Wk 7 Flashcards
Formalin
Tissue fixative For preservation of surgical specimens Potent allergen and carcinogenic Toxic fumes Wear PPE
X-ray and image intensifier
Ionising radiation which staff are exposed to
Principles:
Time: avoid uneccesary exposure
distance: leave room, stand 6 feet away
shielding: portable lead screens, lead gear
Laser (light amplification by stimulated emission of radiation)
Non ionising Cut, vaporise or coagulate tissue Pulsed or continuous Precise, controlled, accurate Minimal handling of tissue Dry bloodless field Reduced risk of infection Fast healing Reduced operation time
Example of lasers
Argon- destroy specific cutaneous lesions
CO2: vaporisation and Haemostatic action to destroy soft tissue and vascular lesions
YAG: powerful, able to coagulate and vaporise large volumes of tissue
Laser plume
Toxic substances may become airborne through vaporisation
Mechanical smoke evacuator with charcoal filter close to laser sight
Tight fitting high filtration masks
Surgical plume
Biological tissue is disrupted by energy based surgical equipment
Anaesthetic gases
Risk from waste anaesthetic gases Pt's expirations Anaesthetic machine, hose, connections Face mask Scavenging, ventilation systems
Latex allergy - nurse precaution
Sensitivity can increase over time Use latex free gloves Irritant or contact dermatitis Type IV delayed hypersensitivity Type 1 most serious immediate response
Hazards to pt safety
Retained items Pt position Hypothermia Latex allergy Malignant hyperthermia Infection
Retained items
Surgical count
Accurate documentation
Understand legal responsibility
Pt position
Development of pressure areas
Falling from table
Nerve injury or impaired function
Hypothermia
Inadvertent operative hypothermia Core temp less than 36 in PACU Triple infection rate Prolonged hospital stay Pt exposure Cool irrigating fluids Prevent this: temp probe, IV hydration, head covering
Latex allergy - pt risk
Local or systemic reaction
Anaphylactic shock: hypotension, tachycardia, bronchospasm, erythema
Common latex products - ETT, catheters, drains, tapes,
Malignant hyperthermia
Inherited disorder
Common in male young adults
Calcium released from muscle cells
Metabolic rate increases
Muscles contract and become rigid
Heat is generated
Organ damage follows
Triggering agents: desflurane, enflurane, halothane
Signs: increased body temp, increased metabolic rate, tachycardia, hypo, cyanosis
Treatment: discontinue triggering agent, infuse dantrolone, treat acidosis, treat hyperkalaemia, active cooling
Infection
Strict application of aseptic technique
Surgical conscience
Prophylactic use of antibiotics
