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OR Safety Flashcards

1
Q

What is the definition of current?

A

The flow of electrical charges (electrons)

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2
Q

What is the definition of circuit?

A

The path that the current flows through

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3
Q

What is the definition of conductor?

A

The current moves easily (copper, bronze)

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4
Q

What is the definition of insulator?

A

The current moves through poorly (glass, air) (keeps current in wire)

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5
Q

What is the definition of amps?

A

The amount of current flow per second

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6
Q

What is the definition of voltage?

A

Pressure pushing electrons

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7
Q

What is the definition of ohms?

A

Measure of resistance (skin)

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8
Q

What is the definition of hertz?

A

Number of cycles per second

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9
Q

What is the definition of current density?

A

Amount of current and area it flows over

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10
Q

How does electricity work?

A

A specific amount of alternating current (AC) (amp) is pushed through a circuit by voltage (120 v) at a specified frequency (60 hz)

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11
Q

How many wires do circuits have?

A

3; HOT, NEUTRAL, AND GROUND

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12
Q

Hot supplies ________, neutral provides the ______ path, and _______ is for safety

A

Current; Return; Ground

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13
Q

Can current flow through an open system?

A

No, current can only flow through an unbroken, closed system

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14
Q

Can current escape the designated circuit and travel an alternate path?

A

Yes, called a leakage current

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15
Q

_______ provides a low resistance path for leakage current to flow away from electrical equipment

A

Ground

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16
Q

What do circuit breakers do?

A

Interrupt the circuit when the current flow is high

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17
Q

Electricity is ______

A

Energy (If this energy is not controlled, it can cause fires, burns, electrocution)

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18
Q

Current will travel to the path of _____ resistance

A

Least

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19
Q

Frequency is measure with what unit?

A

Hertz (1 hz is one cycle per second)

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20
Q

The higher the frequency, the ______ dangerous

A

Less

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21
Q

Frequencies between 0 hz and 1 khz can interfere with ___________ and __________ in the myocardium and cause arrhythmias

A

Depolarization & Repolarization

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22
Q

The frequency at which minimum current induces fibrillation is ____ - _____ Hz, which is the frequency used for AC around the world.

