This document provides information about laser safety for clinical staff. It defines what a laser is, discusses laser classifications from class 1 to 4 based on their hazard level, and describes the types of laser hazards including those for eyes, skin, and from electrical or fire sources. It provides details on laser signage, protective eyewear, key controls, and proper procedural practices like using laser checklists and smoke evacuators. The document also lists some common urological laser procedures and the laser devices and fibers used at the center.

1. Laser Safety
For
Clinical Staff

2. • LASER is an acronym that stands for "Light
Amplification by Stimulated Emission of Radiation".
• Laser light is a form of non-ionizing radiation.
• Laser equipment produces and amplifies light that has
unique properties that cannot be produced any other way.
• The light that it produces is monochromatic - it is
composed of one single color at a specific wavelength.
What is LASER?

3. • The classifications categorize lasers according to their ability to
produce damage in exposed people, from class 1 (no hazard
during normal use) to class 4 (severe hazard for eyes and
skin)
• Necessary control measures are determined by these
classifications
• In the U.S., laser classifications are based on American
National Standards Institute’s (ANSI) Z136.1 Safe Use of
Lasers
Laser Classifications

4. The Stone Center Lasers are all Class 4
• The highest and most dangerous class of lasers
• Equipped with a key switch and a safety interlock
• Can burn the skin, or cause devastating and permanent eye
damage as a result of direct, diffuse or indirect beam
viewing
• May ignite combustible materials, and thus may represent a
fire risk
LASER Class

5. • Laser beam hazards include eye and skin burns which are due
to laser beam shining on a person's body.
• Non-beam hazards are associated with the laser equipment or
the hazardous substances released from the laser equipment,
and fumes emitted from materials exposed to laser beams,
including laser-plumes produced during surgical procedures.
Sources of laser hazards include:
• Accidental eye exposure during alignment
• Misaligned laser beam
• Lack of eye protection
• Equipment malfunction
• Improper handling of high voltage systems
• Use of unfamiliar equipment
• Improper restoration of equipment following service
LASER Hazards

6. • Eye : Acute exposure of the eye to lasers of certain
wavelengths and power can cause corneal or retinal burns
(or both). Chronic exposure to excessive levels may cause
corneal or lenticular opacities (cataracts) or retinal injury.
• Skin : Acute exposure to high levels of optical radiation
may cause skin burns; while carcinogenesis may occur
for ultraviolet wavelengths (290-320 nm).
• Chemical : Some lasers require hazardous or toxic
substances to operate (i.e., chemical dye, Excimer lasers).
• Electrical : Most lasers utilize high voltages that can be
lethal.
• Fire : The solvents used in dye lasers are flammable. High
voltage pulse or flash lamps may cause ignition.
Flammable materials may be ignited by direct beams or
specular reflections from high power continuous wave
(CW) infrared lasers.
Type of Hazards

7. • During all laser procedure you will see a warning sign
posted on the door with extra goggles/glasses for anyone
who needs to enter
Signage

8. • Must be worn by all personnel during the procedure
• Patients eyes need to be protected during the procedure
• All laser protective eyewear shall be clearly labeled with
the optical density and the wavelength for which
protection is afforded
• Laser protective eyewear shall be inspected for damage
prior to use
GLL Evolve
Eyewear

9. GreenLight Laser Evolve Laser Holmium Laser
Lasers used at the Center

10. • Key must not be left in the switch when the laser system
is unattended
• Key kept in the specified area
Laser key

11. • The most common reason for a damaged blast shield is,
without a doubt, contamination on the proximal (connector)
end of the fiber. If there is enough debris on the face of the
fiber when the laser is fired, the debris will absorb the energy
and flash or burn.
• If you have a damaged blast shield you need to change both
the fiber and shield.
Blast Shields

12. Blast Evolve Fiber
Shield
Evolve Laser Blast Shield

13. Blast Shield Insertion Site Holmium Fiber with Blast Shield
Holmium Laser Blast Shield

14. • BPH
• Bladder Biopsies
• Condyloma
• Fulguration of bladder tumors
• Lithotripsy
• Strictures
Urological Laser Procedures

15. LASER CHECKLIST
Date__________________Time:________ RN/RT__________________________
HOLMIUM LASER _______ GLL _______ EVOLVE _______ OTHER_______
Check as completed:
All doors closed _______
COVER THE WINDOW (on the door) _______
LASER Warning signs posted on all entrances_______
Protective eye wear for: _______
Staff _______
Patient _______
Urologist _______
Anesthesiologist _______
Other _______
Extra pair hung on outside the door _______
Electrical cord checked for damage _______
LASER Unit _______
Self check done _______
Verify aiming beam _______
Cleave fiber if applicable _______
Foot switch checked for damage _______
Fire Extinguisher ________
Comments_______________________________________________________________________________________________
_________________________________________________________________________________
_____________________________________________________________________
Laser Checklist

16. • Laser foot pedal
• Pedal is to be activated only by physician performing
procedure – no other foot operated device can be used by
the physician!
• Laser used correctly
• Laser in “Standby” when not in direct use
• Physician must communicate “laser on” and “laser standby”
with nurse/technician
• Laser nurse or technician at control panel for emergency shut
down
Procedural Practices

17. • Smoke evacuator used when lasing produces particulates
• Check filter unit before use for capacity
• Check alignment of laser prior to use
• Set energy setting
• Verify “kill” switch works
• Complete Medical Record for laser use
Procedural Practices, cont’d

18. Holmium Laser Fibers
-200
-365 (Most Commonly Used)
-550
-1000
Evolve Fiber
GLL Fiber
-Fiber Card
Fibers

19. Safety First