This document discusses various hazards in the operating room. It identifies the most common hazards as fires and explosions, static electricity, electrical hazards, radiation injury, air pollution, and power failure. It provides details on the causes and risks of fires and explosions, as well as ways to reduce static electricity such as using conductive flooring and clothing. Electrical hazards from equipment are also discussed. The document outlines risks from waste anesthetic gases, as well as the consequences of power failure in critical care areas. Overall it provides an overview of potential hazards in the operating room and recommendations to improve patient safety.
Itp (presentation) sundram jha me 5th.pptSUNDRAM JHA
This presentation summarizes medical devices and equipment used at AIIMS. It describes the Central Workshop at AIIMS which repairs and maintains biomedical equipment. Key devices discussed include infusion pumps, centrifuges, ECG machines, X-ray machines, pacemakers, incubators, nebulizers, laryngoscopes, and stethoscopes. Their functions and uses are outlined. The Central Workshop trains staff in electronics, electrical, mechanical and other disciplines needed to service this medical equipment.
This document discusses electrical safety in hospitals. It covers various electrical hazards like electric shocks and equipment failures. It discusses physiological effects of electricity on patients and how electrical safety depends on factors like frequency, skin resistance, and leakage current. The document also covers protective circuits and standards like ground fault interrupters. It describes classifications for medical devices and hospital areas based on electrical risk. Power distribution systems in hospitals are also discussed along with references.
This document discusses emergency drugs used in radiology departments. It notes that medical emergencies may occur due to medications, procedures, or pre-existing conditions. A crash cart containing emergency drugs like adrenaline, atropine, buscopan, hydrocortisone, and dopamine is used to manage complications from sedation, invasive procedures, or errors. While serious emergencies are rare, the increasing complexity of procedures means they will become more frequent. It is essential that radiology departments are prepared to deal with any emergency immediately. The presentation will discuss emergency drugs and their uses.
Occupational exposure to radiation in a nuclear power plant, medicalsJanne Anttila
This document discusses health evaluations and follow-ups of radiation workers at the Loviisa nuclear power plant in Finland. It describes the working conditions at the plant, which involve risks from radiation exposure. It emphasizes the importance of qualified occupational health professionals conducting health evaluations and providing radiation risk information to workers. Evaluations should ensure workers are fit for duty and appropriately informed about radiation health hazards. Regular oversight is needed to protect worker health and safety in their specialized roles at the nuclear facility.
The document provides information on the Maestro 3000 Cardiac Ablation System manufactured by Boston Scientific Corporation. It includes indications for use, contraindications, and extensive warnings and precautions for safe use of the system and ablation catheters. Physicians are referred to catheter instructions for compatibility and risk information. The system is intended for cardiac ablation procedures to address arrhythmias.
Pacemaker | Implantable Cardiac Devices For Heart FailuresYashodaHospitals
Implantable cardiac devices are electronic, battery-operated medical devices that are implanted to restore the heart's normal rhythm and prevent sudden cardiac death. Implantable cardioverter-defibrillator, Pacemaker and LAVD are such devices that help to maintain rhythm and pumping. A pacemaker is a small implantable cardiac device that is placed under the skin in the chest to help control the heartbeat, improve quality of life and for longevity. It is used to help the heart beat more regularly for irregular heartbeat also known as arrhythmia.
What does it help with?
Pacemaker helps in controlling the rhythm and of the heart by either:
Resynchronizing the rhythm
Correcting the rhythm
Facilitating adequate circulation to support a failing heart
Biotelemetry is the measurement and transmission of biological parameters such as heart rate, blood pressure, and body temperature from a distance. It allows for monitoring of things like astronauts in space, patients during exercise or in ambulances, and collecting medical data from homes or offices. It also enables research on unrestrained animals in their natural habitats. Biotelemetry systems consist of components like amplifiers, oscillators, power supplies, analog-to-digital converters, digital-to-analog converters, transducers, and processors to adapt existing measurement methods to transmit the resulting data.
Itp (presentation) sundram jha me 5th.pptSUNDRAM JHA
This presentation summarizes medical devices and equipment used at AIIMS. It describes the Central Workshop at AIIMS which repairs and maintains biomedical equipment. Key devices discussed include infusion pumps, centrifuges, ECG machines, X-ray machines, pacemakers, incubators, nebulizers, laryngoscopes, and stethoscopes. Their functions and uses are outlined. The Central Workshop trains staff in electronics, electrical, mechanical and other disciplines needed to service this medical equipment.
This document discusses electrical safety in hospitals. It covers various electrical hazards like electric shocks and equipment failures. It discusses physiological effects of electricity on patients and how electrical safety depends on factors like frequency, skin resistance, and leakage current. The document also covers protective circuits and standards like ground fault interrupters. It describes classifications for medical devices and hospital areas based on electrical risk. Power distribution systems in hospitals are also discussed along with references.
This document discusses emergency drugs used in radiology departments. It notes that medical emergencies may occur due to medications, procedures, or pre-existing conditions. A crash cart containing emergency drugs like adrenaline, atropine, buscopan, hydrocortisone, and dopamine is used to manage complications from sedation, invasive procedures, or errors. While serious emergencies are rare, the increasing complexity of procedures means they will become more frequent. It is essential that radiology departments are prepared to deal with any emergency immediately. The presentation will discuss emergency drugs and their uses.
Occupational exposure to radiation in a nuclear power plant, medicalsJanne Anttila
This document discusses health evaluations and follow-ups of radiation workers at the Loviisa nuclear power plant in Finland. It describes the working conditions at the plant, which involve risks from radiation exposure. It emphasizes the importance of qualified occupational health professionals conducting health evaluations and providing radiation risk information to workers. Evaluations should ensure workers are fit for duty and appropriately informed about radiation health hazards. Regular oversight is needed to protect worker health and safety in their specialized roles at the nuclear facility.
The document provides information on the Maestro 3000 Cardiac Ablation System manufactured by Boston Scientific Corporation. It includes indications for use, contraindications, and extensive warnings and precautions for safe use of the system and ablation catheters. Physicians are referred to catheter instructions for compatibility and risk information. The system is intended for cardiac ablation procedures to address arrhythmias.
Pacemaker | Implantable Cardiac Devices For Heart FailuresYashodaHospitals
Implantable cardiac devices are electronic, battery-operated medical devices that are implanted to restore the heart's normal rhythm and prevent sudden cardiac death. Implantable cardioverter-defibrillator, Pacemaker and LAVD are such devices that help to maintain rhythm and pumping. A pacemaker is a small implantable cardiac device that is placed under the skin in the chest to help control the heartbeat, improve quality of life and for longevity. It is used to help the heart beat more regularly for irregular heartbeat also known as arrhythmia.
What does it help with?
Pacemaker helps in controlling the rhythm and of the heart by either:
Resynchronizing the rhythm
Correcting the rhythm
Facilitating adequate circulation to support a failing heart
Biotelemetry is the measurement and transmission of biological parameters such as heart rate, blood pressure, and body temperature from a distance. It allows for monitoring of things like astronauts in space, patients during exercise or in ambulances, and collecting medical data from homes or offices. It also enables research on unrestrained animals in their natural habitats. Biotelemetry systems consist of components like amplifiers, oscillators, power supplies, analog-to-digital converters, digital-to-analog converters, transducers, and processors to adapt existing measurement methods to transmit the resulting data.
