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Veterinary technicians must be familiar with the human safety considerations involved in veterinary anesthesia Workplace S...
Hazards of Waste Anesthetic Gas  <ul><li>Sources of waste inhalant anesthetic gas </li></ul><ul><ul><li>Exhaled by patient...
Hazards of Waste Anesthetic Gas (Cont’d) <ul><li>Short-term effects of exposure to high levels of waste anesthetic gas  </...
<ul><li>Long-term effects of exposure to high levels of waste anesthetic gas </li></ul><ul><ul><li>Serious health problems...
Long-Term Effects of High Level Exposure to Waste Anesthetic Gas  <ul><li>Reproductive effects </li></ul><ul><ul><li>Risk ...
Long-Term Effects of High Level Exposure to Waste Anesthetic Gas (Cont’d)  <ul><li>Renal effects </li></ul><ul><ul><li>Pos...
Measuring Waste Gas Levels  <ul><li>Highest levels are in surgery suites, surgical prep rooms, and anesthesia recovery roo...
Reducing Exposure  to Waste Anesthetic Gas <ul><li>Use a scavenging system </li></ul><ul><ul><li>Collects waste gas from t...
Active and Passive Scavenging Systems
Potential Difficulties  with a Scavenging System <ul><li>Prevent the negative (vacuum) pressure on the breathing circuit <...
Alternative to Scavenging System  <ul><li>Activated charcoal cartridges </li></ul><ul><ul><li>Used in rooms not set up for...
Reducing Exposure  to Waste Anesthetic Gas <ul><li>Check equipment for leaks </li></ul><ul><li>Common sites for leaking eq...
Types of Leak Tests  for Anesthetic Equipment <ul><li>High-pressure tests </li></ul><ul><ul><li>Check for leaks between th...
Types of Leak Tests  for Anesthetic Equipment (Cont’d) <ul><li>Low-pressure tests </li></ul><ul><ul><li>Check for leaks in...
Reducing Exposure  to Waste Anesthetic Gas  <ul><li>What type of leak test to perform </li></ul><ul><ul><li>High-pressure ...
Monitoring Waste Gas Levels <ul><li>Important considerations </li></ul><ul><ul><li>Hospital employee becomes pregnant </li...
Safely Handling Compressed Gases  <ul><li>Fire safety </li></ul><ul><ul><li>Oxygen and nitrous oxide support combustion  <...
Safely Handling Compressed Gases (Cont’d) <ul><li>Use and storage </li></ul><ul><ul><li>Cylinders are storehouses of large...
Labeling Compressed Air Cylinders
Accidental Exposure to Injectable Agents  <ul><li>Opioids used for restraint and capture of wild animals </li></ul><ul><ul...
Accidental Exposure to Injectable Agents (Cont’d) <ul><li>Precautions </li></ul><ul><ul><li>Become educated on potent opio...
Accidental Exposure to Injectable Agents (Cont’d) <ul><li>Cyclohexamines (ketamine, tiletamine) </li></ul><ul><ul><li>Acci...
Accidental Exposure to Injectable Agents (Cont’d) <ul><li>Precautions </li></ul><ul><ul><li>Personal protective equipment ...
