liquid droplets, solid particles n a fine mist or spray ie. explosive type of cough or sneeze

61
Q

lab procedures that create aerosols

A

grinding, blending, sonicating(applying sound energy to agitate particles ie. ultrasound), centrifuging

62
Q

Sodium azide or picrates

A

insidious hazard

-can cause an explosion when it reacts with copper or lead piping

63
Q

Mercury

A

insidious hazard
-contamination of a room can occur from breaking a clinical thermometer
extremely toxic
found in zenker’s fluid
-acute exposure may cause psychotic reactions, delirium, hallucinations and suicidal tendency

64
Q

carcinogens and mutagens

A

often used in histopathology and chemistry labs, always perform in laminar flow hood

65
Q

polycyclic hydrocarbons

A

well known as carcinogens

66
Q

benzene

A

cause liver damage quickly and can cause cancer.

benzidine was used for occult blood testing; now known to be a dangerous carcinogen

67
Q

Threshold Limit Value (TLV)

A

the concentrations of substances a person can be repeatedly exposed to during an 8 hour day without adverse effect
-often measured in ppm

68
Q

Threshold limit value- Short term exposure limited (TLV-STEL)

A

the concentration of a substance a worker can be exposed to for a maximum of 15 minutes without adverse effect

69
Q

Lethal dose 50% kill (L.D.50)

A

the dose of a substance when administered orally or intravenously to test animals kills half of them
-expressed in mg of toxic material per kg of body mass

70
Q

Lethal concentration 50% kill (L.C.50)

A

the concentration of toxicant inhaled by test animals for a known period of time, which kill half of them
-reported in ppm

71
Q

Radiation

A

energy that comes from a source and travels through material or space

72
Q

ionizing radiation

A

has high energy to remove electrons from atoms or molecules

  • results in the formation of a charged atom called an ion
  • changing the chemical composition of the matter
  • ie. xray, gamma ray
73
Q

non-ionizing radiation

A

has enough energy to vibrate atoms, but not enough to remove electrons, including lasers, microwaves and ultraviolet radiation.

74
Q

The degree of radiation exposure depends on these 4 factors:

A
  • distance between the source of radiation and the individual
  • amount of time of exposure
  • type of shielding or protection used
  • type of radiation; ionizing or non ionizing radiation
75
Q

radiation acute effects include:

A

skin disorder, bone marrow disorder, digestive disorder, neuromuscular system disorder

76
Q

radiation chronic effects include:

A

leukemia, other malignancies in the body

77
Q

CNSC

A

Canadian Nuclear Safety Commission controls the standards for workplace exposure to radiation in Canada

78
Q

Laboratory monitoring with a _______ and wipe tests to measure radiation exposure

A

Geiger-Mueller Counter

79
Q

Disposal of Radioactive materials

A

radioactive reagents with a short half-life are poured down the sink
-other disposable are put into biohazard containers and held until background counts are reached, then treated as standard biohazard waste

80
Q

Steps in handling major spills with radioactive material

A
  1. warn personnel and evacuate area
  2. decontaminate personnel
  3. turn off all services except lighting and ventilation
  4. close doors and windows
  5. inform supervisor
81
Q

asepsis

A

free from infection or pathogens

82
Q

medical asepsis

A

an object or area is clean and free from infection, non pathogens may still present, but pathogens are eliminated

83
Q

microorganisms

A

tiny living animals or plants that cannot be seen by naked eye ie. bacteria, virus, parasites

84
Q

growth requirements for microorganisms

A
  1. proper nutrition
    autotrophs feed on inorganic or non-living and heterotrophs feed on organic or living substance
  2. oxygen
    aerobes need oxygen, anaerobes do not need oxygen
  3. optimum temperature for each microorganism is body temperature 37 degrees celsius or 98 degrees fahrenheit
  4. darkness
  5. moisture
    6.pH -most like neutral 7
85
Q

majority of microorganisms do not normally cause disease True or false

A

true

86
Q

pathogens, microorganisms that cause disease ________ the body, ________ and cause infection

A

invade, multiply

87
Q

communicable disease

A

infection may spread from person to person

88
Q

nosocomial or iatrogenic infection

A

occur from contact with infected patients, employees, visitors or contaminated equipment in the hospital

89
Q

biohazards

A

infectious materials which present a risk or potential risk to humans

90
Q

examples of biological hazards

A

blood, urine, feces, CSF, tissue, semen, synovial fluid, pleural fluid, amniotic fluid, sputum, peritoneal fluid

91
Q

The infection process cycle:

A
  • sources of infection(people, contaminated objects),
  • means of exit(mouth, nose, throat, ears), —means of transmission (inhalation, ingestion, absorption, percutaneous exposure),
  • means of entry (mouth, nose, ears, eye etc)
  • susceptible host(this can be anyone)
92
Q

how to break the chain of infection

A

stop infection at the source, eliminate means of transmission, reduce susceptibility of a potential host

93
Q

personal protective equipment

A

lab coats and gowns, goggles, face shields eye shields, safety gloves, masks, respirators, automatic pipettes and pro pipettes, acid bottle carriers

94
Q

Fume hood

A

not used in clinical medical labs, can be used when working with materials like strong base or acid, that generate fumes, gases, vapours and dust

95
Q

biological safety cabinet

A

used to prevent the escape of aerosols into the lab.

