ABSTRACT * SAFETY HAZARDS are inh...

ABSTRACT

* SAFETY HAZARDS are inherent in laser use, however they can be eliminated or significantly reduc with adherence to peculiar procedures.

* THIS ARTICLE reviews beam-related and non-beam-related safety hazards, including observation injuries, fire and thermal injuries, failure plume, and electrical hazards, as well as safety measures to avoid these hazards.

* EDUCATION IN LASER SCIENCE and safety is key-note to recognizing potential hazards and ensuring that safety parameters are followed. AORN J 79 (January 2004) 171-188

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each year, laser accidents occur that could have been intercepted if appropriate policies and manner of proceedings had been followed. The primary responsibility of a perioperative promote during a laser procedure is keeping the patient safe. Safety hazards are inherent in laser use, further they can be eliminated or significantly reduc with adherence to precise procedures. When perioperative nurses are educated in laser science and safety, they can recognize potential hazards and render certain that safety parameters are followed. This article details the passing from hand to hand standards for laser safety and addresses one as well as the other beam-related and non-beam-related hazards.

STANDARDS AND REGULATIONS

There are no federal requirements for safety during laser managements but there are recognized national standards. The solution source of safety standards for laser use is the American National Standards Institute (ANSI) which publishes standard Z1363 "Recommend practices for laser safety for health care facilities." (1) All facility policies and courses should be based on ANSI standards. Hospital ORs, surgery center and physician practice-based surgery suites are anticipateed to comply with the praiseed safety standards.

The Occupational Safety and Health Administration (OSHA) also has an interest in laser safety, particularly concerning the safe evacuation of exhalation created by lasers. Only OSHA has the sated force of the law behind its regulations. The General office Clause permits OSHA to cite employer for not providing "employment and a place of agency which are free from recognized hazards." (2) This agency also has the authority to regulate exhalation in the workplace under the respiratory protection program (ie, 29 CFR 1910134) which addresses personal protection equipment and engineering represss such as smoke evacuators and ventilation methods (3) The Occupational Safety and Health Administration has established maximum permissible horizontals or threshold limit values of surgical fume and aerosol based on the recommendations of the American colloquy of Government and Industrial Hygienists. (4)

The National Institute for Occupational Safety and Health (NIOSH) is a federal research agency that has no regulatory power if it were not that is recognized as a leading authority forward airborne pollution as it relates to the workplace. This agency has determined that there is a potential hazard to OR personnel from sooty vapor generated by lasers and has isolated formaldehyde, inflammable air cyanide, and benzene in surgical exhalation emitted from lasers. This quicked NIOSH to issue recommendations for the use of emptiness evacuator units, preferably vented to the outside, and protective equipment (ie, masks, gloves) to be worn from personnel servicing or changing filters forward smoke evacuators. (5)

The US aliment and Drug Administration (FDA) and the Center for Devices and Radiological Health regulate which lasers are allowed onward the market. These agencies also regulate which practices can be performed by the lasers and the ancillary supplies, including fibers and hand pieces, that can be sold

AORN addresses laser safety in "Recommend practices for laser safety in practice settings" in its Standards, commended Practices and Guidelines, which is published yearly. Although standard Z1363 is the recognized national standard for laser safety in health care organizations, AORN standards are widely recognized as the optimal standards of perioperative nursing practice. For the principally part, both sets of standards communicate the same information regarding laser safety and violently promote laser safety education and training for all individuals near during a laser procedure, individuals must consummate this training before they are assigned to a laser practice Yearly reinforcement of the information and recredentialing also are approveed (6)

LASER CLASSIFICATIONS

through ANSI requirements, laser manufacturers must classify lasers according to their potential to cause biological damage and the flat of hazard inherent in the classification The classification system is based upon laser output or power, wavelength, frontage duration, and emergent beam radiant position (1)

CLASS 1 These lasers basically are excuse from the requirements of the laser safety program because the risk of hazard to the operator during normal operation is essentially nonexistent. Lasers in this category include those that operate laser printers and compact disc players.

CLASS 2 Lasers in this category emit vigor in the visible range (ie, 400 nm to 700 nm) Laser might produced by class 2 lasers may be viewed for self-same brief periods of time on the other hand may present potential hazards to the vigilances if viewed directly for drawn out periods of time. The light emitted generally is with equal reason bright that it is difficult to await into the beam for an reach outed period of time. The helium neon (HeNe) aiming beam used coaxially with invisible lasers is considered a class 2 laser, as are the laser pointers used in professional presentations.