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Safety

Safety

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Published by Marcus, RN

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Published by: Marcus, RN on Sep 22, 2008
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09/06/2012

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Safety
A.
Specific hazards to safety
 I.
fire
 a.
three elements necessary to start a fire:
 i.
sufficient heat to start the fire
 ii.
a combustible material
 iii.
sufficient oxygen to support the fire
 II.
scalds and burns
 a.
scalds
 i.
result from hot liquid or vapor, such as steam
 b.
burns
 i.
result from excessive exposure to thermal, chemical, electrical, or radioactive agents
 III.
falls
 IV.
poisoning
 V.
electric shock
 a.
types of electric shock
 i.
macroshock
 a.
electric current passing through a relatively large area of a person
 ii.
microshock
 a.
electric current passing through a relatively small area of a person, usually part of the heart
 b.
equipment needs to be properly grounded
 i.
transmits an electric current from an object or surface to the ground
 c.
grounded electrical plugs have three prongs:
 i.
the two short prongs transmit power to the equipment
 ii.
the third, longer, prong carries short circuits or stray electric currents to the ground
 VI.
excessive noise
 a.
danger of excessive noise depends on three factors:
 i.
the overall level of noise
 ii.
the frequency range of the noise
 iii.
the duration of exposure and individual susceptibility to the noise
 b.
decibel levels (units of loudness)
 i.
noises above 120 decibels are painful
 ii.
exposure to noises of 85 to 95 decibels for several hours a day can lead to progressive or permanent hearing loss
 VII.
radiation
 VIII.
suffocation or choking
 IX.
equipment-related accidents
 X.
procedure-related accidents
 B.
Factors affecting safety
 I.
age
 a.
developing fetus
 i.
exposure to maternal smoking, alcohol consumption, addictive drugs, radiographs (first trimester), certain pesticides
 b.
newborns and infants
 i.
falling, suffocation in crib, choking from aspirated milk or ingested objects, burns from both water or spilled hot liquids, automobile accidents, crib orplaypen injuries, electric shock, poisoning
 c.
toddlers
 i.
physical trauma from falling, banging into objects, getting cut by objects, automobile accidents, burns, poisoning, drowning, electric shock
 d.
preschoolers
 i.
injury from traffic, playground equipment, and other objects; choking, suffocation, and obstruction of airway and ear canal by foreign objects;poisoning; drowning; fire and burns; harm from other people or animals
 e.
adolescents
 i.
vehicle (automobile, bicycle) accidents, recreational accidents, firearms, substance abuse
 f.
other adults
 i.
falling, burns, pedestrian and automobile accidents
 II.
life-style
 a.
work environments can be a potential safety hazard by the presence of the following:
 i.
heavy machinery, industrial belts and pulleys, chemicals, pollutants, radioactive substances
 b.
living environments can be a potential safety hazard by the presence of the following:
 i.
high crime rate, chemicals, pollutants, radioactive substances, guns and ammunition
 c.
insufficient income can be a potential safety hazard by lack of monetary funds to do the following:
 i.
buy necessary safety equipment or make necessary safety repairs
 d.
risk-taking behavior can be a potential safety hazard by failure to do the following:
 i.
operate machinery safely, e.g.:
 a.
driving automobiles at high speed
 ii.
wear safety devices when operating machinery, e.g.:
 a.
seat belts while driving/riding in automobiles, headgear while driving/riding on motorcycles, flotation jackets while on boats
 III.
mobility
 a.
impaired mobility can be a potential safety hazard by decreasing the ability to move safely and avoid dangerous situations in the environment
 b.
examples of conditions resulting in impaired mobility are the following:
 i.
paralysis, which may result from the following:
 a.
spinal-cord injury, cerebral vascular accident (CVA)
 ii.
muscle weakness, which may result from the following:
 a.
recent surgery or prolonged illness
 iii.
poor balance or coordination, which may result from the following:
 