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13. Workplace Safety

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13. Workplace Safety

  1. 1. Veterinary technicians must be familiar with the human safety considerations involved in veterinary anesthesia Workplace Safety Chapter 13
  2. 2. Hazards of Waste Anesthetic Gas <ul><li>Sources of waste inhalant anesthetic gas </li></ul><ul><ul><li>Exhaled by patient or escaped from anesthetic machine during anesthetic period </li></ul></ul><ul><ul><li>Inhaled when emptying or filling anesthetic vaporizers </li></ul></ul><ul><ul><li>Inhaled after an accidental anesthetic liquid spill </li></ul></ul><ul><li>Measurement of waste anesthetic gas in parts per million (ppm) </li></ul>
  3. 3. Hazards of Waste Anesthetic Gas (Cont’d) <ul><li>Short-term effects of exposure to high levels of waste anesthetic gas </li></ul><ul><ul><li>Direct effect of anesthetic agent on brain neurons </li></ul></ul><ul><ul><li>Resolve spontaneously when area is left </li></ul></ul><ul><ul><li>Frequent occurrence indicates excessive waste gas levels </li></ul></ul>
  4. 4. <ul><li>Long-term effects of exposure to high levels of waste anesthetic gas </li></ul><ul><ul><li>Serious health problems </li></ul></ul><ul><ul><ul><li>Reproductive Oncogenic </li></ul></ul></ul><ul><ul><ul><li>Hepatic Renal </li></ul></ul></ul><ul><ul><ul><li>Hematologic Neurologic </li></ul></ul></ul><ul><ul><li>May be the result of toxic metabolites produced by the liver </li></ul></ul><ul><ul><li>Anesthetics eliminated through the lungs are less likely to produce long-term effects </li></ul></ul>Hazards of Waste Anesthetic Gas (Cont’d)
  5. 5. Long-Term Effects of High Level Exposure to Waste Anesthetic Gas <ul><li>Reproductive effects </li></ul><ul><ul><li>Risk of spontaneous abortion </li></ul></ul><ul><ul><li>Infertility </li></ul></ul><ul><ul><li>Congenital anomalies in children </li></ul></ul><ul><li>Oncogenic effects </li></ul><ul><ul><li>None of the commonly used agents are associated with an increased risk of developing cancer </li></ul></ul><ul><li>Hepatic effects </li></ul><ul><ul><li>Hepatotoxicity </li></ul></ul><ul><ul><ul><li>Rare, most common with halothane exposure </li></ul></ul></ul>
  6. 6. Long-Term Effects of High Level Exposure to Waste Anesthetic Gas (Cont’d) <ul><li>Renal effects </li></ul><ul><ul><li>Possible renal toxicity with methoxyflurane exposure </li></ul></ul><ul><li>Neurologic effects </li></ul><ul><ul><li>Possible loss of motor skills and short-term memory </li></ul></ul><ul><ul><li>Possible increased incidence of neurological disease </li></ul></ul><ul><li>Hematologic effects </li></ul><ul><ul><li>Possible bone marrow abnormalities </li></ul></ul>
  7. 7. Measuring Waste Gas Levels <ul><li>Highest levels are in surgery suites, surgical prep rooms, and anesthesia recovery rooms </li></ul><ul><li>Highest levels during the anesthetic period are nearest the anesthetic machine </li></ul><ul><li>Factors that determine levels </li></ul><ul><ul><li>Duration of anesthesia </li></ul></ul><ul><ul><li>Flow rate of carrier gas </li></ul></ul><ul><ul><li>Anesthetic machine maintenance </li></ul></ul><ul><ul><li>Effective scavenging system </li></ul></ul><ul><ul><li>Anesthetic techniques used </li></ul></ul><ul><ul><li>Room ventilation (15-20 air changes per hour is ideal) </li></ul></ul><ul><ul><li>Anesthetic spills </li></ul></ul>