This document provides information about pacemakers, including their history, components, types, indications, contraindications, and nursing management. It discusses how pacemakers generate electrical impulses to initiate heartbeats when the heart's intrinsic system cannot. It reviews the development of pacemakers from early experimentation in the 1820s-1830s to the first implanted pacemaker in 1960. The document also describes the various pacemaker components, types (including single chamber, dual chamber, biventricular), and programming codes. Nursing management includes pre-operative, intra-operative, and post-operative care of pacemaker patients.
The document discusses cardiac monitoring and electrocardiography (ECG). It defines a cardiac monitor as a device that displays electrical and pressure waveforms of the cardiovascular system. Cardiac monitors are used to continuously monitor heart rate, blood pressure, respiratory rate, and other vital signs in critically ill patients. They allow for prompt detection of arrhythmias and other cardiac conditions. A 12-lead ECG provides a graphical recording of the heart's electrical activity over time and is useful for diagnosing arrhythmias and detecting other cardiac abnormalities.
This document discusses various implantable cardiac devices including pacemakers, implantable cardioverter-defibrillators (ICDs), cardiac resynchronization therapy (CRT), and cardiac assist devices. It describes the components, indications, and complications of pacemakers and ICDs. It also covers topics such as pacemaker/ICD terminology, programming, interactions with defibrillation, and transcutaneous pacing. Cardiac assist devices are briefly discussed, noting examples like LVADs, BiVADs, and total artificial hearts.
A pacemaker is an implantable device that uses electrical pulses to help regulate an abnormal heart rhythm. It consists of a pulse generator and leads that are placed in the heart. Patients may present with symptoms like dizziness, fainting, or fatigue due to bradycardia. Early pacemakers were external, asynchronous, and unreliable, but modern pacemakers are internal, dual-chamber devices that are programmable and long-lasting. Advancements continue to improve diagnostic functions, rate response capabilities, and reliability of pacemakers.
The number of patients with implantable devices continues to grow. There are important aspects and difficulties in the perioperative management of these patients.
This document discusses considerations for surgery in patients with implantable cardioverter-defibrillators (ICDs) or pacemakers. Electrocautery can cause electromagnetic interference that temporarily or permanently affects the device's functioning by resetting modes, inhibiting pacing, or triggering ICD shocks. The impact depends on factors like device type, lead placement, and whether the patient relies on pacing. Evaluation involves assessing the device and settings. Measures like using bipolar cautery, maximizing distance between devices and cautery, and magnet placement can reduce risks. After surgery, devices may need reprogramming and checking.
The document discusses various types of biomedical equipment used in medical settings. It defines medical equipment as devices designed to aid in diagnosis, monitoring, or treatment of medical conditions. It then proceeds to describe several pieces of equipment in 1-2 paragraphs each, including their purposes and basic functions. The equipment discussed includes cervical traction, syringe drives, pulse oximetry, electrosurgical units, laser microtomes, anemostats, cardiopulmonary bypass machines, aesthesiometers, home ultrasounds, nasogastric intubation, lung counters, dermatomes, Hirtz compasses, rhinoscopes, and plethysmographs.
The sinoatrial (SA) node is the dominant pacemaker of the
heart which initiates the process of impulse generation in the
cardiac tissue, thereby defining the rate and rhythm of cardiac
contraction. The automaticity of the conduction cells in the
SA node is due to ion channels which are inter-linked by
molecular, histological and electrophysiological mechanisms
causing spontaneous diastolic depolarization and generation of
an impulse. The SA nodal action potentials are then transmitted
to the ventricles by electrical coupling of the myocytes in
different areas of the heart. Regulatory pathways overseeing
cardiac impulse generation and conduction provide effective
and safe pacing, and help maintain the rate according to the
physiological demands of the individual’s body. Failure of
physiological pacing due to any pathology in the SA or atrioventricular
node necessitates implantation of a permanent
pacemaker. Implantable pacemakers, despite technological
advances, are not without practical limitations including a
defined battery life leading to lead and/or generator replacement
at periodic intervals, vascular complications, occasional
component failure, electronic interference from external/
internal sources, e.g. myopotentials, electromechanical interference,
etc., inadequate or incomplete physiological rate response
to autonomic influences (devices have certain algorithms
to address these issues) and most importantly the risk of
infection. A biological pacemaker is therefore emerging as a
promising technique to counter these challenges.
This document provides an overview of cardiac pacemakers. It discusses the anatomy of the heart, conduction pathways, history of pacemakers, pacemaker components, types of pacemakers including permanent and temporary, indications for pacemakers, procedures, pacing modes, complications, nursing management, and patient education. The key points are that pacemakers are electronic devices used to treat bradyarrhythmias, they consist of a pulse generator and leads that are placed transvenously, and nursing care involves monitoring function and educating patients.
The document discusses pacemakers, including:
1. Defining pacemakers as electric devices that stimulate the myocardium to initiate contractions.
2. Different types of pacemakers including single chamber, dual chamber, permanent, and temporary models.
3. The functions of pacing, sensing, and capture that pacemakers perform.
4. Nursing responsibilities in caring for patients with pacemakers such as monitoring for complications, providing education, and maintaining device function.
This document provides guidelines for post-cardiac arrest care. It recommends:
1) Performing emergency coronary angiography for OHCA patients with suspected cardiac cause and ST elevation on ECG.
2) Maintaining blood pressure above 90 mmHg systolic or 65 mmHg mean and immediately correcting any hypotension.
3) Inducing therapeutic hypothermia between 32-36°C for at least 24 hours in comatose cardiac arrest patients to minimize brain injury.
The document discusses electrical safety testing of medical equipment. It begins by introducing the importance of electrical safety testing to ensure patient safety and meet regulatory standards. It then covers common electrical hazards for medical devices, the physiological effects of electricity on the human body, and international standards for electrical safety testing (IEC 60601 and IEC 62353). The document concludes by describing the specific tests performed during an electrical safety test, including earth resistance testing, insulation testing, and leakage current testing.
4.hazards of working in the operation roomHenok Eshetie
This document outlines various hazards faced by those working in operating theatres. It discusses pollution from anaesthetic agents which can cause health issues with chronic exposure. Biological hazards like infections from needlesticks or airborne pathogens are also a risk. Physical hazards include injuries from sharp objects, falls, fires or radiation. Electrical accidents are another danger, as are personal hazards such as stress, fatigue, or drug and alcohol abuse. A variety of precautions are recommended to minimize risks from these various hazards of working in operating rooms.
This document provides an overview of electrical safety testing for medical equipment. It discusses the various classes and types of medical equipment and the electrical safety tests that should be performed on each. The key tests mentioned are protective earth continuity testing, insulation testing, and testing for earth leakage current and enclosure leakage current. Maintaining electrical safety is important to prevent electric shock to patients and users from medical equipment.
