LASER SAFETY Flashcards
What does ANSI stand for? Who publishes the ANSI LASER Standards?
American National Standards Institute
LIA=Laser Institute of America
Which ANSI standard applies for the Safe Use of Lasers in Health Care?
ANSI Z136.3
Whose responsibility is it to know the State and Local requirements for safe use of health care laser systems?
1) LASER SAFETY OFFICER
2) LASER OPERATOR
What is the term for the max accessible level of laser radiation permitted within a particular laser class
AEL=Accessible Emission Limit
Class of most dental surgical lasers, if emit > .5 Watts Avg Radiant Power
Class 4 Hazardous to eye or skin from
1) direct beam
2) Reflective Surface
Class of medium powered lasers (Visible or Invisible regions)-potential eye hazard
3B Potential eye hazard
1) direct beam
2) specular (“mirror-like”) conditions
Class of laser system that is potentially hazardous to eyes if the eye is appropriately focused and stable
3R Potential eye hazard (if the eye is appropriately focused and stable)
1) direct beam
2) specular (“mirror-like”) conditions
What is the difference in Class 1 and Class 4 lasers?
Class 1 = safe for direct beam viewing under most conditions
Class 2 = not considered an eye hazard unless viewed with collecting optics
Class 4 = requires the most strict controls
The value of exposure to laser energy above which a risk of hazardous effects or adverse biologic changes in the eye or skin may occur…
MPE = Maximum Permissible Exposure
A value that defines the attenuation property of a filter and is equal to the logarithm to the base ten of the reciprocal of the transmittance at a particular wavelength
OD = OPTICAL DENSITY “measure of TRANSMITTANCE through an optical medium”
The space within which the MPE is being exceeded…all persons must wear laser protection within this zone…
NHZ = NOMINAL HAZARD ZONE
The distance from the emission port of the laser, with which the MPE is being exceeded…must wear laser device specific protective eyewear within this zone…
NOHD = NOMINAL OCULAR HAZARD ZONE
LSO (Laser Safety Officer) reponsibilities
1) P/Ps written for Class 3B and Class 4 Lasers
2) Retraining programs at intervals at least q 5 yrs
3) LASER Safety items maintained
4) Maintain written operating/maintenance/calibration procedures from Manufacturer
5) Monitor laser maintenance from trained technicians
6) Maintain records
What is a LASER SAFETY OFFICER?
indiv designated to be
1) responsible for a laser or system of lasers
2) prep and enforce of safety plan (P/Ps)
LSO P/Ps (Policies and Procedures)
1) Education of team members
2) Maintenance procedures
3) Serial number of laser, model, date of laser purchase
4) Inspections of equipment-Laser protective eyewear
How often should LSO do equip safety audits?
at least once per year
What labeling is required on LPE (Laser Protective Eyewear)?
1) OPTICAL DENSITY
2) WAVELENGTH
Is LPE designed for looking directly at laser beam?
NO
What part of the eye is mostly at risk at the 400 nm-1400 nm wavelength?
RETINA
CO2 Laser- its the Cornea, Lens and Aqueous Humor (>1400 nm wavelength)
SIGNS OF EYE EXPOSURE (Laser damage)
HA/Burning/Floaters/Extreme Watering/Gritty Sand/Popping Noise/no eye pain
Only fatalities from lasers are due to what?
Electrocution - careful when maint/repair/calibration when accessing high voltage components
Combustible Hazards
1) Alcohol based products (ie alcohol wipes)
2) Oxygen (must use scavenging with N2O)
3) Endotracheal tubes must be protected
LGAC - what does Laser Generated Airborne Contaminants consist of?
1) poss viable Bacteria, Viruses, cellular debris
2) Noxious Fumes
(surgical masks do not provide protection from plume contaminants)
What is combustible hazards training?
annual competency on the operation of all fire extinguishers in the laser use area
What should be documented for Laser use?
1) fiber size/spot size 2) tip shape and size
3) Emission Mode (CW or Pulse)
4) Energy/power settings
5) time of exposure 6) eye protection worn
Longer WLs are highly absorbed by H2O - more damage to what part of eye?
CORNEA (outer surface)
1) Er,Cr, YSGG 2) Er: YAG 3) CO2
Shorter WLs not absorbed well by H2O, target pigmented tissues in eye, deeper penetration, damage what parts of the eye?
Lens-IRIS (pigmented) and Retina (deeper in eye) 1) Diode 2) Nd:YAG 3) HeNe 4) Argon (composite curing lights)
What laser WLs cause damage to Aqueous Humor (due to high H2O content)?
1) Er,Cr, YSGG 2) Er: YAG
LASER INFECTION CONTROL consists of the following:
- *Steam Sterilization only**
- *Fiber Optic tip considered a “sharps”
1) Biohazards - coagulum on end of fiber, ie fibroma
2) Plume Hazards-use surgical mask-filter < .1 micron
3) Proper surgical wear 4) Decontamination of Field
5) Disposal of Laser Supplies