  8. 8. Reducing Exposure to Waste Anesthetic Gas <ul><li>Use a scavenging system </li></ul><ul><ul><li>Collects waste gas from the anesthetic machine and conducts it to a disposal site outside the building </li></ul></ul><ul><ul><li>Installation and consistent use are most important factors </li></ul></ul><ul><ul><li>Include exhaust from anesthetic machine, nonrebreathing systems, ventilators, anesthetic chambers, and capnometers </li></ul></ul><ul><ul><li>Active (high vacuum, low vacuum) or passive </li></ul></ul><ul><ul><li>Active system with dedicated vacuum pump is most efficient </li></ul></ul><ul><ul><li>Passive system is least expensive and is best used in rooms with exterior walls </li></ul></ul>
  9. 9. Active and Passive Scavenging Systems
  10. 10. Potential Difficulties with a Scavenging System <ul><li>Prevent the negative (vacuum) pressure on the breathing circuit </li></ul><ul><ul><li>Reservoir bag will collapse </li></ul></ul><ul><ul><li>Negative pressure relief valve will open </li></ul></ul><ul><li>Obstructions may block waste gas from entering the scavenging system </li></ul><ul><ul><li>Anesthetic gas will accumulate in the anesthetic circuit </li></ul></ul><ul><ul><li>Excess pressure develops in circuit and patient’s lungs </li></ul></ul><ul><ul><li>Positive-pressure relief valve will open </li></ul></ul>
  11. 11. Alternative to Scavenging System <ul><li>Activated charcoal cartridges </li></ul><ul><ul><li>Used in rooms not set up for scavenging </li></ul></ul><ul><ul><li>Charcoal absorbs anesthetic vapors </li></ul></ul><ul><ul><li>Replace cartridge every 12 hours or when weight increases 50 g </li></ul></ul><ul><ul><li>Don’t absorb nitrous oxide vapors </li></ul></ul><ul><ul><li>Inefficient at flow rates >2 L/min </li></ul></ul><ul><li>Masks with charcoal filters </li></ul><ul><ul><li>Worn by personnel at special risk </li></ul></ul><ul><ul><li>Not effective for nitrous oxide </li></ul></ul><ul><ul><li>Don’t use masks designed for particulate matter </li></ul></ul>
  12. 12. Reducing Exposure to Waste Anesthetic Gas <ul><li>Check equipment for leaks </li></ul><ul><li>Common sites for leaking equipment </li></ul><ul><ul><li>Nitrous oxide connections not tightly secured </li></ul></ul><ul><ul><li>Rings, washers, other seals joining tanks to machine hanger yokes are missing, worn, or out of position </li></ul></ul><ul><ul><li>Covering of unidirectional valve is not tightly closed </li></ul></ul><ul><ul><li>Carbon dioxide absorber canister is not securely sealed </li></ul></ul><ul><ul><li>Pop-off valve/scavenger connection is not airtight </li></ul></ul><ul><ul><li>Holes in or loose connections for breathing hoses, reservoir bag, or ET tubes </li></ul></ul><ul><ul><li>Vaporizer cap missing </li></ul></ul>
  13. 13. Types of Leak Tests for Anesthetic Equipment <ul><li>High-pressure tests </li></ul><ul><ul><li>Check for leaks between the gas tanks and the flow meter </li></ul></ul><ul><ul><li>Gas pressure ≥50 psi </li></ul></ul><ul><ul><li>Only oxygen or nitrous oxide (the carrier gasses) is released through any leaks </li></ul></ul>
  14. 14. Types of Leak Tests for Anesthetic Equipment (Cont’d) <ul><li>Low-pressure tests </li></ul><ul><ul><li>Check for leaks in the anesthetic machine and breathing circuit </li></ul></ul><ul><ul><li>Gas pressure ≤15 psi </li></ul></ul><ul><ul><li>Oxygen, nitrous oxide, and anesthetic gas released through any leaks </li></ul></ul>
  15. 15. Reducing Exposure to Waste Anesthetic Gas <ul><li>What type of leak test to perform </li></ul><ul><ul><li>High-pressure and low-pressure: both nitrous oxide and oxygen carrier gasses </li></ul></ul><ul><ul><li>Low-pressure test alone: oxygen carrier gas alone </li></ul></ul><ul><ul><li>Low-pressure test: prior to machine use each day </li></ul></ul><ul><ul><li>High-pressure test: nitrous oxide tank weekly or when tank is changed </li></ul></ul><ul><li>Leaks may be found by locating a hiss of escaping air or by using a detergent solution </li></ul><ul><li>Don’t use machine with a leak until the source of the leak has been identified and repaired </li></ul>
