Safe use of equipment Flashcards
What mandates that a user facility must report all incidents resulting from defective medical devices or user error that cause or contribute to the death, serious injury, or serious illness of a patient?
Safe Medical Device Act of 1990
What 3 things would be considered a medical device?
- Electrocardiogram machine
- OR bed
- patient warming unit
What do a Manufacturer’s IFU include? How to…
- assemble a device
- use a device
- clean, decontaminate, or sterilize a device
- store a device
The manufacturer’s IFU must be what?
easily available to the periop team
What 2 ways should the manufacturer’s IFU be available?
online and paper
Where should copies of a manufacturer’s IFU for medical devices be located?
- sterile processing department
- biomedical engineering department
- surgical services
Failure to follow manufacturer’s IFU for medical devices can do what?
- result in patient injury
- invalidate the equipment warranty
- result in accreditation organization citations
What does non-ionizing radiation include?
- UV
- visible light
- infrared
- microwave
- radio frequency
- extremely low frequency
Examples of non-ionizing radiation include?
- home microwaves
- infrared radiation used in a heat lamp
- lasers
- tanning beds
- televisions
What 3 medical devices use ionizing radiation?
- X-ray
- CAT or CT
- nuclear medicine (brachy therapy and gamma knife)
What are the 3 tenets of radiation safety?
- time
- distance
- shielding
define time in the tenets of radiation safety
maintain the shortest amount of exposure time as possible
define distance in the tenets of radiation safety
maintain the greatest distance possible from the radiation source
define shielding in the tenets of radiation safety
wear lead aprons, thyroid shields, and, when possible, leaded eyewear
true or false: electrosurgery and electrocautery are the same thing
false
What do monopolar ESU include?
- ESU generator
- Active electrode
- dispersive pad
Esu dispersive pads are either…
- single-use
2. reusable
Single-use ESU pads are…
- opened as close to the time of use as possible
- have an expiration date
- are available in a variety of sizes
- should be connected to a return-electrode generator
- should not be cut/altered
Bipolar electrosurgery equipment includes what 2 things?
- ESU generator
2. Bipolar forceps
true or false; it is necessary to place a dispersive pad on a patient when using bipolar energy equipment
false
What must be done when using monopolar ESU on the patient with an IED?
precaution must be taken
What are recommendations for IED’s and ESU’s?
- Inactivate or reprogram the IED when it is safe to do so.
- Place the dispersive pad as close as possible to the surgical site.
- Place the active electrode cord away from the pulse generator.
- Verify that the IED leads are not between the active electrode and the dispersive pad.
What are laser safety precautions?
- Place laser warning signs on the outside of the OR doors.
- Place protective eyewear for the type of laser being used at each entrance to the room where a laser is in use.
- Keep the doors closed.
- Cover the windows with laser blocking covers.
- Test the laser before use; follow the IFU for the laser to be used.
- Include a laser tine out before laser use.
- Keep the laser in standby mode when it is not in use in the OR.
- Remove the laser key and store it in a secure location.
what type of radiation is a laser?
non-ionizing
what is the operating or procedure room where the laser is used?
nominal hazard zone
What are the 5 hierarchy of controls?
- elimination (most effective)
- substitution
- engineering controls
- administrative controls
- PPE (least effective)
What is elimination in the 5 hierarchy of controls?
physical removal of the hazard
What is substitution in the 5 hierarchy of controls?
hazard replacement
what is engineering controls in the 5 hierarchy of controls?
hazard isolation - smoke evacuation and needless IV system
What is administrative controls in the 5 hierarchy of controls?
- policies and procedures
- education
- competency testing
What are the 2 uses of a pneumatic tourniquet?
- near bloodless procedure
2. confine a bolus of IV regional anesthesia
A form of treatment that uses electrical energy, heat, cold, alcohol, or other modalities to destroy a small section of damaged tissue.
ablation
A dynamic process of searching for insulation failures and capacitive coupling during monopolar electrosurgery. If the monitor detects an unsafe level of stray energy, it signals the generator to deactivate.
active electrode monitoring
Injuries caused by an electrosurgical device that occur away from the dispersive electrode site.
alternate site injuries
argon-enhanced coagulation
Radio-frequency coagulation from an electrosurgical generator that is capable of delivering monopolar
current through a flow of ionized argon gas.
