OR Environment Flashcards
Exam treatment room
High level disinfection, sterile instruments
Procedure
High level disinfection, sterile instruments SOME OR controls
OR
High level disinfection, sterile instruments, Environmental controls, capability for aseptic field
Unrestricted area
Traffic not limited, if in scrubs you need a lab coat.
Semi restricted area
Traffic limited, so scrubs and cap needed
Restricted area
Traffic only to necessary personnel. Unwrapped sterile supplies
Standard OR temp
68-75 degrees F
Hypothermia associated with : increased wound infection, impaired coagulation, increased blood loss, prolonged hospitalization
Standard humidity levels OR
30-55%
<30- increased fire, alters sterile indicator strip, increased infection risk (flying debris)
> 55%- increased risk of infection, mold/mildew, uncomfortable for staff
Ventilation in OR?
Engineered to decrease turbulent flow and be unidirectional. Not part of waste anesthesia gas system,
Maintains a small amount of positive presure
Fresh air introduced near ceiling with return near floor
25 air exchange/hr, remove 90% particles in air
Fresh air standard for OR
80/20 mixture of recycled/fresh air
Needed air exchanges/hr
25
Necessary percentage for high efficiency particulate filters
90%
Normal OR dB level
75-90
Voice needs to be what dB level to be heard
20 above background
Ionizing radiation
Enough energy to detach e from atoms, nuclear decay, gamma rays and X-ray, UV light
Appropriate radiation exposure
ASARP (as little as reasonably possible)
Law of inverse square
Amount radiation changes inversely with distance
Macroschok
100-300 causes Vfib Current applied through body through skin
Micro shock
Current applied directly to heart/internal organ. VF potential is 30 ma in humans
LASER safety precautions
- Restrict access to area
-Close all doors and windows - post warning signs
-eye protection for pt and people
-cover all exposed skin - remove bright reflective objects
-maintain room lights as bright as possible
=alarm to indicate use of laser
-don’t leave laser unattended
-keep laser beemabove/below normal line of sight
-avoid looking into primary beam at all times
Anesthesia gases during laser use
<30%O2. Avoid NO. Special ETT (laser approved). LMA sensitive to laser
Eye trauma from lasers
May not be readily apparent. Color vision goes first. Depends on intensity and wavelength.
Smoke plume
Pollution from cauterya nd laser six. Fine particulates in plume that may contain viruses, bacteria, tissue, fungus. Use protective masks o
Ordinary protective mask
5 micrometers particulates
High efficiency mask
0.1-0.3 micrometers
Class 1 WOUND
Clean. No s/s infection. Risk infection <2%
Class 2 wound
Clean-contaminated. No s/s infection. Repairing or removing an organ (appy) <10% risk of infection
Class 3 wound
Contaminated. Open wound with blood/body fluids present. Up to 20% risk of infection
Class 4 wound
Dirty. Infection already present. 40% risk of infection
Low level disinfection
Kills vegetative bacteria and some fungus and virus but not TB and spores
Intermediate level
Kills vegetative bacteria, fungus, virus, and TB but no spores
High level disinfection
Kills all organisms and spores but not CJD
Sterilization
State of being free from all organisms
Steam sterilization
Time based on temp. Needs to dry at room temp, Can damage sensitive equipment
Dry heat
Items that may be damaged by moisture. Time varies depending on temp
Direct and indirect effects of radio action therapy
Direct- breaks down atoms of DNA and other genetic components
Indirect-impairs protein, enzyme function
LASER stands for?
Light amplification by the Stimulated Emission of Radiation
4 classes of LASERS?
Class 1- CD player
Class 2- Laser pointer/scanner
3- entertainment light shows
4- medical lasers (eye damage, fire hazard, airborne contamination)
Precaution with ETT and lasers?
PVC easily ignites
Rubber tubes are more resistant
LASER approved tubes should be used (double cuff to prevent leaking of gas if cuff is ruptured)
What do you do if fire in OR?
Turn off o2 and ignition source Remove ett/drapes Extinguish fire Ventilate with 100% Assess for damage Reintubatr
Noise pollution in OR?
Can be as high as 125 dB with surgical saws and power tools.
Complications of noise pollution
Inability to hear alarms Interfere with communications Increased level of endogenous catecholamins Irritability Increased BP HEARING LOSS
Radiation Therapy
Harmful effect- direct breaks atoms of DNA and other genetic components
Indirect - Impairs protein, enzyme function
Exposure
ASLARP
Law of inverse squares (1/d2)
LASER pulses can result in:
Tissue rupture and damage of retina
Corneal photokeratitis
Cataracts
Loss of color vision
Talk about equipment and various levels of sterilization?
Critical -sx instruments and implanted devices -sterilized Semi critical -anesthesia equipment (laryngoscopes/blades) -high level disinfection Non-critical -pulse ox, BP cuff, cables -low level Single use -Sterilized -Single pt use
Various methods of sterilization?
Pasteurization (30 min 700 deg C)
Steam (autoclaving)
- time based on temp (15@120, seconds at 1500c)
- needs to dry room temp
- can damage sensitive equipment
Dry head
- items damaged by moisture
- time varies based on temp
Chemical
-high concentration of low ph can damage equipment
Gas sterilization
Radiation
Types of chemical sterilization
Quaternary ammonium compounds Alcohols Glutaraldehydes Hydrogen peroxide based compounds Formaldehyde Phenolic compounds Chlorine
