Reports indicate that electrical hazards associated even with low power lasers while operating or experimenting with laser equipments. A minimum of 220 AC voltage is required for operating medium and high power lasers. According to sources, the presence of high voltage in the laser heads lead to an average death of two people in a year due to laser electrocution (Electrical hazards. 2008).
The adherence of proper safety rules and regulations are likely to reduce disasters due to laser usage to a certain extent. The key responsibility of a perioperative personal while conducting laser process is to keep the patient protected. The risk factors while using lasers process are already inbuilt, but if proper measures are followed, they can be avoided or partly reduced. To recognize potential hazards and ensure the safety parameters, health care personnel is educated by providing adequate training. During laser practices, there is no specific rule set out by the nation to avoid disasters.
However there are certain general principles that are followed in a perioperative setting. Standard Z136.3, is a contribution from American National Standards Institute (ANSI) and serves as one of the main sources for safety standard used in laser practice. There after the health care industries were recommended to follow the ANSI Standards while using lasers for treatment. Though Standard Z136.3 was accepted and used nation wide by health care organizations, ARON Standards were considered as the best possible standards for perioperative nursing practice. Both these standards more or less provide the same thoughts concerning laser safety. The Standard requires firms that use laser to categorize it according to their severity and the vulnerability to cause harm. They are mainly classified depending on the amount of radiation exposed, power generation and the like. The lasers considered under the Class 1 category are least hazardous due to the absence of risk in normal operation. Those used in Printers and CD’s are included under this category. Class 2 lasers are those used in laser pointers for business presentations. These lasers may be risky at times for the vision of the viewers in case viewed thoroughly for long hours can cause injury. Class 3 lasers used in ophthalmology labs are average powered systems which are least risky, but if viewed using microscope it can turn dangerous to eyes. Finally, the Class 4 lasers which are highly dangerous are used for surgical process. This is the most dangerous version and can cause damage to the vision of the health care personnel and may damage the skin.
Eye injuries, fire, smoke plume as well as thermal injuries could be categorized under the damages caused by radiation. On the other hand electrical damages are the non radiation based disaster. The damages to eyes are usually caused either by a split in the delivery fiber or due to the energy reflection. In any of the the case, the probality of damage to the eye is high. There are certain measures that can be considered to protect eyes from these damages. Both blinking and turning away from the bright light can protect eyes from severe damages. But this technique is useful only in low powered lasers; high powered lasers are too fast and simple methods of prevention cannot be applied in this case. Another means of protection is by using the protective glasses of different laser wave length. It is very essential to examine the glasses carefully before each process. Even minute scratches can cause laser injury. Eyes have to be protected in every single case without leaving scratches to the glasses. As it is important to protect the eyes of the person using the laser equipments, it is very much important to protect the patients under treatment. If head or neck is considered for conducting the laser procedure, then the patient’s eyes needs to be covered properly by using eye pads and tape and finally with wet towel. In case the face is not considered for the procedure then a pair of soft glasses could be used after properly covering the eyes for protecting it from the laser energy. While performing laser procedure there is even a probablity for catching fire. It should be the prime duty of the healthcare assistant to protect the patient from thermal injury. If the laser device goes beyond the safety rules, then there is always a chance for disaster and the skin being the delicate part of the body, is always prone to thermal injury. Fire occurs in laser procedure when laser ray hits an object that is combustible. In order to avoid thermal injuries, the objects surrounding the laser process area need to be moist. Though it does not avert fire the process could be slowed down to a lesser pace. If laser procedure is being used, then flammable solutions should never be used in the surgical areas. The assistants in the surgical sections should ensure that the surroundings are kept moist before starting the laser procedure. Water need to be kept in an open accessible area. Moreover it is very much essential for the health care assistant to know the place of the nearest fire extinguisher. Knowing the area of the fire extinguisher alone will not satisfy the need. The personnel is also required to understand the procedure to operate the equipment quickly. Irritation to eye and lungs can be caused from the smoke produced from the laser procedure. A proper smoke evacuation system will reduce this risk. A high efficiency smoke evacuation system with triple filtration system can protect health care workers from the damages caused to their body. This system pulls the smoke generated in the surgical units, and allows it to pass through various filters and after purifying, it will in turn send the purified air back to the room. Yet another danger inherent in the use of laser equipment is electrical safety. Before the laser equipment is brought to the process place, electrical safety must be ensured. Since the laser uses high voltage, the cords and plugs used must be verified properly.
Specifically trained health care assistants need to be appointed as in charge for these laser procedure suites. The nurse in charge of the laser room need to operate and see the condition of the equipment before the patient is brought for the procedure. They should be responsible for the over all checking on the safety factors before each laser procedure is conducted. The laser nurse needs to have regular contact with the surgeon when the equipment is ready for use. It should be the laser nurse’s duty to ensure the complete control of the equipment while it is in use as well as when it is in the standby mode and must be entrusted with this sole responsibility. From time to time it is essential to update health personnel with proper training about the operation of new equipments. More over this will help them in educating the patients undergoing the laser procedure on the safety measures. Perioperative personnel should never open and operate the equipment unless they are trained about the electrical hazards. In addition to it, laser equipment suppliers should give proper information pertinent to the particular equipment and a detailed brochure need to be attached along with the device.
Safe use of laser procedure is not optional. The use of this deadly procedure is to be given utmost importance in the surgical unit. Before starting with the process the perioperative staff members need to be equipped with proper information on the usage of the laser equipments to avoid the disasters to the patient and the health personnel who operate it (Andersen. 2004).
Reference
Electrical hazards 2008. Web.
Andersen, K. 2004. Safe use of lasers in the operating room: what perioperative nurses should know. AORN Journal. 2008. Web.