Hazard

1. HAZARDS IN THE OPERATING ROOM
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2. • Learning Objectives
1.Identify the main dangers in the OR.
2.Explain the factors that increase the hazards in the
OR.
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3. Introduction
• OR has been a place full of hazards for
 the patient
 the care giver.
The primary dangers are :
fire,
chemical exposure to anesthetic agents
direct exposure to biologic materials ..
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4. Classification of Hazards
• Hazards in the OR environment can be classified as :
1 .Physical:
back injury, fall, irradiation, electricity and fire
2. Chemical:
 anesthetic gases.
cleaning agents.
3 .Biologic:
 the patient (as a source of pathogenic m/o ),
infectious waste,
cuts or needle-stick injuries,
latex sensitivity
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5. Regulation of hazards
• Standards, guidelines and recommended practices
have been developed by many professional
associations, governmental and nongovernmental
agencies such as MoH,WHO, CDC, the likes.
• The appropriate use of electronic devices is a prime
concern of health care providers seek safer patient
care.
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6. Grounding
• Grounding systems are designed to discharge any
harmful electricity directly to the ground without
including the patient in the circuit
• This prevents the inadvertent passage of electric current
through the patient,
• There by preventing shock or burn.
• So, the system is essential for all electrical equipment
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7. Minimize electrical hazards by:
• Checking electrical equipment before each use
• Checking plugs and cords for exposed wire or damage
• Disconnecting cords by pulling on the plug not the
cord
•
• Water and electricity do not mix! Keep hands dry &
keep areas surrounding electrical equipment dry
• Keeping cords from kinking while equipment is in use
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8. Fire and Explosion
• Fire is prime concern in the OR.
• Fires in an oxygen-enriched atmosphere are fundamentally
different in character than those occurring in normal atmosphere.
• The presence of flammable and combustible liquids, vapors and
gases in an oxygen-enriched atmosphere can result in the
ultrarapid combustion
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9. A fire or explosion con..
is the result of a combination of threefactors, these are:
• A flammable gas, vapor, or liquid (e.g., alcohol,
• A source of ignition (e.g., electrosurgery, static electricity, …)
• Oxygen (pure or in air) or some other substances that provide
oxygen, such as nitrous oxide gas
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10. Expectations of staff:
• Keep fire pull stations, extinguishers, and fire doors clear for
easy access
• Do not go through closed fire doors during fire
• Keep exits clear
Prevent fires by keeping these sources separate:
• Heat – anything that can cause a spark
• Fuel – anything that can burn
• Oxygen/Air – oxygen or air
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11. 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.
E.g. anaphylactic reactions
Malignant Hyperthermia
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12. Anaphylactic Reactions
• Anaphylaxis is the most severe form of an allergic reaction,
• manifesting with life-threatening pulmonary and circulatory
complications.
• Produced from antibiotics, blood products and plasma expanders
• An anaphylactic reaction causes
hypotension, tachycardia, bronchospasm and possibly
pulmonary edema.
• rapid intervention are essential
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13. Malignant Hyperthermia
• is a rare metabolic disease characterized by : - hyperthermia with
rigidity of skeletal muscles that can result in death.
It occurs in
 Genetic predisposition
 exposure to certain anesthetic agents.
 during general anesthesia often with inhalants,
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14. Emergency Treatment of Malignant Hyperthermia
• Stop surgical procedure/anesthesia if possible.
• Hyperventilate with 100% oxygen
• Administer DANTROLENE
• Direct acting skeletal muscle relaxant
• Inhibits Ca2+ release channel
• Reduced muscle twitch force
• 20mg vial is dissolved using 60 mL sterile water.
• 2.5 mg/kg IVP q 5 minutes
• Continue until patient is stabilized
• Undertake body cooling measures:
- Iced NS intravenously
- Cooling blanket
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15. Drugs for resuscitation trolley
• Sodium bicarbonate solution 8.4%
• Adrenaline 1:1000
• Calcium chloride 10%, Atropine
• Lignocaine for intravenous use
• Beta-blocking drugs e.g. propranolol
• A cardiac glycoside, e.g. digoxin
• An antihistamine, e.g. promethazine
• A bronchodilator, e.g. aminophylline
• Antinarcotics agents, e.g. naloxone
• Hydrocortisone, Sterile water for injection
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16. THE END
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