Medico-legal risk hazards Prof Andries Stulting Emeritus Professor, Faculty of Health Sciences, University of the Free State

Medico-legal risk hazards A hazard is a situation that poses a level of threat to life, health, property or environment.

Medico-legal risk hazards 1. Occupational hazards in the Operating Room 2. The Surgical Safety Checklist 3. Medico-legal risks in the han dling of specimens (OR)

Medico-legal risk hazards 4. Medico-legal risks in Practice 5. Major Incident Medical Management and Support

Medico-legal risk hazards 1. Occupational hazards in the Operating Room

Medico-legal risk hazards Surgery has the ability to save lives, but a number of hazards are lurking in operating rooms.

Medico-legal risk hazards Surgeons, nurses, anaesthetists, assistants and other professionals working in surgical environments put themselves at risk every day in their careers.

Medico-legal risk hazards If you work as part of a surgical team, it is essential that you familiarize yourself with potential hazards in order to avoid getting injured or exposing yourself to other dangers while on the job.

Classification of OR hazards Physical hazards Biological hazards Chemical hazards Health hazards

Physical hazards Cuts with a scalpel or needle-prick injuries Electrical shocks Burns

Physical hazards Slips and falls can occur if the floor is wet or if a team member fails to wear slip-resistant footwear. Head injuries can occur if a professional hits his/her head against the theatre light or operating microscope.

Physical hazards Radiation injury: C-arms in the OR Power failure Open flames

Physical hazards No synthetic materials such as nylon, wool or plastic are allowed in the OR Do not use electric blankets in conjunction with electro-surgery. Exposure to lasers, for example, the Xenon Arc Laser Photocoagulator

Contact with blood and other body fluids Biological hazards Contact with blood and other body fluids

Biological hazards OR people can easily be exposed to a number of diseases, including AIDS and Hepatitis. Blood particles can come into contact with the eyes of the surgical team players. Follow all established safety guidelines to minimize the risk of exposure and infection.

Chemical hazards Exposure to released particulates Exposure to waste anaesthetic gases Possible exposures to chemical cleaning agents

Chemical hazards Anaesthetic equipment can mal-function during surgery. Leaks in the connective tubing allow anaesthetic gases to seep out, exposing everyone in the OR.

Chemical hazards Exposure to waste anaesthetic gases can harm a patient’s motor skills, reflexes and alertness. An anaesthetist should carefully inspect the equipment and connections before every operation to identify any potential leaks or other problems.

Chemical hazards Disinfectants and other cleaning and sanitizing agents can cause sickness or injury after exposure.

Health hazards Orthopaedic complications, including spinal misalignment and disc degeneration. A few years ago, quite a number of Vitreo-retinal surgeons in RSA complained of neck and spinal problems due to the heavy indirect ophthalmoscopes (for example, the MIRA).

Health hazards Incorrect posture may also lead to Orthopaedic complications. Life or death situations may lead to a great deal of stress. Over time this stress can wear down a person’s mental health, causing anxiety, depression or burnout.

Female anaesthetists Increased rates of abortion Increased rates of infertility

Female anaesthetists Headache Irritability Lack of concentration Nausea Fatigue Depression