Workplace Safety

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Workplace Safety
2012-03-27 20:14:02
Clinical Practice

Clinical Practice
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  1. Which are waste anesthetic gases?
    • N2O
    • isoflurane
    • sevoflurane
  2. How are humans exposed to waste anesthetic gases?
    • escape from anesthesia machine
    • breathed out by patient
    • escape as anesthetist fills or empties vaporizer
  3. What does short term exposure to anesthesia gas cause?
    • fatigue
    • headache
    • drowsiness
    • nausea
    • depression
    • irritability
  4. How much isoflurane is retained in body fat?
  5. How is isoflurane metabolized and excreted?
    very minor liver metabolism and kidney excretion
  6. Which gas anesthesia is the safest?
  7. How much sevoflurane is retained and metabolized?
  8. How much Halothane is retained? Where is it retained?
    • 20%
    • fat
  9. How much methoxyflurane is retained? Where is it retained?
    • 50%
    • fat
  10. Where is halothane metabolized and excreted?
    intermediate liver metabolism and kidney excretion
  11. Where is methoxyflurane metabolized and excreted?
    high rate of liver metabolism and kidney excretion
  12. Which anesthetic gas is the most hazardous?
    nitrous oxide (N2O)
  13. What are the reproductive effect of gas anesthesia?
    • increased risk of abortion
    • infertility (abnormal sperm morphology, reduced ovulation)
    • congenital abnormalities in babies born to exposed women
  14. What are the hepatic effects of gas anesthesia?
    • "halothane hepatitis" - massive liver necrosis
    • liver disease
  15. What are the renal effects of gas anesthesia?
    • methoxyflurane - known to cause kidney damage
    • compound A
  16. What is compound A?
    • sevoflurane interaction with soda lime or baralyme
    • nephrotoxic
  17. What are the neurological effects of gas anesthesia?
    • muscle weakness
    • tingling
    • numbness
    • decline in motor skills
    • decline in short-term memory
  18. What are the hematologic effects of gas anesthesia?
    nitrous oxide has been associated with bone marrow abnormalities
  19. What is the recommendation for reducing unwanted effects from gas anesthesia?
    room air concentration of halothane, isoflurane, or methoxyflurane should not exceed 2 ppm
  20. How do we reduce exposure to anesthetic gas?
    scavenger system
  21. What is active scavenger?
    uses suction to draw waste gas out
  22. What is passive scavenger?
    • directs gas outside using pressure from anesthesia machine
    • gravity
  23. What is activated charcoal cartridge?
    • hooks to scavenger port by hose
    • replace after 12 hours of use
  24. When do we do high pressure tests?
    for tanks that are hooked to flowmeters
  25. How do we preform a high pressure test?
    • turn tanks on
    • apply 10% detergent to connection tubes
    • look for bubbles
  26. What is a low pressure test?
    how to test the rest of the machine for leaks
  27. How do we preform a low pressure test?
    • turn on O2 tank and flowmeter
    • close pop-off valve
    • hold off Y-piece
    • squeeze bag
    • see if it hold pressure
  28. What kind of anesthetic techniques can we do to reduce exposure?
    • anesthetic chamber
    • masks
    • trach tubes
    • closed rebreathing system
    • vaporizer
    • maintain machine and tubes properly
    • fill vaporizer in a well ventilated area
  29. What do we do at the end of anesthesia before we unhook the patient?
    • turn off vaporizer
    • 100% oxygen for a few minutes
  30. What are the clinical signs of O2 toxicity?
    • cramps
    • nausea
    • dizziness
    • hypothermia
    • blindness
    • respiratory difficulties
    • bradycardia
    • fainting spells
    • convulsions
    • death