  16. 16. Monitoring Waste Gas Levels <ul><li>Important considerations </li></ul><ul><ul><li>Hospital employee becomes pregnant </li></ul></ul><ul><ul><li>Odor of anesthetic gas is frequently detected </li></ul></ul><ul><ul><li>Special concerns about waste gas levels </li></ul></ul><ul><li>Professional monitoring </li></ul><ul><ul><li>Accredited industrial hygiene laboratory </li></ul></ul><ul><li>In-house monitoring </li></ul><ul><ul><li>Detector tubes or badge dosimeters </li></ul></ul>
  17. 17. Safely Handling Compressed Gases <ul><li>Fire safety </li></ul><ul><ul><li>Oxygen and nitrous oxide support combustion </li></ul></ul><ul><ul><li>Static electricity can cause fire when oxygen and combustibles are present </li></ul></ul><ul><ul><li>Eliminate all sources of ignition or flames from any room where cylinders are stored or used </li></ul></ul>
  18. 18. Safely Handling Compressed Gases (Cont’d) <ul><li>Use and storage </li></ul><ul><ul><li>Cylinders are storehouses of large amounts of energy </li></ul></ul><ul><ul><li>Wear impact-resistant goggles when connecting cylinders to anesthetic machine </li></ul></ul><ul><ul><li>Turn valve slowly and with proper wrench when turning on the cylinder </li></ul></ul><ul><ul><li>Chain or belt cylinders to wall </li></ul></ul><ul><ul><li>Store in an upright position to prevent damage </li></ul></ul><ul><ul><li>Store cylinders away from high traffic areas </li></ul></ul><ul><ul><li>Don’t drag or roll a cylinder </li></ul></ul><ul><ul><li>Keep full and empty cylinders separate </li></ul></ul><ul><ul><li>Label with tear-off labels </li></ul></ul><ul><ul><li>Use cylinders in the order they are received </li></ul></ul>
  19. 19. Labeling Compressed Air Cylinders
  20. 20. Accidental Exposure to Injectable Agents <ul><li>Opioids used for restraint and capture of wild animals </li></ul><ul><ul><li>Etorphine (Immobilon, M99) and carfentanil (Wildnil) </li></ul></ul><ul><ul><li>More potent than morphine </li></ul></ul><ul><ul><li>Absorbed through mucous membranes or broken skin </li></ul></ul><ul><ul><li>Accidental exposure through accidental injection, eye splash, or oral ingestion </li></ul></ul>
  21. 21. Accidental Exposure to Injectable Agents (Cont’d) <ul><li>Precautions </li></ul><ul><ul><li>Become educated on potent opioids before using them </li></ul></ul><ul><ul><li>Don’t work alone and wear gloves when using potent opioids </li></ul></ul><ul><ul><li>Have reversal agents drawn up and ready for use </li></ul></ul><ul><ul><li>Have a treatment plan in place </li></ul></ul><ul><ul><li>Dispose of needles and syringes in a closed container immediately </li></ul></ul>
  22. 22. Accidental Exposure to Injectable Agents (Cont’d) <ul><li>Cyclohexamines (ketamine, tiletamine) </li></ul><ul><ul><li>Accidental eye splash may cause disorientation, excitement, dizziness, or unconsciousness </li></ul></ul><ul><li>Alpha 2 -agonists </li></ul><ul><ul><li>Xylazine, detomidine, medetomidine, dexmedetomidine </li></ul></ul><ul><ul><li>Accidental injection or skin contact may cause sedation, hypotension, bradycardia, respiratory depression, coma </li></ul></ul>
  23. 23. Accidental Exposure to Injectable Agents (Cont’d) <ul><li>Precautions </li></ul><ul><ul><li>Personal protective equipment </li></ul></ul><ul><ul><li>Carefully load syringes </li></ul></ul><ul><ul><li>Properly dispose of needles and syringes </li></ul></ul><ul><ul><li>First aid, including eye wash, readily available </li></ul></ul>

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