 
a.
casts, braces, crutches
 IV.
sensory/perceptual alterations
 a.
sensory/perceptual alterations can be a safety hazard by decreasing sensitivity to and ability to correctly interpret dangerous situations in the environment
 b.
examples of conditions resulting in sensory/perceptual alterations are the following:
 i.
blindness, which may resulting in the following:
 a.
falls from tripping over objects in the environment
 ii.
deafness, which may result in the following:
 a.
unawareness of signals about dangerous situations in the environment
 b.
misunderstanding about instructions regarding medications and health care
 iii.
anosmia (loss of smell), which may result in the following:
 a.
failure to smell smoke or gas in the environment
 iv.
tactile anesthesia (loss of touch), which may result in the following:
 a.
extremes of temperature being unnoticed
 v.
gustatory anesthesia (loss of taste), which may result in the following:
 a.
contaminated food being undetected
 V.
level of awareness
 a.
altered level of awareness can be a safety hazard by interfering with sensitivity to and ability to correctly interpret dangerous situations in the environment
 b.
examples of conditions resulting in an altered level of awareness are the following:
 i.
sleep deprivation
 ii.
altered consciousness, e.g.:
 a.
unconsciousness or semiconsciousness
 iii.
altered perception of reality, e.g.:
 a.
disorientation
 iv.
perception of stimuli that do not exist, e.g.:
 a.
visual, auditory, tactile, olfactory hallucinations
 v.
altered judgment as a result of disease or medications, e.g.:
 a.
opioid analgesics, tranquilizers, hypnotics, sedatives, Alzheimer's disease
 VI.
emotional state
 a.
emotional states can be a safety hazard by interfering with sensitivity to and ability to correctly interpret dangerous situations in the environment
 b.
examples of emotional states are the following:
 i.
anxiety or anger, which results in the following:
 a.
reduced perceptual awareness, level of concentration, awareness of external stimuli; increased errors in judgment
 ii.
depression, which results in the following:
 a.
reduced reaction to environmental stimuli
 VII.
ability to communicate
 a.
altered ability to communicate (read and write) can be a potential safety hazard by decreasing the ability to receive or send messages about dangerousconditions in the environment
 b.
examples of conditions that result in altered ability to communicate are the following:
 i.
aphasia, language barriers, illiteracy
 VIII.
knowledge of safety precautions
 a.
lack of knowledge about unfamiliar factors in the environment can be a potential safety hazard by unfamiliarity of the danger they possess
 b.
examples of unfamiliar factors in the environment are the following:
 i.
special equipment (e.g., oxygen tanks, Hoyer lifts, intravenous transfusions), medications, cleaners
 C.
Appraisal of specific hazards to safety
 I.
fires
 a.
home hazard appraisal for fires
 i.
living room
 a.
electrical cords in good condition (e.g., not frayed or worn)?
 b.
electrical cords not threaded under carpets or pinched behind furniture?
 c.
ashtrays readily available if there are smokers in the house?
 d.
wastebaskets free of carelessly discarded cigarettes?
 e.
draperies and furniture more than three feet away from the fireplace?
 ii.
chimney
 a.
fuel for the fireplace (e.g., kindling, newspapers, firewood) stacked at least three feet away from the hearth?
 b.
firescreen over the entire opening of the fireplace?
 c.
flue open when a fire is burning in the fireplace?
 d.
Christmas tree branches or needles properly discarded and not used to start or maintain a fire?
 e.
metal pail available to carry out the ashes from the fireplace?
 f.
ashes cold when carried out in the metal pail?
 g.
chimney cleaned annually?
 h.
fires started properly and not with charcoal starter or gasoline?
 iii.
kitchen
 a.
appliances turned off before going to bed or leaving the house?
 b.
fire extinguisher(s) readily available?
 c.
garments with short or snug sleeves worn when working over the stove?
 d.
baking soda available to snuff out a grease fire?
 iv.
bedroom
 a.
smoking in bed or a comfortable chair forbidden to deter the chance of falling asleep with a burning cigarette?
 b.
two escape routes out of the bedroom been determined in the case of a fire?
 c.
rope or chain ladders installed to escape from a fire quickly if the house has rooms above the ground floor?
 d.
electric space heaters have an automatic shut-off in case they are tipped over?
 e.
operable smoke detectors installed outside sleeping area(s)?
 f.
electric space heaters kept out of damp or wet areas?
 g.
batteries from smoke detectors forbidden to be "borrowed" for other equipment?
 h.
smoke detectors tested regularly?
 i.
smoke detectors always activated and never deactivated for sounding a low battery alarm?
 v.
garage
 