Bipolar ESU
Electrosurgery in which current flows between two tips of a bipolar forceps that are positioned around tissue to create a surgical effect. Current passes from the active electrode of one tip of the forceps through the patient’s tissue to the other, dispersive electrode tip of the forceps, thus completing the circuit without entering another part of the patient’s body.
what is the movement of electrons analogous to the flow of a stream of water?
current
what is the route taken by the current when traveling from the active to the dispersive electrode. Generally, it is
the shortest route and a straight line.
current pathway
what is dispersive electrode
The accessory that directs electrical current flow from the patient back to the electrosurgical generator.
Often called the patient plate, return electrode, inactive electrode, or grounding pad.
A surgical device, often battery powered, that is used to cauterize blood vessels. No electrodes are used. The current flows through the wire at the end of the application device and not through the patient. Cauterization is produced by heat.
electrocautery
The cutting and coagulation of body tissue with a high-frequency (ie, radio-frequency) current. The current passes through the body or the tissue and between two poles. Heat is generated in the tissue through which the current passes.
electrosurgery
The active electrode with tip(s), dispersive electrode, adapters, and connectors to attach these devices
to the electrosurgery generator.
electrosurgical accessories
what is inadvertent activation?
An unintentional activation of the active electrode.
what is insulation failure?
Damage to the insulation of the active electrode that provides an alternate pathway for the current to
leave that electrode as it completes the circuit to the dispersive electrode.
Electrosurgery in which only the active electrode is in the surgical wound, and the electrical current is directed through the patient’s body, received by the dispersive electrode, and transferred back to the generator, completing the monopolar circuit.
monopolar electrosurgery
Radio waves used to conduct therapeutic procedures. The specific frequency, dosage, and intensity used vary depending on the desired effects, which include heating, electrical stimulation, or ablation of tissues.
radio frequency
return-electrode contact quality monitoring
A dynamic monitoring circuit that measures impedance of the dispersive return electrode. If the
dispersive electrode becomes compromised, the circuit inhibits the electrosurgical unit’s output.
what is a black finish applied to metal surgical instruments to decrease reflectivity.
ebonized
what is a laser?
A device that produces an intense, coherent, directional beam of light by stimulating electronic or molecular transitions to lower energy levels. An acronym for light amplification by stimulated emission of radiation.
who is the person responsible for effecting the knowledgeable evaluation of laser hazards and authorized and
responsible for monitoring and overseeing the control of laser hazards?
laser safety officer
what are devices that are applied to a piece of equipment that prevent it from being activated and alert
personnel that the machine has malfunctioned?
lockout/tagout devices
what is optical density?
The value that defines the ability of a filter to absorb a specific laser wavelength.
what is active warming method?
A method that warms the patient by application of heat to the surface of the skin, blood, or internal structures and may be categorized as convective or conductive.
what is hypothermia?
Core body temperature below 36° C (96.8° F).
what is normothermia?
Normal core body temperature between 36° C and 38° C (96.8° F and 100.4° F).
what is passive insulation method?
A device used to prevent patient heat loss (eg, insulating garment, warm blanket).
what is A pathologic condition caused by the progressive development of arterial compression and consequent reduction of blood supply?
compartment syndrome
what are s/sx of compartment syndrome?
swelling, restriction of movement, vascular compromise, and severe pain or lack of sensation.
A pneumatic tourniquet cuff with a distal edge shorter than the proximal edge, creating a funnel-like
shape when applied to a tapered extremity.
contoured tourniquet cuff
The process of forcible expulsion of blood from an extremity before inflation of the pneumatic
tourniquet.
exsanguination
what is limb occlusion pressure?
The minimum pressure required to stop the flow of arterial blood into the limb distal to the pneumatic
tourniquet cuff.
what is a synonym of limb occlusion pressure?
arterial occlusion pressure.
define shearing
A sliding movement of skin and subcutaneous tissue that leaves the underlying muscle stationary.
what is a device used to determine the external radiation dose that a person has received.
dosimeter
what is scatter radiation
when an x-ray beam strikes a patient’s body, as it passes through the patient’s
body, and as it strikes surrounding structures (eg, walls, OR furniture).
