mini study guide (OR Safety)

Question 1

give the equation for electricity that follows Ohm’s Law?

Answer 1

voltage= current x impedance

Question 2

voltage is known as the?

Answer 2

driving pressure

Question 3

current is also known as?

Answer 3

flow

Question 4

impedance is also known as?

Answer 4

resistance

Question 5

the electrocautery delivers a high frequency current that is ____ to ____ hertz

Answer 5

500,000 to 1 million hertz

Question 6

the electrocautery is used to?

Answer 6

cut, coagulate, dissect, or destroy tissue

Question 7

the higher the frequency on the electrocautery, they will have a _____ tissue penetration and does not affect _____ cells. thus what is not a risk?

Answer 7

low
excitable
Vfib

Question 8

monopolar electrocautery requires a?

Answer 8

grounding pad

Question 9

a grounding pad is placed on a patient to allow?

Answer 9

for the exit point of a return current

Question 10

a grounding pad is also called a?

Answer 10

functional return electrode

Question 11

A functional return electrode serves as the exit point by providing?

Answer 11

a large, low impedance surface area for the electrical current to exit the body and return to the power generator

Question 12

if a return electrode fails, what does this place the patient at risk for?

Answer 12

burns

Question 13

if the return electrode malfunctions the electrical current will?

Answer 13

find another pathway to exit the patient, such as the EKG electrodes, temperature probe, or metal components of the surgical table.

Question 14

the smaller the area that the electricity exits the body other than the functional return electrode, the greater the?

Answer 14

intensity of the burn

Question 15

To prevent burns at the return pad site, the entire surface of the return electrode should be?

Answer 15

in direct contact with the patient’s skin

Question 16

the functional return electrode should never be placed where?

Answer 16

over bony prominences ro metal implants

Question 17

what happens if the gel on the functional return electrode dries out?

Answer 17

the electrical current won’t have a direct path to the return electrode and will find another way to exit the body

Question 18

the electrocautery can emit ____ and cause a fire

Answer 18

sparks

Question 19

the bipolar electrocautery has two electrodes known as?

Answer 19

active and return electrode

Question 20

the bipolar electrocautery does not have a ?

Answer 20

return pad

Question 21

what is a critical aspect of using an electrocautery on a patient with a pacemaker or an ICD?

Answer 21

the current must not pass across the pacemaker.

Question 22

to recieve a shock, a person must become a part of and complete an?

Answer 22

electrical circuit

Question 23

for current to flow, there has to be a voltage difference across an ______.

Answer 23

impedance.

Question 24

therefore, if a closed circuit exists, then exposure to a live electricity source provides an electromotive force (voltage) that pushes the current through an impedance. The impedance can be?

Answer 24

you or the patient

Question 25

an electrical current that enters the body will exit the body along the path?

Answer 25

of least resistance

Question 26

name three consequences of electrical injury?

Answer 26

cardiac arrhythmias nerve injury thermal injury

Question 27

with electrical injury resulting in nerve injury you could have _____ paralysis and muscle contractions

Answer 27

diaphragmatic

Question 28

with thermal injury from an electrical injury the damage to the ______ may be more extensive than the damage you observe on the skin

Answer 28

internal organs

Question 29

define macroshock?

Answer 29

a comparatively larger amount of current that is applied to the external surface of the body.

Question 30

why must larger amounts of current be applied to the external surface of the body?

Answer 30

because the impedance of the skin offers a high resistance

Question 31

1 mA of macroshock results in?

Answer 31

threshold for touch perception of electrical shock

Question 32

5 mA of macroshock results in?

Answer 32

maximum current for a harmless electrical shock

Question 33

10-20 mA of macroshock results in?

Answer 33

"let go" current occurs before sustained contraction

Question 34

50 mA of macroshock results in?

Answer 34

loss of consciousness

Question 35

100 mA of macroshock results in?

Answer 35

ventricular fibrillation

Question 36

define microshock?

Answer 36

a comparatively smaller amount of current that is applied directly to the myocardium

Question 37

with microshock, the high resistance of the skin is bypassed, so it takes a significantly ____ amount of current to induce ventricular fibrillation.