A

50 - 60 Hz

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23
Q

Most household circuits = ___ - ____ amps, ____ - ____ volts

A

15-20 amps, 110-120 volts

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24
Q

Amps x volts = ______

A

Watts

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25
What is electrical resistance?
Impedance of current flow (can lead to storage of charges (capacitor))
26
Long power cords cause _____ resistance
High
27
Is skin a poor conductor?
Yes and very resistant
28
Dry, healthy, intact skin = _______ ohms
1 million ohms
29
Perspiring, intact skin = ________ ohms
12,000 ohms
30
Conductive jelly applied to skin = ______ ohms
1,000 ohms
31
Catheter, pacer wires on skin = < ____ ohms
< 100 ohms
32
Wet skin = _____ electrical conductor
Bigger
33
Dry skin can cause ______
Burns
34
As current flows through the skin, _______ will decrease
Resistance
35
Human effects of 60 Hz currents: 1 mA
Threshold of perception (barely feel)
36
Human effects of 60 Hz currents: 5 mA
Maximum harmless current intensity (feel a little more)
37
Human effects of 60 Hz currents: 10-20 mA
"let go" prevent release of object
38
Human effects of 60 Hz currents: 50-100 mA
Pain, mechanical injury, heart and respiratory function continues (can cause tissue damage)
39
Human effects of 60 Hz currents: 100-2500 mA
Vfib, respiratory center intact
40
Human effects of 60 Hz currents: >6000 mA
Sustained myocardial contraction, respiratory paralysis, burns if current density is high
41
What is macroshock?
- Current applied directly to body surface - Effects determined by surface area, amount of current flow (amps), duration of exposure, frequency of the current, path
42
It requires a ______ amount of current to overcome skin's resistance
Large
43
What can macroshock cause?
Produces muscle contraction, pain, burns, open wounds, pacer disruption, arrhythmias
44
What is microshock?
- Current applied directly to heart - Small amounts of voltage or current applied directly to myocardium bypassing the skin via a IV catheter, pacer wires, etc.
45
Current as little as ____ microamps can cause fatal arrhythmias
100 microamps
46
1000 microamps = __ milliamp
1 milliamp
47
1000 milliamp (mA) = __ amp
1 Amp
48
What is a leakage current?
The current that escapes the circuit due to stray capacitance and poor insulators ( a lot of resistance = build up & leak out)
49
Leakage current takes the path of _____ resistance
Least (rings that can't be removed need to be taped)
50
The _____ wire is designed to safely conduct leakage current and carry it aways
Ground
51
Lack of a proper ground wire leakage current can conduct through the ______ or __________
Patient or OR personnel
52
What does the line isolation monitor do?
- Designed to make it impossible for the patient and OR staff to become a path for current to go to ground - LIM measures how much leakage current would flow to ground if a grounding system were present - If the electrical equipment being used in the OR allows a large amount of leakage current to escape through its circuitry, the LIM will detect it and alarm - Measures how much electricity is going in & out; if large difference - concerning (don't want too much leaking back or not returning)
53
LIM alarm indicates what?
That the current is no longer isolated; an unsafe amount of leakage current may be present
54
An LIM alarm usually indicates what?
That the last piece of equipment plugged in may have a fault or that too much equipment is being used simultaneously, which results in too much leakage current
55
When does the LIM alarm?
If lose more than 5 mA
56
What is an electrosurgical unit (ESU)? AKA Bovie
Electrical current used to cauterize vessels and cut tissue
57
Are ESUs high frequency?
Yes, they are 300 kHz - 2 MHz (higher frequency = safer)
58
What is a unipolar Bovie/ESU?
Current applied using a single electrode that returns to the ESU by way of the dispersal pad
59
What is a bipolar Bovie/ESU?
Two pronged cutting electrode instrument. Current travels only between the two prongs; used when unipolar is unsafe
60
What cases should you use a bipolar Bovie/ESU instead of an unipolar one?
Brain, ovarian, or fallopian tube surgery
61
What is a dispersal pad?
Also called Bovie or grounding pad; it is applied as close as possible to the surgical site; large surface area to minimize current density; not required for bipolar
62
Why do we tape people's rings if they cannot take it off?
Because if tuck arms & it touches metal table, then conductivity will take path of least resistance = won't use Bovie, will use ring (metal against skin completes circuit, metal conducted)
63
Can ESUs/Bovies effect pacemakers?
Yes, ESU current traveling through pacer can alter functioning (no unipolar current path through heart)
64
What can you do to reduce effects of ESU/Bovie on pacemaker?
- Dispersal pad close to surgical site as possible - Reducing cautery current or use low current - Use bipolar cautery - Have magnet if pacer requires reprogramming - Magnet placed on pace = asynchronous mode (Pacer = synched; asynchronous with magnet) (interfering current with pacemaker) (want Bovie pad closer to where operating)
65
How will ESUs/Bovies effect AICDs?
ESU current will trigger AICD to fire (don't want to happen), so have device turned off prior to surgery (some can be left on; call manufacturer/pacemaker person to ask before surgery)
66
What is an important question to ask a patient when doing surgery and they have pacing wires or a pacemaker?
Are they pacemaker dependent (important question! want an external pacemaker when changing out)
67
How close can cause impact to ICD current?
Within 15 cm from generator
68
Should you have a magnet with you if the patient has a pacemaker of ICD?
Yes, always
69
What is a disinfectant?
Antibacterial agent applied to non-living objects (SANI wipes)
70
What is an antiseptic?
Antibacterial agent applies to living tissue (don't want to be wiping skin with disinfectant) (Betadine, Chloraprep, etc)
71
Some chemicals are used in the OR. What is ammonia?
A disinfectant liquid cleaning agent. Vapors irritate eyes and respiratory tract
72
Some chemicals are used in the OR. What is chlorine bleach?
Disinfectant liquid cleaning agent. Vapors irritate respiratory tract.
73
What is one thing you need to remember about using ammonia and chlorine bleach?
Never use them together!!! Forms chlorine gas!!!
74
Some chemicals are used in the OR. What is chlorhexidine?
Antiseptic used to clean skin. Splashed in eye can cause keratitis or loss of vision
75
Some chemicals are used in the OR. What is iodine?
Antiseptic used on skin. Splashed in eyes can cause irritation
76
Some chemicals are used in the OR. What is hydrogen peroxide?
Antiseptic used to clean skin. Splashed in eyes can cause corneal ulceration.
77
What should you do in a face or eye case when using antiseptics?
Cover eye with a patch

Principles I (4 decks)

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