Tufail Ahmad

Demonstrator surgical
BS SURGICAL (GOLD MEDALLIST)
HAZARDS MPH
Training Scientist in Fundamental of
biosafety and biosecurity
The Agha Khan University Karachi
 ENVIRONMENTAL HAZARDS
 A Hazard is a potential source of harm or adverse health effects on a persons
 The perioperative environment poses many hazards for both patients and personnel.
 The potential for physical injury from electric shock, burns, fire, explosion, exposure to
bloodborne pathogens, and inhalation of toxic substances is ever present.
 Therefore it is important that staff have knowledge of the hazards involved in equipment use,
the causes of accidental injury, and the sources of health risks.
 Faulty equipment or improper usage increases the hazards of potential risk factors.
 The health care facility should be made as safe as possible
ENVIRONMENTAL HAZARDS
 Potential hazards should be identified and safe practices established.
 The facility’s risk management personnel are charged with the responsibility of tracking issues
of safety and potential injury.
 The recommendations that arise from these data are established to guide personnel in
corrective actions.
 Patients and caregivers are never completely free from risks, but the risks can be minimized.
 Safety refers to conditions that will not cause injury or harm to the employee, the patient, and
other people in the health care facility.
 Safety goes hand in hand with knowledge, skill, and competency.
 ENVIRONMENTAL HAZARDS
 Some equipment, such as lasers, x-ray equipment, and chemical sterilizers, can cause long-range
injury if personnel are lax in safety and protective practices.
 No one should be permitted to use equipment until properly instructed in its correct use and care.
 Each caregiver should seek instruction when needed and follow the safety and control measures
established by facility policies and procedures.
 Failure to use equipment and devices, places both the caregiver and the patient at risk for injury.
ENVIRONMENTAL HAZARDS
 Competency in using equipment should be tested periodically because technology changes
frequently and the knowledge and skill associated with one piece of equipment may not apply
to a newer model.
CLASSIFICATION OF
HAZARDS
 Hazards in the OR environment can be classified as follows
 Physical, including back injury, fall, noise pollution, electricity, and fire
 Chemical, including anesthetic gases, toxic fumes from gases and liquids, cytotoxic drugs, and
cleaning agents.
• Biologic, including the patient (as a host for or source of pathogenic microorganisms),
infectious waste, cuts or needlestick injuries, surgical plume, and latex sensitivity.
PHYSICAL HAZARDS AND
SAFEGUARDS
 The architectural design of the perioperative environment affects its overall efficiency and
productivity.
 The physical facility is designed to control traffic patterns, decrease contamination, facilitate
the handling of equipment and supplies, and provide a comfortable working environment
ENVIRONMENTAL FACTORS
 Several factors contribute to providing a safe, comfortable working environment: temperature
control, ventilation, lighting, color and noise.
 Temperature control should provide physical comfort (i.e., it should not be too warm or too
cool).
 The ventilating system in the perioperative environment usually evacuates odors quickly by
exchanging air 15 times per hour, with three exchanges of fresh air.
 The ventilating system should help remove toxic fumes and anesthetic gas waste that is not
picked up by the scavenger system on the anesthesia machine.
ENVIRONMENTAL FACTORS
 Perfume and other odors can cause headaches, nausea, or respiratory congestion in sensitive
people.
 Heavy perfume can also have an annoying, lingering effect; therefore people in the
perioperative environment should avoid wearing it.
 Lighting should be adequate, but excessive glare causes fatigue.
 A bright, highly polished mirror finish on an instrument tends to reflect light and can restrict
vision.
 Dull-finished instruments eliminate glare and lessen eyestrain.
ENVIRONMENTAL FACTORS
 These instruments are made with varying degrees of dullness depending on the manufacturer.
 Lightly tinted or polarized eyewear may save sterile team members from visual fatigue but
should not distort the color of tissues.
 For drapes and walls, soft, cool colors, especially blues and greens, are less reflective than
white.
 Drapes with blue, gray, or green tones help to reduce the contrast between most tissues and the
surrounding field.
 Some facilities have piped-in music in waiting areas.
ENVIRONMENTAL FACTORS
 Music can be stimulating for personnel and relaxing for patients who are awaiting for surgery
or undergoing a surgical procedure under local anesthesia.
 The selection of music should be appropriate for the intended listener.
 Music with a low volume, moderate rhythm, and bright tone can motivate muscular activity
and increase levels of efficiency of OR personnel.
 However, this type of music would not be conducive to relaxation for the patient who is
awaiting surgery.
ENVIRONMENTAL FACTORS
 On the other hand, music can be a distraction and an annoyance, especially for the anesthesia
provider, who may depend on auscultation when monitoring the patient.
 Music should be turned off at the request of the patient, surgeon, or anesthesia provider
 Extreme noise from drills, fan motors in equipment, and other sources can be annoying and
potentially dangerous to patients and personnel.
 The noise can become intense enough to increase blood pressure and provoke peripheral
vasoconstriction, dilation of the pupils, and other subtle physiologic effects.
ENVIRONMENTAL FACTORS
 It also can interfere with necessary communication and thereby provoke irritation.
 The EPA recommends that noise levels in hospitals not exceed 45 decibels during daytime
hours.
 The OR should be as quiet as possible except for the essential sounds of communication
among team members directly concerned with the patient’s care.
 Any necessary talking should be done in a low voice. Counts or requests for supplies should
be done quietly or by hand signals.
 Conversation unrelated to the surgical procedure is out of place.
ENVIRONMENTAL FACTORS
 Even during the deep stages of anesthesia, a patient may perceive and remember noise that
occurs during the surgical procedure.
 This phenomenon is referred to as anesthesia awareness.
 If a regional or local anesthetic is used, the patient can hear the conversation.
 Because patients interpret anything they hear in terms of themselves, all words should be
guarded.
 Major sources of noise in the OR involve paper, gloves, objects wheeled across the floor,
instruments striking one another, monitors, and high-pitched power instruments, including
suction.
 The scrub person should keep in mind the sources and the effects of this noise.
ENVIRONMENTAL FACTORS
 Except while in actual use, suction tubing can be clamped or kinked to minimize noise.
 Paper wrappings should not be crushed.
 Monitors with audible signals should be placed as far away from the patient’s ears as possible;
continuous monitor beeps also can distract the surgeon and anesthesia provider.
 The circulating nurse should keep the doors to the OR closed to shut out the noise of the
corridors, water running in the scrub room, or the sterilizer operating in the substerile room.
ENVIRONMENTAL FACTORS
 Aside from blocking noise, the doors should remain shut to maintain the proper functioning of
the air-handling system in the OR.
 Working in a pleasantly quiet environment is less fatiguing, produces fewer psychological and
physiologic adverse effects, and allows for greater efficiency on behalf of the patient.