Answer 37

smaller

Question 38

10 uA of microshock results in?

Answer 38

maximum allowable current leak in the OR

Question 39

100 uA of microshock results in?

Answer 39

ventricular fibrillation

Question 40

what unit are used in microshock?

Answer 40

uA

Question 41

what unit of measurement are used in macroshock?

Answer 41

mA

Question 42

What type of devices provide a direct conductive pathway to the heart, so it should make sense that they increase the patient's susceptibility to microshock.

Answer 42

central line PA catheter pacing wires

Question 43

How does the electrical system in the OR reduce the risk of electrical shock in what two ways?

Answer 43

OR power supply is NOT grounded the equipment is grounded

Question 44

for an electrical shock to occur in the OR there must be ___ faults in the system, which are?

Answer 44

2 faults first, the OR power supply becomes grounded second, the equipment is not grounded.

Question 45

the line isolation monitor serves what purpose?

Answer 45

to assess the integrity of the undergrounded power system in the OR

Question 46

the line isolation monitor, tells you when the OR becomes grounded and how much?

Answer 46

current could potentially flow through you or a patient if a second fault occurs

Question 47

if the line isolation monitor alarm sounds what should you do?

Answer 47

the last piece of equipment that was plugged in should be unplugged

Question 48

the line isolation monitor will alarm when?

Answer 48

when 2-5 mA of leak current is detected

Question 49

all electrical devices leak a small amount of?

Answer 49

current

Question 50

if the sum of the leak of currents from devices in the OR exceeds 2-5 mA, the LIM alarm will sound, however, there is no risk of electrical shock in this situation, and what corrective action is required?

Answer 50

none

Question 51

does the LIM by itself protect you or the patient from macro or micro shock?

Answer 51

no

Question 52

what is the primary purpose of the LIM?

Answer 52

to alert the OR staff of the first fault, meaning the OR has become grounded

Question 53

CRNAs are at greater risk for exposure to ____ radiation

Answer 53

ionizing

Question 54

where are potential areas for ionizing radiation exposure for the CRNA?

Answer 54

CT, CCL, EP lab, IR, NM, RAD therapy, anywhere fluoroscopy is used

Question 55

ionizing radiation can remove electrons from atoms, this causes ______.

Answer 55

free radicals

Question 56

free radicals can be damaging on the ____ level | which includes risk of tissue injury, chromosomal damage or malignancy

Answer 56

cellular

Question 57

most exposure of ionizing radiation is the result of ___ ____ , not direct exposure

Answer 57

scattering x-rays

Question 58

how do we quantify exposure to ionizing radiation?

Answer 58

roentgen (R)

Question 59

the roentgen equivalent in man (REM) is a unit dose equivalent, this relates the?

Answer 59

human tissue absorption to the effective biological damage of the radiation

Question 60

the yearly maximum radiation exposure is ___ rem

Answer 60

5 rem

Question 61

the yearly maximum exposure for the fetus of a pregnant worker is ___ rem or ___ rem/month

Answer 61

0.5 or 0.05 rem/month

Question 62

in the non-pregnant person, the ___ and ____ are the most susceptible to injury from radiation on the body.

Answer 62

eye and thyroid

Question 63

in the pregnant person, who is most suseptible to injury the mother or the fetus?

Answer 63

the fetus

Question 64

how can you protect yourself from radiation? 3 ways

Answer 64

distance duration shielding

Question 65

the minimum safe distance is ___ feet from the radiation source.

Answer 65

6 feet

Question 66

the amount of exposure is _____ proportional to the square of the distance of the source

Answer 66

inversely

Question 67

six feet of air confers the same protection from radiation as ___ inches of concrete or ___ mm of lead

Answer 67

9 inches of concrete | 2.5 mm of lead

Question 68

a lead apron is usually ___ mm thick

Answer 68

0.25 to 0.5 mm

Question 69

what is the measuring device for radiation exposure?

Answer 69

dosimeter

Question 70

where should a pregnant provider where her second dosimeter?

Answer 70

under her apron

Question 71

where should a provider wear a dosimeter?

Answer 71

on the shirt collar near the thyroid gland.