MECHANICAL , ELECTRICAL HAZARDS AND SAFETY REGULATIONS.pptxGNIPST
Welcome to our presentation on hazards, with a specific focus on mechanical and electrical hazards.
Our primary goal is to raise awareness about the potential risks associated with these hazards and provide practical solutions to ensure a safer working environment.
Topic 1: Understanding Hazards
Topic 2: Mechanical Hazards
Topic 3: Electrical Hazards
Topic 4: Preventive Measures You can read and makes notes
Share your views related to this.
Thank You.
UC-Santa Clara Electrical Safety for Engineering Online Course 2017-18.pptxmziqbalhse
This document provides an overview of electrical safety training for engineering staff. It defines key electrical safety terms and outlines hazards like electric shock and fires. It discusses regulations and best practices for working on energized systems. These include using proper personal protective equipment, establishing zero energy states before work, and restricting live work to qualified personnel. The document also recommends design and work process safety measures for student projects involving medium voltage systems to minimize risks.
Imaging Lecture on maintaining medical Equipmentprojuktimurad
The document discusses maintenance of biomedical equipment, defining maintenance and describing types of maintenance activities. It outlines objectives of maintenance like maximizing production and minimizing costs. Preventative maintenance is emphasized for reducing risks and protecting investments. Different levels of maintenance are described based on expertise required. The full lifecycle of medical equipment management is illustrated in a diagram, emphasizing safety throughout use. Various electrical and clinical safety hazards are outlined.
Basic Safety Procedure in High Risk Activities and IndustriesJames Tolentino
The document provides guidance on safety procedures for hazardous activities and industries. It discusses different types of hazardous energy including electrical, chemical, mechanical, hydraulic, pneumatic and thermal energy. It outlines the steps to develop a hazardous energy control program which includes gathering information, performing task and hazard analyses, implementing controls, and training employees. It also discusses lockout/tagout procedures and provides electrical safety tips for construction workers.
This document discusses industrial safety hazards. It begins by defining key terms like hazard, industrial hazard, safety, and types of accidents. It then describes several common types of industrial hazards like electrical, chemical, gas, dust explosions, and fire/explosion. It outlines causes of accidents from both human failure and machine failure. The document discusses principles of safety programs and their elements. It provides guidance on selecting proper protective equipment for different body parts. Finally, it summarizes guidelines for safely working with electrical, chemical, compressed gas, and dust hazards.
This document provides guidance on basic electrical safety. It discusses the hazards of electricity like shock and burns. It emphasizes following safe work practices when working with electricity, such as wearing personal protective equipment and locking out energized equipment. Proper training and preventing unsafe equipment, workplaces, and practices can help avoid electrical accidents.
The document outlines the scope and objectives of an electrical safety audit conducted at a petrochemical plant. The audit inspected electrical equipment and components to assess safety, personnel safety, and the system's capability. It aimed to evaluate the adequacy of the existing electrical system and identify strengths and weaknesses to suggest improvements and ensure compliance with safety and statutory requirements.
This document provides information about pacemakers, including their history, components, types, indications, contraindications, and nursing management. It discusses how pacemakers generate electrical impulses to initiate heartbeats when the heart's intrinsic system cannot. It reviews the development of pacemakers from early experimentation in the 1820s-1830s to the first implanted pacemaker in 1960. The document also describes the various pacemaker components, types (including single chamber, dual chamber, biventricular), and programming codes. Nursing management includes pre-operative, intra-operative, and post-operative care of pacemaker patients.
The document discusses cardiac monitoring and electrocardiography (ECG). It defines a cardiac monitor as a device that displays electrical and pressure waveforms of the cardiovascular system. Cardiac monitors are used to continuously monitor heart rate, blood pressure, respiratory rate, and other vital signs in critically ill patients. They allow for prompt detection of arrhythmias and other cardiac conditions. A 12-lead ECG provides a graphical recording of the heart's electrical activity over time and is useful for diagnosing arrhythmias and detecting other cardiac abnormalities.
This document discusses various implantable cardiac devices including pacemakers, implantable cardioverter-defibrillators (ICDs), cardiac resynchronization therapy (CRT), and cardiac assist devices. It describes the components, indications, and complications of pacemakers and ICDs. It also covers topics such as pacemaker/ICD terminology, programming, interactions with defibrillation, and transcutaneous pacing. Cardiac assist devices are briefly discussed, noting examples like LVADs, BiVADs, and total artificial hearts.
A pacemaker is an implantable device that uses electrical pulses to help regulate an abnormal heart rhythm. It consists of a pulse generator and leads that are placed in the heart. Patients may present with symptoms like dizziness, fainting, or fatigue due to bradycardia. Early pacemakers were external, asynchronous, and unreliable, but modern pacemakers are internal, dual-chamber devices that are programmable and long-lasting. Advancements continue to improve diagnostic functions, rate response capabilities, and reliability of pacemakers.
The number of patients with implantable devices continues to grow. There are important aspects and difficulties in the perioperative management of these patients.
This document discusses considerations for surgery in patients with implantable cardioverter-defibrillators (ICDs) or pacemakers. Electrocautery can cause electromagnetic interference that temporarily or permanently affects the device's functioning by resetting modes, inhibiting pacing, or triggering ICD shocks. The impact depends on factors like device type, lead placement, and whether the patient relies on pacing. Evaluation involves assessing the device and settings. Measures like using bipolar cautery, maximizing distance between devices and cautery, and magnet placement can reduce risks. After surgery, devices may need reprogramming and checking.
The document discusses various types of biomedical equipment used in medical settings. It defines medical equipment as devices designed to aid in diagnosis, monitoring, or treatment of medical conditions. It then proceeds to describe several pieces of equipment in 1-2 paragraphs each, including their purposes and basic functions. The equipment discussed includes cervical traction, syringe drives, pulse oximetry, electrosurgical units, laser microtomes, anemostats, cardiopulmonary bypass machines, aesthesiometers, home ultrasounds, nasogastric intubation, lung counters, dermatomes, Hirtz compasses, rhinoscopes, and plethysmographs.
The sinoatrial (SA) node is the dominant pacemaker of the
heart which initiates the process of impulse generation in the
cardiac tissue, thereby defining the rate and rhythm of cardiac
contraction. The automaticity of the conduction cells in the
SA node is due to ion channels which are inter-linked by
molecular, histological and electrophysiological mechanisms
causing spontaneous diastolic depolarization and generation of
an impulse. The SA nodal action potentials are then transmitted
to the ventricles by electrical coupling of the myocytes in
different areas of the heart. Regulatory pathways overseeing
cardiac impulse generation and conduction provide effective
and safe pacing, and help maintain the rate according to the
physiological demands of the individual’s body. Failure of
physiological pacing due to any pathology in the SA or atrioventricular
node necessitates implantation of a permanent
pacemaker. Implantable pacemakers, despite technological
advances, are not without practical limitations including a
defined battery life leading to lead and/or generator replacement
at periodic intervals, vascular complications, occasional
component failure, electronic interference from external/
internal sources, e.g. myopotentials, electromechanical interference,
etc., inadequate or incomplete physiological rate response
to autonomic influences (devices have certain algorithms
to address these issues) and most importantly the risk of
infection. A biological pacemaker is therefore emerging as a
promising technique to counter these challenges.