  • used when working with toxic chemicals, that generate dust or fumes.
  • there are three types class 1, 2 and 3
96
Q

class I biological safety cabinets

A

user is protected, the test or specimen is not.

  • cabinet is a partial container unit
  • can be used with an open front, an enclosed panel without gloves and with a panel with gloves
97
Q

class II biological safety cabinets (laminar air flow hood)

A
  • user and specimen are protected
  • the most common BSC used in clinical labs
  • airborne containments in the cabinet are prevented from escaping across the the front opening by a curtain or air supplied by a grill in the top of the cabinet
  • open flames should not be used
98
Q

class III biological safety cabinet

A

total enclosed

-provides the highest level of personal and environmental protection as well as test of specimen protection

99
Q

safety can

A

these cans are explosion and fire proof, used to discard potentially flammable or explosive chemicals

100
Q

safety emergency shower

A

used to wash off any acid, base, or toxic chemical from the body,
-used when large amounts of the body have been exposed to a chemical, should provide flow of water for at least 15 min

101
Q

chemical spill kits

A

used to clean up accidental acid, solvent or alkaline reagent spill.
- most kits contain: absorbent material, a neutralizer for acids and bases, eye shield, scoop, brush and disposable bags

102
Q

flammable storage cabinets

A

used to store flammable or combustible laboratory chemicals safely.

  • has welded steel double wall construction with an air space between the walls.
  • the door has a strong lock, leak proof sill, and a large FLAMMABLE KEEP AWAY label and hazard symbols on the front
103
Q

Purpose of isolation

A

keep infectious agents from spreading outside the patient’s room

104
Q

nosocomial infection

A

acquired infection while in hospital,

MRSA and VRE are the most epidemiologically important of antibiotic-resistant pathogens

105
Q

MSRA

A

Methicillin-resistant staphylococcus aureus

106
Q

VRE

A

vancomycin resistant enterococcus

107
Q

Types of Isolation (5)

A

strict isolation, enteric isolation, wound and skin precautions isolation, respiratory isolation, reverse isolation

108
Q

strict isolation

A

a private room with the door locked, where persons entering must wear gowns, gloves and masks.
-prevents the spread of infection spread by both air and contact

109
Q

enteric isolation

A

used to prevent infections that are transmitted by direct or indirect contact with feces
-must wear gloves

110
Q

wound and skin precaution isolation

A

designed to prevent transmission of infections by direct contact
-wear gloves

111
Q

respiratory isolation

A

private room, and persons entering must wear masks, gloves and gowns are not necessary
-designed to prevent transmission through droplet or airborne means

112
Q

reverse isolation

A

designed to protect the patients from infection.

-visitors must wear protective gear and constantly wash hands

113
Q

Blood specimen collection techniques for isolated patients

A
  • take only the equipment necessary into the room,
    do not take blood collection tray into room
    -procure specimen, label appropriately and affix “isolation” sticker on tubes
    -place specimen in a clean plastic specimen bag located just outside the room
    -do not step outside the room
    -dispose of needle properly in the room
    -remove protective clothing, seal the specimen bag, wash hands
    -take specimen to lab
114
Q

Standard Precautions

A

issued by CDC, set of procedures for dealing with patients under the assumption that all patients and all body fluids, substances, organs should be regarded as potentially infectious and potentially positive with hep B and HIV

115
Q

Universal Precautions

A

a method of infection control in which all human blood and other body fluids containing visible blood are treated as if infectious

116
Q

body substance precautions

A

all specimens, fluids, tissues, smears, blood, serum, plasma, swabs, must be considered potentially infectious. must wear gloves and coat when handle and deal with body fluid

117
Q

procedure for accidental needle stick

A
  • allow injury to bleed freely,
  • decontaminate with iodine-providone for a minimum of 30 seconds
  • cover with a waterproof bandaid
  • report to supervisor in writing within 24 hrs
  • do not milk the wound, may promote hyperemia
118
Q

procedure for mucous membrane exposure

A
  • flush the site with water for a min. Of 10 minutes
  • report all exposure incidents, to an immediate supervisor with 24 hrs
  • the employer must provide confidential medical evaluation and treatment to the employee
  • source patient and employee tested for HIV and HBV.
  • if source patient is HBV positive the employee’s immune status is determined and immune globulin shots may be given
119
Q

Biosafety Level 1

A

suitable for work involving well characterized agents not known to consistently cause disease.
-minimal potential hazard to laboratory personnel and the environment

120
Q

biosafety level 2

A

similar to biosafety level 1 with moderate potential hazard to personnel and the environment.
-agents such as hepatitis A, B, C, influenza, lyme disease, salmonella, HIV

