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Principles I > OR Safety > Flashcards

OR Safety Flashcards

1
Q

What is the definition of current?

A

The flow of electrical charges (electrons)

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2
Q

What is the definition of circuit?

A

The path that the current flows through

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3
Q

What is the definition of conductor?

A

The current moves easily (copper, bronze)

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4
Q

What is the definition of insulator?

A

The current moves through poorly (glass, air) (keeps current in wire)

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5
Q

What is the definition of amps?

A

The amount of current flow per second

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6
Q

What is the definition of voltage?

A

Pressure pushing electrons

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7
Q

What is the definition of ohms?

A

Measure of resistance (skin)

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8
Q

What is the definition of hertz?

A

Number of cycles per second

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9
Q

What is the definition of current density?

A

Amount of current and area it flows over

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10
Q

How does electricity work?

A

A specific amount of alternating current (AC) (amp) is pushed through a circuit by voltage (120 v) at a specified frequency (60 hz)

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11
Q

How many wires do circuits have?

A

3; HOT, NEUTRAL, AND GROUND

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12
Q

Hot supplies ________, neutral provides the ______ path, and _______ is for safety

A

Current; Return; Ground

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13
Q

Can current flow through an open system?

A

No, current can only flow through an unbroken, closed system

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14
Q

Can current escape the designated circuit and travel an alternate path?

A

Yes, called a leakage current

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15
Q

_______ provides a low resistance path for leakage current to flow away from electrical equipment

A

Ground

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16
Q

What do circuit breakers do?

A

Interrupt the circuit when the current flow is high

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17
Q

Electricity is ______

A

Energy (If this energy is not controlled, it can cause fires, burns, electrocution)

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18
Q

Current will travel to the path of _____ resistance

A

Least

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19
Q

Frequency is measure with what unit?

A

Hertz (1 hz is one cycle per second)

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20
Q

The higher the frequency, the ______ dangerous

A

Less

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21
Q

Frequencies between 0 hz and 1 khz can interfere with ___________ and __________ in the myocardium and cause arrhythmias

A

Depolarization & Repolarization

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22
Q

The frequency at which minimum current induces fibrillation is ____ - _____ Hz, which is the frequency used for AC around the world.

A

50 - 60 Hz

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23
Q

Most household circuits = ___ - ____ amps, ____ - ____ volts

A

15-20 amps, 110-120 volts

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24
Q

Amps x volts = ______

A

Watts

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25
Q

What is electrical resistance?

A

Impedance of current flow (can lead to storage of charges (capacitor))

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26
Q

Long power cords cause _____ resistance

A

High

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27
Q

Is skin a poor conductor?

A

Yes and very resistant

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28
Q

Dry, healthy, intact skin = _______ ohms

A

1 million ohms

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29
Q

Perspiring, intact skin = ________ ohms

A

12,000 ohms

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30
Q

Conductive jelly applied to skin = ______ ohms

A

1,000 ohms

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31
Q

Catheter, pacer wires on skin = < ____ ohms

A

< 100 ohms

32
Q

Wet skin = _____ electrical conductor

A

Bigger

33
Q

Dry skin can cause ______

A

Burns

34
Q

As current flows through the skin, _______ will decrease

A

Resistance

35
Q

Human effects of 60 Hz currents: 1 mA

A

Threshold of perception (barely feel)

36
Q

Human effects of 60 Hz currents: 5 mA

A

Maximum harmless current intensity (feel a little more)

37
Q

Human effects of 60 Hz currents: 10-20 mA

A

“let go” prevent release of object

38
Q

Human effects of 60 Hz currents: 50-100 mA

A

Pain, mechanical injury, heart and respiratory function continues (can cause tissue damage)

39
Q

Human effects of 60 Hz currents: 100-2500 mA

A

Vfib, respiratory center intact

40
Q

Human effects of 60 Hz currents: >6000 mA

A

Sustained myocardial contraction, respiratory paralysis, burns if current density is high

41
Q

What is macroshock?

A
  • Current applied directly to body surface
  • Effects determined by surface area, amount of current flow (amps), duration of exposure, frequency of the current, path
42
Q

It requires a ______ amount of current to overcome skin’s resistance

A

Large

43
Q

What can macroshock cause?

A

Produces muscle contraction, pain, burns, open wounds, pacer disruption, arrhythmias

44
Q

What is microshock?

A
  • Current applied directly to heart
  • Small amounts of voltage or current applied directly to myocardium bypassing the skin via a IV catheter, pacer wires, etc.
45
Q

Current as little as ____ microamps can cause fatal arrhythmias

A

100 microamps

46
Q

1000 microamps = __ milliamp

A

1 milliamp

47
Q

1000 milliamp (mA) = __ amp

A

1 Amp

48
Q

What is a leakage current?