This document provides an overview of cardiac pacemakers. It discusses the anatomy of the heart, conduction pathways, history of pacemakers, pacemaker components, types of pacemakers including permanent and temporary, indications for pacemakers, procedures, pacing modes, complications, nursing management, and patient education. The key points are that pacemakers are electronic devices used to treat bradyarrhythmias, they consist of a pulse generator and leads that are placed transvenously, and nursing care involves monitoring function and educating patients.
The document discusses pacemakers, including:
1. Defining pacemakers as electric devices that stimulate the myocardium to initiate contractions.
2. Different types of pacemakers including single chamber, dual chamber, permanent, and temporary models.
3. The functions of pacing, sensing, and capture that pacemakers perform.
4. Nursing responsibilities in caring for patients with pacemakers such as monitoring for complications, providing education, and maintaining device function.
This document provides guidelines for post-cardiac arrest care. It recommends:
1) Performing emergency coronary angiography for OHCA patients with suspected cardiac cause and ST elevation on ECG.
2) Maintaining blood pressure above 90 mmHg systolic or 65 mmHg mean and immediately correcting any hypotension.
3) Inducing therapeutic hypothermia between 32-36°C for at least 24 hours in comatose cardiac arrest patients to minimize brain injury.
The document discusses electrical safety testing of medical equipment. It begins by introducing the importance of electrical safety testing to ensure patient safety and meet regulatory standards. It then covers common electrical hazards for medical devices, the physiological effects of electricity on the human body, and international standards for electrical safety testing (IEC 60601 and IEC 62353). The document concludes by describing the specific tests performed during an electrical safety test, including earth resistance testing, insulation testing, and leakage current testing.
4.hazards of working in the operation roomHenok Eshetie
This document outlines various hazards faced by those working in operating theatres. It discusses pollution from anaesthetic agents which can cause health issues with chronic exposure. Biological hazards like infections from needlesticks or airborne pathogens are also a risk. Physical hazards include injuries from sharp objects, falls, fires or radiation. Electrical accidents are another danger, as are personal hazards such as stress, fatigue, or drug and alcohol abuse. A variety of precautions are recommended to minimize risks from these various hazards of working in operating rooms.
This document provides an overview of electrical safety testing for medical equipment. It discusses the various classes and types of medical equipment and the electrical safety tests that should be performed on each. The key tests mentioned are protective earth continuity testing, insulation testing, and testing for earth leakage current and enclosure leakage current. Maintaining electrical safety is important to prevent electric shock to patients and users from medical equipment.
MECHANICAL , ELECTRICAL HAZARDS AND SAFETY REGULATIONS.pptxGNIPST
Welcome to our presentation on hazards, with a specific focus on mechanical and electrical hazards.
Our primary goal is to raise awareness about the potential risks associated with these hazards and provide practical solutions to ensure a safer working environment.
Topic 1: Understanding Hazards
Topic 2: Mechanical Hazards
Topic 3: Electrical Hazards
Topic 4: Preventive Measures You can read and makes notes
Share your views related to this.
Thank You.
UC-Santa Clara Electrical Safety for Engineering Online Course 2017-18.pptxmziqbalhse
This document provides an overview of electrical safety training for engineering staff. It defines key electrical safety terms and outlines hazards like electric shock and fires. It discusses regulations and best practices for working on energized systems. These include using proper personal protective equipment, establishing zero energy states before work, and restricting live work to qualified personnel. The document also recommends design and work process safety measures for student projects involving medium voltage systems to minimize risks.
Imaging Lecture on maintaining medical Equipmentprojuktimurad
The document discusses maintenance of biomedical equipment, defining maintenance and describing types of maintenance activities. It outlines objectives of maintenance like maximizing production and minimizing costs. Preventative maintenance is emphasized for reducing risks and protecting investments. Different levels of maintenance are described based on expertise required. The full lifecycle of medical equipment management is illustrated in a diagram, emphasizing safety throughout use. Various electrical and clinical safety hazards are outlined.
Basic Safety Procedure in High Risk Activities and IndustriesJames Tolentino
The document provides guidance on safety procedures for hazardous activities and industries. It discusses different types of hazardous energy including electrical, chemical, mechanical, hydraulic, pneumatic and thermal energy. It outlines the steps to develop a hazardous energy control program which includes gathering information, performing task and hazard analyses, implementing controls, and training employees. It also discusses lockout/tagout procedures and provides electrical safety tips for construction workers.
This document discusses industrial safety hazards. It begins by defining key terms like hazard, industrial hazard, safety, and types of accidents. It then describes several common types of industrial hazards like electrical, chemical, gas, dust explosions, and fire/explosion. It outlines causes of accidents from both human failure and machine failure. The document discusses principles of safety programs and their elements. It provides guidance on selecting proper protective equipment for different body parts. Finally, it summarizes guidelines for safely working with electrical, chemical, compressed gas, and dust hazards.
This document provides guidance on basic electrical safety. It discusses the hazards of electricity like shock and burns. It emphasizes following safe work practices when working with electricity, such as wearing personal protective equipment and locking out energized equipment. Proper training and preventing unsafe equipment, workplaces, and practices can help avoid electrical accidents.
The document outlines the scope and objectives of an electrical safety audit conducted at a petrochemical plant. The audit inspected electrical equipment and components to assess safety, personnel safety, and the system's capability. It aimed to evaluate the adequacy of the existing electrical system and identify strengths and weaknesses to suggest improvements and ensure compliance with safety and statutory requirements.
This document outlines various hazards found in operating theatres and approaches to managing them. It identifies physical, chemical, biological, electrical, fire, radiation, and psychological hazards. Chemical hazards include irritants, sensitizers, toxins, and anesthetic gases. Prevention techniques include scavenging systems, closed circuits, and personal protective equipment. Electrical hazards can cause shocks or burns, while fires and explosions threaten patient safety. Radiation poses risks of cell damage and malignancies. Proper hazard identification, evaluation, and control are necessary to ensure safety in operation theatres.
Electrical maintenance is important for safety, reliability, and cost savings. It involves regularly inspecting, testing, and repairing electrical equipment to prevent failures, accidents, and costly downtime. An effective preventative electrical maintenance program can reduce hazards, save lives, and minimize unexpected issues by catching small problems before they worsen and cause damage."
Dentists and dental health care workers may face potential occupational hazards due to exposure risks inherent in the profession . Dental practitioners are at the risk of exposure to blood-borne pathogens like HIV , HBV, HCV. STRESS can never be totally eliminated from dental practise , however it can be managed .
Anesthesia carries risks that can lead to patient death or injury. Several factors contribute to risks in the operating room including equipment issues, patient health factors, human performance errors, and system failures. Some key errors that can cause severe harm are airway issues, medication errors, and procedure mistakes. Maintaining vigilance, checklists, standards, training, and learning from adverse events can help improve safety. Thorough documentation and review of incidents is important for quality assurance.
