Within a healthcare facility, compressed gases are usually either fixed piped gas systems or individual cylinders of gases.
- Hazards with compressed gas varies based on the chemicals.
- May include fire, explosion, and toxicity.
- Store, handle, and use compressed gases in accordance with 29 CFR 1910.101.
- All cylinders, whether empty or full, must be stored upright.
- Secure cylinders of compressed gases. Cylinders should never be dropped or allowed to strike each other with force.
- Transport compressed gas cylinders with protective caps in place and do not roll or drag the cylinders.
Laser or electrosurgical units may be required during surgical procedures. Smoke byproduct or "plume" is created when tissue is thermally destroyed. Smoke plume may contain toxic gases and
vapors such as:
- hydrogen cyanide and formaldehyde
- bio aerosols
- dead and live cellular material (including blood fragments)
The research is limited on transmission of disease through surgical smoke, but the potential for generating infectious viral fragments, particularly during treatment of venereal warts, may exist.
Researchers have suggested the smoke may act as a vector for cancerous cells which may be inhaled by the surgical team and other exposed individuals.
Smoke Plume (Continued)
- Exposure to high concentrations of smoke may cause ocular and upper respiratory tract irritation and create visual problems for the perioperative team.
- Smoke may contain toxic gases that could have the potential for adverse health impacts, such as mutagenic and carcinogenic impacts.
- Use portable smoke evacuators and room suction systems with inline filters.
- Keep the smoke evacuator or room suction hose nozzle inlet within 2 inches of the surgical site to effectively capture airborne contaminants.
- Have a smoke evacuator available for every operating room where plume is generated.
- Evacuate all smoke, no matter how much is generated.
- Keep smoke evacuator "ON" (activated) at all times when airborne particles are produced during all surgical or other procedures.
- Consider all tubing, filters, and absorbers as infectious waste and dispose of them appropriately. Use
Universal Precautions as required by the OSHA Bloodborne Pathogens Standard when contaminated with blood or OPIM.
- Use new tubing before each procedure and replace the smoke evacuator filter as recommended by the manufacturer.
- Inspect smoke evacuator systems regularly to ensure proper functioning.
Employees can be exposed to possible hazardous chemicals found and used in the surgical area typically during mixing, preparation, and in the operating room. These may include:
- peracetic acid used in cold sterilant machines
- Methyl Methacrylate (MMA)
- an acrylic cement-like substance used to secure prostheses to bone during orthopedic surgery waste anesthetic gases
- Mix methyl methacrylate only in a closed system.
- Carefully read and follow instructions and warnings on labels, (e.g., when using cold sterilant machines for sterilizating equipment that cannot be autoclaved, use goggles provided and do not open machine until it is in a safe to open mode).
- Consider using disinfectants or other products that are not hazardous.
- Inform employees of chemical hazards and have on hand Material Safety Data Sheets, (MSDS) for all hazardous chemicals used in their facilities.
- Follow all MSDS instructions regarding safe handling, storage, and disposal of hazardous chemicals.
- Surgical employees can be exposed to burns or shocks from poorly maintained equipment (e.g., autoclaves, warming cabinets, defibrillators).
Employers should create a safety and health program to monitor the condition of equipment and address work practices of employees. This program should include practices such as:
- Train employees to correctly and safely use and clean equipment.
- Maintain adequate working space and access to equipment.
- Visually inspect equipment before using.
- Visually inspect cords and do not use if frayed or damaged.
- If something does not look right, do NOT use the machine and call for assistance.
- Ensure that all electrical service equipment near sources of water are properly grounded [29 CFR 1910.304].
- Use appropriate personal protective equipment and safe work practices for assessed hazards (e.g., when handling hot items use gloves, and do not open autoclaves or sterilizers until items are
- Adhere to all manufacturer and operator instructions to ensure safe use of equipment.
Slips, Trips, and Falls
- falling over portable equipment of a color that visually blends into the floor
- slipping on debris (bandages, tubing, blood, IV fluids) that had fallen or spilled on the floor
- tripping on electrical cords that may cross floors
- Keep all places of employment clean, orderly, and in a sanitary condition
[29 CFR 1910.22(a)(1)].
- Keep aisles and passageways clear and in good repair, with no obstructions across or in aisles that may create a hazard
[29 CFR 1910.22(b)(1)].
- Provide ceiling or floor outlets for equipment to ensure that power cords do not run across pathways.
- Mark mobile equipment (e.g., stools) with a bright color, or a taped "X", making them more visible and distinguishable from the floor. Tape should be washable and durable.
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