 
a.
trash, particularly oily or paint-saturated rags, kept from accumulating in the garage?
 b.
oily rags, gasoline, or other flammables stored away from sources of heat or open flames?
 c.
gasoline or paintbrush cleaner used in an open area where fumes can be dissipated and won't drift toward a source of ignition?
 d.
gasoline forbidden to be used as a cleaner for clothing or furniture?
 e.
blown fuses replaced with a proper fuse and not a copper penny?
 b.
hospital hazard appraisal for fires
 i.
are the telephone numbers of emergency services displayed on the phone?
 ii.
does the staff know the location of the fire exits?
 iii.
does the staff know the type and location of fire extinquisher(s)?
 iv.
does the staff participate in routine fire drills or fire evacuation procedures?
 v.
are the hallways free of unnecessary furniture and equipment?
 vi.
are signs posted on the elevator doors regarding the use of stairs in the event of a fire?
 vii.
are locations of the fire exits clearly marked?
 c.
responding to a hospital fire
 i.
direct ambulatory patients to a safe area
 ii.
move nonambulatory patients to a safe area by carrying them, dragging them on sheets or blankets, or pushing them in wheelchairs, beds, orstretchers
 iii.
activate the fire alarm
 iv.
notify the hospital switchboard of the location of the fire
 v.
spray the fire with the appropriate fire extinguisher
 a.
P = Pull the pin on the fire extinquisher
 b.
A = Aim at the base of the fire
 c.
S = Spray the fire
 d.
S = Sweep side to side
 vi.
close windows and doors in the area of the fire
 vii.
turn off oxygen and electrical appliances in the vicinity of the fire
 viii.
clear the fire exits if blocked
 ix.
place damp cloths or blankets around the outside edges of doors
 x.
provide patients with wet washcloths through which to breath
 d.
types of fire extinguishers for types of fires
 i.
class "a" fire (paper, wood, upholstery, rags, ordinary rubbish)
 a.
use a water pump, CO
2,
or multipurpose fire extinguisher
 ii.
class "b" fire (flammable liquids and gases)
 a.
use a CO
2
, dry chemical, multipurpose, or foam fire extinguisher
 iii.
class "c" fire (electrical)
 a.
use a CO
2
, dry chemical, or multipurpose fire extinquisher
 iv.
class "d" fire (designated metals)
 a.
use a dry powder fire extinguisher
 II.
falls
 a.
home hazard appraisal for falls
 i.
exterior
 a.
burnt out or dim exterior lightbulbs?
 b.
lighting along all exterior walking surfaces?
 c.
are exterior walking areas even and in good repair?
 d.
secure hand rails on both sides of exterior steps?
 e.
adequate lighting on exterior steps?
 f.
is the general environment uncluttered and free of debris?
 ii.
bathrooms
 a.
nonslip adhesive strips in front of toilet, sink, and shower area and inside shower area?
 b.
raised toilet seat with support arms?
 c.
grab bars positioned securely next to toilet, tub, and/or shower area?
 d.
scatter rugs eliminated or attached with double-faced, nonslip adhesive strips to undersurface of rug?
 e.
thresholds even with floor?
 f.
burnt out or dim bulbs?
 g.
accessories made with contrasting colors for easy visibility?
 h.
general environment uncluttered and free of debris?
 iii.
kitchen
 a.
secure, sturdy stool with nonslip threads available?
 b.
shelves positioned to allow for easier reach?
 c.
burnt out or dim lightbulbs?
 d.
lighting adequate for working areas?
 e.
hand-held reaching device for inaccessible objects available?
 f.
thresholds even with floor?
 g.
nonslip adhesive strips in front of sink and stove?
 h.
scatter rugs eliminated or attached with double-faced, nonslip adhesive strips to undersurface of rug?
 i.
are kitchen chairs sturdy with armrests?
  j.
kitchen chair height sufficient to allow for easy rising?
 k.
lack of crossbar between front legs of kitchen chairs that interferes with placing feet firmly under chair when rising?
 iv.
bedrooms and other living areas
 a.
chairs sturdy with armrests?
 b.
chair height sufficient to allow for easy rising?
 c.
lack of crossbar between front legs of chairs that interferes with placing feet firmly under chair when rising?
 d.
wobbly accessory tables that may be used for support replaced?
 e.
accessory table surfaces uncluttered?
 f.
colored nonslip adhesive strips on edges of glass tables?
 g.
general environment uncluttered and free of debris?
 h.
burnt out or dim lightbulbs?
 

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