This document discusses various industrial hazards found in pharmaceutical manufacturing processes. It covers fire and explosion hazards, mechanical hazards, electrical hazards, thermal hazards, and process hazards. For each hazard type, the document discusses potential causes and recommended preventive measures. It provides an example case study of a manufacturing company that hired a consultant to improve its safety compliance after recognizing gaps in its in-house safety program. The document emphasizes the importance of identifying hazards, implementing engineering and administrative controls, and training workers to reduce risks in industrial processes.
This document discusses guidelines and considerations for providing anaesthesia services in non-operating room areas (NORA) such as for MRI/CT scans. It notes special challenges in NORA including limited space, equipment issues, and unfamiliar environments. Key guidelines are outlined such as having proper patient monitoring, emergency equipment, and following pre-procedure evaluations. Specific anaesthetic drugs that can be used for moderate sedation are discussed, including propofol, benzodiazepines, dexmedetomidine, and ketamine. Hazards in the MRI environment like magnetic fields, acoustic noise, and restricted access are summarized. The document stresses the importance of patient safety, standards of care, and proper planning for NORA cases.
Introduction to medical equipments safety and testingMEHABOOB RAHMAN
Medical equipment can present a variety of hazards including mechanical, electrical, fire-related, and those resulting from improper function or incorrect output. It is important to properly maintain equipment and perform safety testing using calibrated equipment to minimize risks to patients and users. Regular performance testing helps ensure medical devices are functioning as intended.
This document discusses airway local blocks and awake intubation. It describes the indications for awake intubation including comorbidities, risk of aspiration, difficult airway assessment, and emergencies. It provides details on the pharmacological agents, equipment, personnel, and techniques used for airway local blocks and awake intubation. Specifically, it outlines common methods for anesthetizing different areas of the airway using lidocaine, including dosage calculations and risks of lidocaine toxicity. The goal is to safely anesthetize the airway to allow for awake intubation.
This document discusses endotracheal tubes and intubation. It covers indications for intubation including airway protection, optimizing gas exchange, decreasing metabolic demand, and reducing work of breathing. Conditions associated with difficult intubation are described such as congenital anomalies, infections, tumors, injuries, and obesity. Proper equipment, tube sizing, intubation technique including positioning and confirmation of placement are outlined. Golden rules of intubation emphasize preparation, oxygenation, skills, confirmation, and monitoring.
Appropriate airway equipment and techniques.Nisar Arain
This document provides an overview of airway anatomy, equipment, and techniques for airway management. It discusses:
1. The importance of airway control and the development of advanced cardiac life support.
2. The objectives of reviewing upper and lower airway anatomy, basic and advanced airway techniques, equipment for difficult airways, and clinical management of the airway.
3. Details of upper airway structures including the nose, oral cavity, pharynx, and larynx. It also reviews lower airway structures like the trachea and lungs.
- The laryngeal mask airway (LMA) is a supraglottic airway device that is placed in the hypopharynx to control the airway during general anesthesia or ventilation. It provides an alternative to endotracheal intubation or use of a face mask. The LMA has advantages like ease of insertion, reduced hemodynamic response, and improved oxygenation during emergence from anesthesia. Potential complications include sore throat, coughing, laryngospasm, and airway obstruction. Proper selection of size, lubrication, and insertion technique are important for successful use of the LMA.
This document discusses different types of fluid flow and transport mechanisms in cells. It describes laminar and turbulent fluid flow, how they are characterized, and factors that influence each type. It also outlines different transport mechanisms in cells including diffusion, osmosis, facilitated diffusion, active transport, endocytosis, and exocytosis. Active transport uses carrier proteins and cell energy to move substances against a concentration gradient, while passive transport moves substances down a concentration gradient without cell energy.
1. The document discusses theories of anesthesia including the unitary theory and modern theories involving interactions with membrane proteins and specific ion channels.
2. It describes the stages of general anesthesia from analgesia to surgical anesthesia to medullary respiratory paralysis. However, it notes that the excitement stage is rarely seen with modern anesthesia.
3. GABA receptors are identified as an important target for many anesthetic agents. General anesthetics bind to these receptors, causing chloride channel opening and neuronal inhibition, resulting in anesthesia.
Endotracheal intubation and laryngoscopy part 2Nisar Arain
This document discusses various types of endotracheal tubes and laryngoscopy techniques. It describes specialized tubes like armored tubes, RAE tubes, Oxford tubes, and laser-resistant tubes. It covers direct laryngoscopy using curved and straight blades. Optimal conditions for laryngoscopy are outlined, including using the appropriately sized blade and ensuring good muscle relaxation. Reliable signs of correct endotracheal tube placement include capnography, visualization of the tube passing the vocal cords, and fiberoptic bronchoscopy visualization of tracheal rings.
Endotracheal tubes are used to intubate patients and enable ventilation. They are typically made of PVC or rubber and have features like a Murphy eye, size designations, and a pilot balloon-connected inflation system to create a seal in the trachea. Complications can occur during or after intubation and extubation, like trauma, aspiration, or laryngospasm. Nasotracheal intubation has advantages like patient comfort but risks like trauma or sinusitis. Proper preparation, techniques, and monitoring are important for safe endotracheal intubation.
Complications of artificial applications part 5Nisar Arain
This document discusses the complications that can arise from mechanical ventilation through either invasive or non-invasive means. Some key complications mentioned include pneumonia, infections, injuries to the face/lips/pharynx and larynx/trachea, gastrointestinal effects like esophagitis and decreased motility, renal effects from reductions in blood pressure/flow, disrupted sleep, and decubitus ulcers. Proper diagnosis and management of these various complications is important for patients receiving mechanical ventilation support.
This document discusses endotracheal tubes and intubation. It covers indications for intubation including airway protection, optimizing gas exchange, decreasing metabolic demand, and reducing work of breathing. Conditions associated with difficult intubation are described such as congenital anomalies, infections, tumors, and injuries. Airway assessment techniques like mallampati classification, laryngoscopy view, and thyromental distance are explained. Equipment for intubation and sizing endotracheal tubes are outlined. The technique of intubation is described involving positioning the patient in sniffing position and using a laryngoscope to visualize the vocal cords. Confirmation of proper tube placement is emphasized using methods like auscultation and capnography.
This document discusses various techniques for airway management. It describes mechanical maneuvers like jaw thrust and head tilt-chin lift to clear obstructions. Common airway adjuncts like oropharyngeal and nasopharyngeal airways are also discussed. Guidelines are provided for sizing and inserting these adjuncts safely. Face masks can be used with one, two, or three hands to maintain a patent airway. Risk factors for difficult mask ventilation and potential complications are also outlined.
This document discusses airway assessment and difficult airways. It outlines various predictors of difficult airways like obesity, short neck, and facial hair. It describes tests to evaluate the airway like thyromental distance, inter-incisor gap, and Mallampati grading. The document emphasizes the importance of a thorough airway assessment prior to intubation to identify potential difficulties and prepare appropriate management strategies for difficult intubations.
