1. The operating room poses physical, chemical, and biological hazards for both patients and staff. Physical hazards include electricity, fire, and falling while chemical hazards include toxic gases from anesthesia and cleaning agents. Biological hazards arise from infectious patients, waste, and needlesticks. 2. Two catastrophic events that can occur without warning are anaphylactic reactions, which cause life-threatening symptoms, and malignant hyperthermia, a rare metabolic disease caused by exposure to certain anesthetic agents that requires immediate intervention. 3. The document outlines strategies for eliminating ignition sources, heat sources, high oxygen concentrations, and proper fire safety equipment to minimize hazards in the operating room. Staff must understand hazards in order to maintain a safe

2. Hazards in the operating theater
Learning Objectives
After the completion of this session, the learner will be able to:
1.Identify the main dangers in the operating room.
2.Explain the factors that increase the hazards in the OR.
3.Differentiate between physical and chemical hazards.
4.Discuss malignant hyperthermia.
5.Define anaphylactic reaction.
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3. Introduction
Historically, the operating room (OR) has been a place full of hazards
for both the patient and the care giver.
The primary dangers include, but are not limited to fire, chemical
exposure to anesthetic agents and direct exposure to biologic
materials.
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4. 11.1 Environmental Hazards
The perioperative environment poses many hazards for both patients
and personnel.
The potential for physical injury from electric shock, burns, fire,
explosion, exposure to blood-borne pathogens, and inhalation of toxic
substances is ever present
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5. Injuries can be caused by:
Using faulty equipment
Using equipment improperly
Exposing oneself or others to toxic or irritating agents,
Or Coming into contact with harmful agents
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6. Hazards in the OR environment can be classified as
follows:
•Physical: including back injury, fall, noise pollution,
irradiation, 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 needle-stick injuries, surgical plume
and latex sensitivity
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7. Regulation of Hazards
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1.Elimination
of substances

8. 1.Elimination of sources of ignition
A. Electrostatic Spark
B. Precautions To Be Observed By Personnel
a. The hair must be covered completely
b. Materials that accumulate static (wool, nylon,
rayon, sharkskin, silk, or plastics) must not be worn
c. Conductive shoes should be worn
d. No woolen blankets are permitted in the OR
e. Personnel should avoid any unnecessary motion
in the area near the patient's head and the
anesthesia equipment
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9. C. Precautions Observed in Construction of the Suite and
Equipment
1) Conductive flooring, usually ceramic or vinyl plastic tile, is installed
2) Furniture is made of metal with the leg tips or casters made of
either metal or conductive rubber to provide a conductive path to
the floor
3) Carbon-permeated rubber mattresses, pillows, and sheeting should
be used
4) An instrument (ohmmeter) is used to measure the electric
resistance of personnel and equipment
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10. Cont’d
5. All plugs, sockets, and switches must be explosion-proofed for use in
anesthetizing locations
6.Only electrical equipment that has been designed for use in hazardous
locations may be used
7. The electric cautery is to be used with extreme care
8. The use of photoflash and photoflood bulbs should be prohibited
9. Anesthesia machines or oxygen cylinders are never to be completely
covered
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11. Cont’d
10.Anesthesia equipment must be kept in good repair and must be leak
proof
11. Oil or grease is never to be used on any part of the anesthesia
machine or oxygen valve
12. The humidity of the OR should be kept at 55 to 60 percent to lessen
the accumulation of static charges
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12. 2.Elimination or Control of Sources of Heat
1) No smoking should be permitted in hazardous area.
2) Open flames such as lighted matches or alcohol lamps may be used
in some operative procedures but only after their use has been cleared
by the anesthetist.
3) Electric hot plates should never be used in the same room or area
where flammable agents are stored or used.
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13. 3.ELIMINATION OF HIGH OXYGEN
CONCENTRATION
1. Ventilating or Air-Conditioning Systems
2. Oxygen Cylinders. Oxygen cylinders must be operated properly
4.FIRE EXTINGUISHERS
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14. Catastrophic Events in the operating Room
Unanticipated intraoperative events occasionally occur. Although
some might be anticipated (e.g., cardiac arrest in an unstable patient,
massive blood loss during trauma surgery), others may occur
without warning, demanding immediate intervention by all
members of the OR team. Two such events are anaphylactic reactions
and malignant hyperthermia
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15. Anaphylactic Reactions
Anaphylaxis is the most severe form of an allergic
reaction, manifesting with life-threatening pulmonary
and circulatory complications. The initial clinical
manifestations of anaphylaxis may be masked by
anesthesia
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16. Cont’d
Anesthesia Care Providers (ACPs) administer an array of drugs to
patients, such as anesthetics, antibiotics, blood products and plasma
expanders, and since any parenterally administered material can
theoretically produce an allergic response, vigilance and rapid
intervention are essential
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17. Cont’d
An anaphylactic reaction causes hypotension, tachycardia,
bronchospasm and possibly pulmonary edema. Antibiotics
and latex are responsible for many perioperative allergic
reactions
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18. Malignant Hyperthermia
Malignant hyperthermia (MH) is a rare metabolic disease
characterized by hyperthermia with rigidity of skeletal muscles
that can result in death. It occurs in affected people exposed to certain
anesthetic agents
When it does occur, it is usually during general anesthesia, but it
may manifest in the recovery period as well
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19. Cont’d
The fundamental defect is hypermetabolism of skeletal muscle
resulting from altered control of intracellular calcium, leading to
muscle contracture, hyperthermia, hypoxemia, lactic acidosis, and
hemodynamic and cardiac alterations
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20. summary
1.List four primary dangers for both the patient and the care giver in the
operating room.
2.In order to minimize the potential hazards in the OR, what
knowledges are expected from the OR team?
3.Identify the three hazard classifications that could happen in the OR
environment?
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