121
Q

Biosafety level 3

A

applicable to clinical or production facilities where work is done with indigenous or exotic agents which may cause serious or potentially lethal disease
-agents such as SARS, smallpox, yellow fever, TB

122
Q

biosafety level 4

A

required for work with dangerous and exotic agents that pose a high individual risk of aerosol-transmitted laboratory infections, agents which cause severe to fatal disease for which vaccines and other treatments are not available
-agents such as dengue fever, ebola virus, hanta virus

123
Q

disinfectants

A

products registered by the Canadian Environmental Protection Agency as being effective against HIV and HBV
ie. 1% hypochlorite, 2% glutaraldehyde

124
Q

1% hypochlorite

A

universal intermediate chemical disinfectants aka bleach/javex

  • effectively kills HIV, HBV, bacteria and fungi, but is inactivated by organic material
  • this solution must be made daily
  • not to be used on metal surfaces
125
Q

2% gluteraldehyde

A

a high level and very potent disinfectant may be used on metal surfaces.

  • effectively kills HIB, HBV and HCV
  • must be made weekly and stored at room temperature
126
Q

Formaldehyde

A

a high level disinfectant and sterilant used in both liquid and gaseous states.

  • in liquid state kills bacteria, TB, Fungi, Virus and spores,
  • in vapor, it is used to disinfect large areas
  • full mask must be worn and two ppl must be present at all times
127
Q

Phenols

A

low level disinfectants and should not be used in the laboratory to disinfect work areas, as they do not kill viruses and spores

128
Q

Procedure when spill occurs on the body

A
  1. remove contaminate clothing
  2. vigorously wash exposed area with soap and water for one min
  3. obtain medical attention if open cuts are present
  4. report incident to lab supervisor
129
Q

procedure when cleaning blood spills on hard surfaces

A
  1. isolate the area
  2. wear gloves and other protective equipment
  3. remove visible blood with disposable towels
  4. area should be decontaminated with appropriate germicide
  5. dispose contaminated towels and gloves in biohazard waste container
130
Q

procedure when dealing with small spills

A
  1. cover the spilled material with absorbent towels
  2. gently pour disinfectant onto the paper towels, working in circular motion from outside to in
  3. wait 30 min
  4. remove the towels with forceps
  5. repeat steps 1-4
131
Q

procedure when dealing with larger spills

A
  1. hold breath, inform others in area
  2. close windows and doors
  3. evacuate
  4. allow aerosols to disperse and settle
  5. follow procedures for small spills
132
Q

biomedical waste disposal

A

waste must be segregated from general waste into categories: human anatomical waste, animal waste, microbiology lab waste, human blood and body fluid waste and waste sharps

133
Q

packaging

A

-must remain intact and contained through handling, storage, transportation and treatment

134
Q

properties of sharps container

A

must be sturdy enough to resist puncture under conditions of use to the point of disposal

  • must be colour coded yellow and labelled with biohazard symbol
  • must have lids that can be tightly secured
135
Q

plastic waste holding bags

A

-sturdy enough to resist puncture under conditions of use and to the point of disposal

136
Q

First aid for chemical injury of skin

A
  1. wash away the chemical with large amounts of water for at least 5 min, use a safety shower or hose
  2. remove the victims clothing from the areas involved
  3. do not apply ointments, creams etc
  4. apply a clean dressing bandage and get medical aid
137
Q

First aid chemical injury to eyes

A
  1. wash the eyelids and affected face area with water for at least 15 min, use eye wash station (turn patients head to the side, hold eyelids open, make sure chemical doesn’t wash to other eye
  2. cover the eye with a dry, clean, protective dressing (do not use cotton) and bandage in place
  3. caution victim against rubbing eye
  4. seek medical attention
138
Q

first aid for heat injury (burns)

A
  1. do not break blisters or remove tissue
  2. do not apply antiseptic or ointment
  3. just cover with bandage and seek medical attention
  4. if arms or legs are affected, keep them elevated
139
Q

first aid for trauma

A
  1. apply direct pressure, by placing a hand over a dressing
  2. do not disturb blood clots after they have formed
  3. apply pressure bandage
  4. elevate wound above level of the patient’s heart
  5. seek medical attention
140
Q

first aid for electrical shock

A
  1. remove patient from electrical source if you own safety is guaranteed. use a non-conductive (wood or plastic) device to push or pull patient away
  2. administer CPR if patient is not breathing or has no heart beat
  3. after re-establishing heart and lung function, elevate patient’s feet
  4. cover to keep them warm
  5. seek medical attention
141
Q

first aid for accidental needle stick

A
  1. milk the wound, allow blood to flow freely
  2. wash and decontaminate with iodine for at least 30seconds
  3. apply waterproof bandaid
  4. report to supervisor within 24 hours
142
Q

HCL

A

hydrochloric acid

143
Q

NHO3

A

Nitric Acid

144
Q

H2SO4

A

sulfuric acid

145
Q

KOH

A

potassium hydroxide

146
Q

NaOH

A

sodium hydroxide

Basic Clinical Laboratory Techniques (4 decks)

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