The document discusses preoperative airway assessment for anesthesia. It notes that 1-3 out of 100 anesthetized patients have difficult intubation, while 1 out of 1000 have failed intubation and 1 out of 10,000 experience cannot intubate cannot ventilate scenarios. Factors that can increase intubation difficulty include congenital syndromes, anatomical features like teeth and neck structure, and acquired conditions such as decreased jaw or neck mobility. A thorough preoperative assessment including tests of mouth opening, neck movement, thyromental distance, and Mallampati score can help predict and prepare for a potentially difficult airway.
- Imhotep, an ancient Egyptian priest from around 2600 BC, is considered the first physician and treated many diseases. He extracted medicines from plants and had knowledge of anatomy. Ancient Egyptians used opium and hyoscyamus for anesthesia and performed trepanation surgery.
- In ancient Greece and Rome, mandrake juice was used for its narcotic effects before surgeries to ensure insensibility to pain. Arabic translations of Greek medicine advanced Islamic medicine in the Middle Ages. Physicians like Al Zahrawi described many surgeries and instruments.
- The modern history of anesthesia began with William Morton using ether in 1846 and John Snow advancing the field through publications on ether and chlor
This document discusses different types of anesthesia including local, regional, and general anesthesia. It provides details on common regional anesthesia techniques like spinal blocks, epidurals, and caudal blocks. It also describes local anesthesia techniques such as infiltration, nerve blocks, and intravenous regional anesthesia. The document discusses the mechanisms of local anesthetics and some potential complications as well as benefits of local and regional anesthesia compared to general anesthesia.
This document discusses the problem of anesthesia awareness during surgery. It defines anesthesia awareness as a patient becoming conscious during a surgical procedure under general anesthesia and having recall of events. Risk factors include women, younger age, use of total intravenous anesthesia, long surgeries, prior awareness history, and natural red hair. Causes can include light anesthesia, increased anesthetic requirements, or anesthesiologist error. Prevention strategies include pre-operative evaluation, prophylactic benzodiazepines, monitoring anesthetic levels, and post-operative interviews. Methods to monitor consciousness include clinical signs, isolated forearm technique, brain monitoring like BIS, and measurements of lower esophageal sphincter contractions.
- The document discusses various physiological changes that occur with aging and their implications for anesthesia in geriatric patients. Some key points discussed include:
- Cardiovascular changes like decreased cardiac output and increased risk of hypertension. Respiratory changes like reduced lung capacity and cough reflex. Genitourinary changes like reduced kidney function and bladder issues.
- Gastrointestinal changes like decreased motility leading to constipation. Endocrine changes like increased risk of hypothyroidism and bone issues.
- The implications of these changes for anesthesia include risks of hypotension, bradycardia, respiratory complications, slower drug metabolism and clearance, and risks of gastric aspiration and constipation. Careful preoperative evaluation and
The document provides information on general anesthesia including:
1) It discusses the history, goals, and levels of sedation for general anesthesia. Different levels include minimal sedation, moderate sedation, deep sedation, and general anesthesia.
2) The pre-anesthetic evaluation process involves taking a medical history, performing a physical exam including airway assessment, and ordering lab tests.
3) Common anesthetic equipment is described including laryngoscopes, endotracheal tubes, airways, monitors, and intravenous and inhalational drugs used for induction and maintenance of general anesthesia.
The document provides information on the respiratory system, including its structures and functions. It discusses the processes of ventilation, external respiration, transport of gases, and cellular respiration. It describes the structures of the upper respiratory tract such as the nose, pharynx and larynx. It also details the trachea, bronchi, bronchioles, and alveoli. Furthermore, it examines the muscles involved in inspiration and expiration, respiratory volumes and capacities, and the control of breathing.
The document discusses body temperature regulation and abnormalities. It notes that humans maintain a constant core body temperature of around 37°C through heat gain and loss mechanisms controlled by the hypothalamus. When temperature varies by 0.1°C from the set point, the hypothalamus activates heat conservation or dissipation responses. Disorders include hypothermia, where temperature drops below the normal range, and hyperthermia/fever, where the hypothalamus raises the set point in response to pyrogens like bacterial toxins or cytokines. Heat stroke occurs when temperature exceeds the critical threshold of around 105-108°F.
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“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
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because the population to be treated is known to include substantial numbers of
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Debunking Nutrition Myths: Separating Fact from Fiction"AlexandraDiaz101
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Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Jim Jacob Roy
In this presentation , SBP ( spontaneous bacterial peritonitis ) , which is a common complication in patients with cirrhosis and ascites is described in detail.
The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
2. DEFINATION OF HAZARD
HAZARD ???
-It is asituation that posesalevelof threat to life
health,property, orenvironment
-A hazarddoesnotexistwhenit isnothappening
-Anesthesiaandsurgeryareconductedintechnologically
intenseenvironment…….itispotentiallyHazardous
3. MOST COMMON HAZARDS IN OR
---FiresandExplosion
---StaticElectricity
---ElectricalHazards
---RadiationInjury
---Air Pollutionand
---PowerFailure
4. FIRES and EXPLOSION
--Bothof thesecancausedeath or
injury to the patient.
--Onlyoccurifwehave3 things:
---sparkor ahotsurface,
---flammablesubstanceand
---sourceof oxygen
5. SOURCES OF SPARKS OR HEAT
---Static electricity
--Faulty electrical switchesandapparatus
e.g. saws, plaster cutters and drills
--Foreign matter, e.g. dirt or greasein the
oxygen or nitrous oxide cylinders
--Diathermy
--Openflames
--- Flammablesubstances:Includes ether, ethyl
chloride andsolution in sprits.Theaddition
ofoxygenincreasedflammability
6. STATIC
ELECTRICITY 1
--Electricity present in the atmosphere
--Occurs if two materials which conduct electricity
poorly are brought into contact and then separated.
--If there is friction or movement between the two, a
spark is produced and a spark, of course, can produce
an explosion
7. STATIC ELECTRICITY - 2
-Ex woolen fabrics, non conducting rubber
and synthetic materials such as nylon.
-Should be avoided in the OR, using graphite
impregnated yellow coded rubber instead.
8. -Conductor floor (Concrete or conductive rubber
or plastic, placed on floors)
-Avoid wool, plastic, and nylon fabrics and wear
cotton or other anti-static outer clothes instead.
-Wear aprons of conductive rubber
-Wear antistatic boots or conductive canvas over
shoes.
-Maintain Humidity of 60% static sparks are more
frequent when the air is dry.
OTHER PRECAUTIONS
TO REDUCE STATIC ELECTRICITY 1
9. OTHER PRECAUTIONS TO REDUCE
STATIC ELECTRICITY 2
-Ventilation – Anesthetic gases are heavier than
air and tend to collect at ground level
-Regular inspection of electric switches and
apparatus is required
-Smokes and open flames must be forbidden
immediately
-Fire fighting equipment must be available in the
operation rooms
10. ELECTRICITY HAZARDS 1
-Theymayoccurwhenpatientsare:
-Incontact with faulty electrically-operated
medical equipment
-Accidentally connected to electric circuits by
spillageof blood orsaline
-Dependent on electrical equipment to replace
or support vital organfunctions
-Exposedto fire orexplosions
-Undergoing treatment whensafelevels of
electrical energyareexceeded.