A

The current that escapes the circuit due to stray capacitance and poor insulators ( a lot of resistance = build up & leak out)

49
Q

Leakage current takes the path of _____ resistance

A

Least (rings that can’t be removed need to be taped)

50
Q

The _____ wire is designed to safely conduct leakage current and carry it aways

A

Ground

51
Q

Lack of a proper ground wire leakage current can conduct through the ______ or __________

A

Patient or OR personnel

52
Q

What does the line isolation monitor do?

A
  • Designed to make it impossible for the patient and OR staff to become a path for current to go to ground
  • LIM measures how much leakage current would flow to ground if a grounding system were present
  • If the electrical equipment being used in the OR allows a large amount of leakage current to escape through its circuitry, the LIM will detect it and alarm
  • Measures how much electricity is going in & out; if large difference - concerning (don’t want too much leaking back or not returning)
53
Q

LIM alarm indicates what?

A

That the current is no longer isolated; an unsafe amount of leakage current may be present

54
Q

An LIM alarm usually indicates what?

A

That the last piece of equipment plugged in may have a fault or that too much equipment is being used simultaneously, which results in too much leakage current

55
Q

When does the LIM alarm?

A

If lose more than 5 mA

56
Q

What is an electrosurgical unit (ESU)? AKA Bovie

A

Electrical current used to cauterize vessels and cut tissue

57
Q

Are ESUs high frequency?

A

Yes, they are 300 kHz - 2 MHz (higher frequency = safer)

58
Q

What is a unipolar Bovie/ESU?

A

Current applied using a single electrode that returns to the ESU by way of the dispersal pad

59
Q

What is a bipolar Bovie/ESU?

A

Two pronged cutting electrode instrument. Current travels only between the two prongs; used when unipolar is unsafe

60
Q

What cases should you use a bipolar Bovie/ESU instead of an unipolar one?

A

Brain, ovarian, or fallopian tube surgery

61
Q

What is a dispersal pad?

A

Also called Bovie or grounding pad; it is applied as close as possible to the surgical site; large surface area to minimize current density; not required for bipolar

62
Q

Why do we tape people’s rings if they cannot take it off?

A

Because if tuck arms & it touches metal table, then conductivity will take path of least resistance = won’t use Bovie, will use ring (metal against skin completes circuit, metal conducted)

63
Q

Can ESUs/Bovies effect pacemakers?

A

Yes, ESU current traveling through pacer can alter functioning
(no unipolar current path through heart)

64
Q

What can you do to reduce effects of ESU/Bovie on pacemaker?

A
  • Dispersal pad close to surgical site as possible
  • Reducing cautery current or use low current
  • Use bipolar cautery
  • Have magnet if pacer requires reprogramming
  • Magnet placed on pace = asynchronous mode

(Pacer = synched; asynchronous with magnet)
(interfering current with pacemaker)
(want Bovie pad closer to where operating)

65
Q

How will ESUs/Bovies effect AICDs?

A

ESU current will trigger AICD to fire (don’t want to happen), so have device turned off prior to surgery (some can be left on; call manufacturer/pacemaker person to ask before surgery)

66
Q

What is an important question to ask a patient when doing surgery and they have pacing wires or a pacemaker?

A

Are they pacemaker dependent (important question! want an external pacemaker when changing out)

67
Q

How close can cause impact to ICD current?

A

Within 15 cm from generator

68
Q

Should you have a magnet with you if the patient has a pacemaker of ICD?

A

Yes, always

69
Q

What is a disinfectant?

A

Antibacterial agent applied to non-living objects (SANI wipes)

70
Q

What is an antiseptic?

A

Antibacterial agent applies to living tissue (don’t want to be wiping skin with disinfectant) (Betadine, Chloraprep, etc)

71
Q

Some chemicals are used in the OR. What is ammonia?

A

A disinfectant liquid cleaning agent. Vapors irritate eyes and respiratory tract

72
Q

Some chemicals are used in the OR. What is chlorine bleach?

A

Disinfectant liquid cleaning agent. Vapors irritate respiratory tract.

73
Q

What is one thing you need to remember about using ammonia and chlorine bleach?

A

Never use them together!!! Forms chlorine gas!!!

74
Q

Some chemicals are used in the OR. What is chlorhexidine?

A

Antiseptic used to clean skin. Splashed in eye can cause keratitis or loss of vision

75
Q

Some chemicals are used in the OR. What is iodine?

A

Antiseptic used on skin. Splashed in eyes can cause irritation

76
Q

Some chemicals are used in the OR. What is hydrogen peroxide?

A

Antiseptic used to clean skin. Splashed in eyes can cause corneal ulceration.

77
Q

What should you do in a face or eye case when using antiseptics?

A

Cover eye with a patch

Principles I (4 decks)

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