Week 14 - MM15-27 Flashcards
What is the recommended temperature range for the Operating Room (OR)?
68°F–75°F (20°C–24°C)
This range balances patient safety and staff comfort.
What are the implications of hypothermia under anesthesia?
Impaired thermoregulation
Hypothermia can lead to increased surgical site infections, coagulopathy, and delayed wound healing.
What is the optimal range for humidity in the OR?
20–60% relative humidity
Low humidity promotes static electricity and increases infection risk, while high humidity can lead to microbial growth.
What is the primary goal of ventilation systems in the OR?
Minimize microbial contamination and remove anesthetic gases
High airflow and separate waste gas scavenging systems are essential.
What is the air exchange rate standard for ORs?
≥20 air changes per hour
This is the NFPA standard for ventilation in ORs.
What are the highest risk sources of noise pollution in the OR?
Orthopedic saws, drills, neurosurgical instruments
Prolonged exposure to noise levels above 80 dB can impair cognitive function.
What units measure ionizing radiation exposure?
Grays (Gy), rads, Sieverts (Sv), and REM
Sensitive organs like the eyes and thyroid need protection from radiation.
What does the ALARP principle stand for in radiation safety?
As Low As Reasonably Practical
This principle emphasizes limiting exposure time, maintaining distance, and using shielding.
What is the maximum leakage current allowed for OR equipment?
10 µA
Normal leakage is typically below 1 mA.
What is the purpose of an isolation transformer in the OR?
To create a non-grounded power supply
This prevents shock by ensuring circuit completion is not possible through the patient.
What does a Line Isolation Monitor (LIM) do?
Detects potential current flow from power supply to ground
It alarms when leakage exceeds a set threshold, usually 2–5 mA.
What are the NFPA 99 Risk Categories in U.S. Health Care Facilities?
- Major injury or death likely
- Minor injury likely
- Causes discomfort
- No impact on care
These categories help assess electrical safety risks.
What is the primary cause of surgical fires?
Open oxygen delivery
Flammable solutions and ignition sources are key risk factors.
What are the three components of the Fire Triad?
Fuel, oxidizer, ignition source
High-risk situations occur when an ignition source is near an oxidizer.
What precautions should be taken for oxygen delivery in the OR?
> 30% oxygen concentrations increase fire risk
Secure airway with ET tube or supraglottic device when surgical site is above xiphoid.
What should be done immediately if an airway fire occurs?
Stop fresh gas flow, remove ET tube, pour sterile water or saline into airway
Actions must be performed simultaneously or independently to extinguish the fire.
What is the frequency range for Electrosurgical Units (ESUs)?
0.1–3 MHz
This frequency range avoids cardiac excitation.
What is a significant risk associated with the dispersive pad in ESUs?
Current may exit through unintended routes, causing burns
Full contact and correct placement of the pad are essential for safety.
What is the risk of using alcohol-based skin preparations?
They are flammable; allow full drying before surgical procedures
Pooling of alcohol can increase fire risk.
What is the function of bipolar electrodes in electrosurgery?
Confine current to a few millimeters
They do not require a return electrode.
What should be done if the dispersive pad malfunctions during electrosurgery?
Ensure full contact and monitor for burns
Avoid placing the pad over prosthetic or bony areas.
What should be done to resume ventilation in case of a fire?
Resume ventilation with room air; avoid O₂ and N₂O
This is crucial to prevent further injury from combustible gases.
What should be checked on the ET tube?
Check ET tube for missing parts
Ensures proper ventilation and airway management.
What should be done if a fire occurs on a patient?
Stop oxidizer gas flow, remove drapes, extinguish fire with water or smothering, assess for injury
If unsuccessful, use CO₂ extinguisher and consider patient evacuation.
What are the reporting requirements for fires causing injuries or death?
Must be reported to the fire marshal; know local reporting requirements
Important for accountability and safety regulations.
What is the most common scenario leading to surgical fires?
Supplemental oxygen use + surgical site above xiphoid
Commonly involves face or airway, resulting in life-threatening injuries.
What are the characteristics of CO₂ extinguishers?
Dissipate quickly, non-toxic, unlikely to cause thermal injury
Safe for patient fires in the OR.
What are the issues with ‘A’-rated extinguishers in the OR?
Problematic due to electrical equipment
Water can cause short circuits or additional hazards.
What is the limitation of water mist ‘AC’-rated extinguishers?
Require time and multiple attempts; can be large and hard to maneuver
Effective for specific types of fires but not ideal in all situations.
What are Halon extinguishers being phased out for?
Ozone depletion, creating hypoxic environments for rescuers
Environmental concerns lead to the search for alternatives.
What are the benefits of Halotrons?
Lower environmental impact, no residue
A more environmentally friendly option compared to traditional Halon.
What should be done before laser surgery?
Ensure laser device is present, post warning signs, provide protective eyewear
Compliance with ANSI standards is crucial for safety.
What type of eyewear is required for laser procedures?
Goggles for staff, goggles or eye patches for the patient
Specific to the laser’s wavelength and type.
What is the compatibility requirement for laser endotracheal tubes (ETTs)?
Selection must match laser type and wavelength
ETTs <4 mm diameter are not compatible with Nd:YAG or argon lasers.
What is a key principle of Crew Resource Management (CRM)?
Adaptability/Flexibility
Ability to change course when new information emerges.
What does assertiveness in CRM involve?
Willingness to speak up and act with courage
Essential for maintaining patient safety.
What is the importance of communication in CRM?
Clear, accurate sending and receiving of information
Must be two-way to ensure clarity.
What does decision making in CRM include?
Use of logic and sound judgment, seeking advice when inexperienced
Critical for safe patient care.
What is situational awareness in CRM?
Accurate perception of the environment
Distinguishing between equipment issues and patient crises is vital.
What is necessary for successful application of CRM in the OR?
Supportive environment where team members feel safe to speak up
Encourages proactive safety measures.