11. Electrical hazards
2
Electric Shock
--When the body becomes part of an electrical
circuit with significant current.
--Wiring defects, faulty equipment components
and deteriorated insulation
--Lack of maintenance and misuse are the usual
causes
12. ELECTRICAL HAZARDS 3
MACRO-SHOCK
-Most common
-Occurs when the body conducts an electric current
which does not pass directly through the “Heart”
- Mild sensory stimulation @5 to 10 mA
-@50 to 60 mA – muscular contraction
-@100 mA – breathing becomes extremely difficult
-Somewhere above this level respiratory paralysis
cardiac arrest and severe burning occurs
13. ELECTRICAL HAZARDS 4
MICRO SHOCK
--When very tiny currents, such as
100 micro ampere, are intentionally
passed directly through heart muscle
e.g.
1-Cardiac catheterization
2-Carbon monoxide measurement
14. ELECTRICAL HAZARDS 5
High Frequency Currents
--Above 50 hertz are less likely to produce
electric shock but can cause burns and
interference with other devices such as
pacemakers
--DC is less likely to cause VF than high
frequency AC (above 50 Hz) but can
cause Muscle contraction
--Nerve damage often occurs with high
voltage currents
--Short circuits may be involved by large
currents passing from either
a-Head to foot or
b-Arm to arm
15. ELECTRIC BURNS AND ELECTRICALLY INITIATED BURNS
-Three types
-Carbonization of skin (From burns at a very high
temperature of 1,000 degrees C
-Flame burns
-Direct heating of tissues produce coagulation and
necrosis at entry and exit points and associated
injury in muscle and BV.
16. ELECTROSURGICAL UNITS
-Diathermy are arranged so that current from
the active electrode flows through the patient
and back to the generator
-Don’t use electric blankets in conjunction with
electro - surgery
17. -RISKS
a-spontaneous miscarriage
b-congenital abnormalities and
c-Liver disorders
-Waste anesthetic gases escape from
a-Faulty valves
b-The ventilators
c-Poorly fitted components in the breathing circuit
d-Split anesthetic drugs
e-Expired gases from the spill valve of the anesthetic
breathing circuit drugs
f-Gases exhaled by the patient
AIR POLLUTION 1
18. REMEDIES
This pollution can be reduced by
-a-Regular thorough inspection of all anesthetic equipment
-b-Limit or avoid the use of inhalational gases and agents
e.g. circle system, TIVA, and RA
-c-An efficient scavenging system
-d-Closed circuits
-e-Anti spill devices
20. POWER FAILURE
-Critical areas employing electrically driven
equipment such as respirators (Ventilators)
and dialysis machines require standby
equipment (I.e. generators)
23. RISK
-Risk is the potential that a chosen action will
lead to a loss or an undesirable outcome
-Risk is a ubiquitous, natural part of life,
because everything we do, including doing
nothing, poses uncertain outcome
-Occasionally the term refer to the outcome
itself (e.g Death as a one risk of anesthesia)
24. ANESTHESIA RISK AND INJURIES
-Accident is an unplanned, unexpected, undesired event
-Because there are no standard methods for assigning
causality, yet no accurate estimates of the rate of adverse
out-come is available
- Errors related to AW mgt(measured gas temperature)
monitoring, and sudden cardiac arrest during SA
equipment failures, or nerve injuries
25. ADVERSE RESPIRATORY EVENTS
-The most serious Hazards in anesthesia
-Causes of Death and Brain Damage are
inadequate ventilation,
esophageal intubation, and
difficult ETI
-Cases in the first two causes were judged
to have been preventable if better
monitoring had been employed
-Anticipated difficult ETI-refer to better
institution or surgical AW
should be performed before anesthesia
26. FAILURE TO MONITORING
-An important contributor to anesthesia adverse events
-There are numerous ways in which pulse oximetry
Capnometry, and Automated blood pressure monitors
can give false information, leading to missed or incorrect
diagnoses
27. MEDICATION INDICATORS
-The most frequent error in anesthesia, and in
healthcare practice in general
-Similarity of drug names, containers, and label
colors
28. MEDICAL ERRORS
-Dosing errors related to the frequent need for individual
-Error in numerical calculations when drawing and mixing
drugs for bolus administration or IV infusion
-Wrong drugs (e.g among various insulin formulations)
-Flushing a catheter with a solution containing another
potent drug.
-confusion in the programming of infusion pumps
31. EQUIPMENT ERRORS AND FAILURES
-Current anesthesia machines and associated technology
incorporated substantial safety features
-Frequent and can occur in many ways, but rarely causes
injury directly
-Equipment associated injury: It is more likely to be from
misuse than from overt failure of a device
32. LACK OF STANDARD PRACTICE AND UNUSUAL SITUATIONS
-Accidental dislodgement of ETT during transportation
-Undiluted phenytoin by rapid IV infusion – refractory HN
arrythmias, and death.
-Undiluted K+ by rapid IV infusion – and Cardiac arrest
-Neostigmine given without an antimuscarinic cause
a systole / severe bradycardia and AV block, and can be
fatal.
33. LACK OF STANDARD PRACTICE AND UNUSUAL SITUATIONS
-Inadvertent IV injection of LA –neurologic and cardiac
toxicity, which can be fatal (specially with Bupivacaine)
-Air Embolism during the placement or removal of
central venous catheter
-Limb necrosis if the tourniquet is left on the patient
for a prolonged period
37. ENHANCING PATIENTS SAFETY
-Avoidance, prevention and amelioration of
adverse outcomes or injuries
QUALITY OF CARE
-Extent to which health services for individuals
and populations increase likelihood of desired
health outcomes and are consistent with
current professional knowledge
-Patients safety is focused on prevention of injury
-Quality assurance generally deals with the
broader spectrum of quality, including the
success of treatments
-Risk management is focused on proactive patient
safely, based on the principle that prevention of
injuries via error reduction and system
improvements
38. -
-
PRACTICAL ELEMENTS 1
-Avoidance of unnecessary risk taking
-Almost unending anticipation of what might go wrong
-Projection of actions in anticipation of failure and, above all
MINDFULNESS
-Being patient cantered………..PATIENT IS ABOVE OUR EGO !!
39. PRACTICAL ELEMENTS 2
Maintaining vigilance
-The anesthesia provider must maintain alertness
and be aware of, compensate for, and counteract
the forces working against vigilance
-Fatigue and sleep deprivation are probably the
most common causes of lapses in vigilance
40. -Practice in a system of care
-Teamwork
-Preparation
-Monitoring
-Control for human factors, organized
arrangement of supplies and drugs,
esp. labeling and establishing and
adhering to local standards
PRACTICAL ELEMENTS 3
41. PRACTICAL ELEMENTS 4
-Care to keep IV cannula and monitoring cables orderly
lighting, and reducing clutter, noise, and distractions
-Infection control
-Antibiotic administration in the perioperative interval
reduces postoperative wound infection.
-Surgical wound infection rates are increased 3 – fold
by hypothermia
42. ANESTHESIA CRISIS MANAGEMENT
-Seek assistance early and quickly inform others
-Establish clarity of roles for each person involved in
mgt(measured gas temperature) of event(event manager
-Use effective communication processes
-Use resources effectively and identify what additional
resource(People, Supplies, Equipment, Transportation)
are available to manage situation
43. CRISSMANAGEMENT DURING ANESTHESIA
C1 Circulation Adequacy of peripheral circulation (rate, rhythm, and character of pulse).
If pulse is absent(CPR)
C2 Color Note saturation. Examine for evidence of central cyanosis,Pulseoximetry
O1 Oxygen Checkrotameter settings; ensure inspired mixture is not hypoxic.
O2 Oxygen
analyzer
Adjust inspired oxygen concentration to100%
Check that oxygen analyzer showsarising oxygen concentrationdistal
to common gas outlet.
V1 Ventilation Ventilate lungs by hand to assessbreathing circuit integrity, airway patency,
chest compliance, and air entry by “feel,” careful observation, and
auscultation.
Also inspect capnograph’s trace if available
V2 Vaporizer Checkall vaporizer filler ports, seating’s, and connections for liquid or gas
leaks during pressurization of thesystem.
Consider possibility of wrong agent being in vaporizer.
44. CRISSMANAGEMENTDURING ANESTHESIA
C1 Circulation Adequacyof peripheralcirculation(rate,rhythm,andcharacterof pulse).If pulse
isabsent(CPR)
C2 Color Note saturation.Examinefor evidenceof central cyanosis,Pulseoximetry
O1 Oxygen Checkrotameter settings;ensureinspiredmixtureisnot hypoxic.
O2 Oxygen
analyzer
Adjust inspired oxygenconcentration to100%
Checkthat oxygen analyzershowsarising oxygenconcentrationdistal
to common gas outlet.
V1 Ventilation Ventilate lungsbyhandto assessbreathing circuit integrity, airway patency,chest
compliance,andairentry by“feel,” carefulobservation, andauscultation.
Alsoinspect capnograph’strace ifavailable
V2 Vaporizer Checkallvaporizerfiller ports,seating’s,andconnectionsfor liquid or gasleaks
during pressurizationof thesystem.
Considerpossibilityof wrongagentbeinginvaporizer.
45. CRISISMANAGEMENTDURINGANESTHESIA(CONT…)
A Air way Check patency of non-intubated airway. Consider laryngospasm, FB,blood, gastric contents,
or nasopharyngealor bronchial secretions
B Breathing Assesspattern, adequacy, and distribution of ventilation. Consider, examine, and auscultate
for bronchospasm,pulmonary edema, lobar collapse, and pneumo- orhemothorax
C Circulatio n Repeat evaluation of peripheral perfusion, pulse, BP
, ECG, and filling pressures and any
possible obstruction to venousreturn, raisedintra thoracicpressure(e.g.,inadvertentPEEP)
D Drugs Review intended (unintended) drug or substance administered Consider whether problem
may be a consequence of an unexpected effect, a failure of administration, or wrong dose,
route, or mannerof administrationof drug
49. INFECTIONS
-Blood born diseases through needle stick injuries-HIV 0.3%
HBV-3% HCV-30%
-32% HAD ATLEAST 1 NSI in the preceding 12M (only half of them
took treatment)
-More risk with hollow – core and large bore
-NSI more in nondominated hands
-NSI more during disposal of contaminated needles
-Anesthesiologists have risk for occupational infection during
30 years of exposure 0.045—4.5%
50. INFECTIONS - HIV
-Health care workers contribute 5% of total cases
-4% of emergency department patients are
unidentified cases
-Patients considered infective if both screening
(ELISA) and confirmatory (western blot, indirect
fluorescent ab) tests are positive
51. INFECTIONS - HIV
-54 reported cases of occupationally acquired HIV(1998)
-88% of them had H / NSI
-?Quantity of inoculums- (a case report: 100 to 200
micro ml of blood through IV produced HIV)
-Risk for the patients – 6 cases reported
52. INFECTIONS - HBV
-Non immunized HCW – higher risks
-17.8% of seropositive among anesthesiologists
-30% became positive after 11 years of exposure
-Disinfectants and gloves are not completely
protective viruses viable for >14 days in needles,
gloves, and surfaces
53. INFECTIONS - HCV
-No immunization available
-No specific treatment available
-Advice: serologic monitoring for
HCV and LFT3 – 6 Monthly
54. Management of occupational infections
SAFE PRACTICE
INFECTIONS
-Protective equipments
-Washing methods
-Disposal methods
55. -INFECTIONS – CDC RECOMMENDATIONS
Universal precautions – 1900
-Considering as all patients, blood and
body fluids are infective
Isolation precautions – 1996
-2 tier recommendations
1-Standard precautions:- To be followed
for handling all patients as infective
2-Transmission based precautions:-For
handling patients known to be /
suspected of being risks
56. INFECTIONS – CDC RECOMMENDATIONS
-Transmission based precautions
-Based on the properties of specific pathogens
-Airborne precautions {Measles, Varicella, TB} – to
prevent from small particles <5-micron meter by
specific filters, air handling devices, HEPA NEGATIVE
PRESURE ENVIRONMENT
-Droplet precautions {HBV, mycoplasma, streptococcal
pharyngitis, rubella} – to prevent from large particles
>5micron meters, keep distance >1 meter
-Contact precautions{HAV, HSV, Viral conjunctivitis}
57. INCOMPATIBILITIES / ALLERGIES
-Latex Allergy
-Type IV / Type I
-Risk groups
1-Spina bifida
2-Urogenital abnormalities
3-HCV
4-Rubber Factory workers
59. -LATEX ALLERGY
-Management – drug regimens
-Pre-operative protocol
1-Di phenhydramine -1mg/kg.po/iv,q 6hr at 13,7,1 hr
before surgery
2-Prednisolone – 1 mg/kg,po/iv,q 6hr at 13, 7 ,1 hr
before surgery or Hydrocortisone 4 mg/kg
3-Ranitidine – 2 mg / kg po, 1mg/kg iv, q 12 hr at 13, 1 hr
before surgery
-post –op protocol
1-drugs to be repeated for 12 hrs
60. STRESS
-Inevitable, universal phenomenon to which no
one is immune
-Job related stress are unavoidable but may be
controlled
-2Types – unavoidable and Avoidable
-Unavoidable-professional stress
-Avoidable-sleep related
63. CHEMICAL DEPENDENCE
-Self administration of drugs and suicidal rates are high among
anesthesiologists
ADDICTION
Compulsive continued use of drugs inspite of adverse, a chronic
relapsing condition resulting from long term effects of drugs on
Brain , due to molecular, structural, cellular, and functional
changes
DEPENDENCE
Physical / Psychological inability to control drug use
ABUSE
Use of drugs in detrimental way but not to the point of
addiction. A pre-Addiction level can easily quit a voluntary act.