LASER APPLICATION AND SAFETY

TERMINAL OBJECTIVE F STATE THE STANDARD SAFETY MEASURES FOR PATIENT AND STAFF SAFETY IAW THE MANUFACTURER’S MANUAL

MAIN TEACHING POINTS F BASIC PRINCIPLE F CHARACTERISTICS F TYPES F SURGICAL PROCEDURES F SAFETY

BASIC PRINCIPLES F BEGAN IN 1917 WITH EINSTEIN’S THEORY OF “STANDARD EMISSION” F TOWNES DEVELOPED PRINCIPLES OF LASER

F LIGHT F AMPLIFICATION BY THE F STIMULATED F EMISSION OF F RADIATION L. A. S. E. R.

LASER F LIGHT, CONCENTRATED AND FOCUSED, STIMULATES ATOMS TO EMIT RADIANT ENERGY WHEN ACTIVATED.

CHARACTERISTICS LIGHT F ELECTROMAGNETIC ENERGY - RANGES FROM VISIBLE TO INVISIBLE AND TRAVELS IN WAVES - CHARACTERIZED BY WHERE IT FALLS ON ELECTROMAGNETIC SPECTRUM (VISIBLE LIGHT ONLY SMALL PART)

CHARACTERISTICS F PULSED - EMIT IN BRIEF, REPEATED EMMISSIONS THAT HAVE A DURATION OF SMALL FRACTION OF SECOND F CONTINUOUS -PRODUCES CONTINUOUS LIGHT BEAM

CHARACTERISTICS OF LASER F FOUR PROPERTIES –WAVELENGTH - THE DISTANCE TRAVELED ALONG THE ELECTROMAGNETIC SPECTRUM

CHARACTERISTICS OF LASER F FOUR PROPERTIES –AMPLITUDE - HEIGHT OF WAVE FROM PEAK TO BOTTOM

CHARACTERISTICS OF LASER F FOUR PROPERTIES VELOCITY - RATE OF SPEED WAVE TRAVELS

CHARACTERISTICS OF LASER F FOUR PROPERTIES FREQUENCY - THE NUMBER OF WAVES PER SECOND (CYCLES PER SECOND)

TYPES OF LASERS F CARBON DIOXIDE (GAS) F ARGON (GAS) F ND YAG (SOLID) F DYE

PROCEDURE/SERVICE USE OF LASERS F OPTHAMOLOGY –ARGON (DETACHED RETINAS, NARROW ANGLE GLAUCOMA) F GYNECOLOGY –CO2 (EROSION OF CERVIX, BLEEDING, ADHESIONS, IMPLANTS) ND: YAG AND ARGON

PROCEDURE/SERVICE USE OF LASERS F OTORHINOLARYNGOLOGY –C02 (LESIONS), ND: YAG (TUMORS), ARGON (EPISTAXIS) F PLASTIC/RECONSTRUCTIVE ARGON (PORTWINE HEMANGIOMAS, TATTOOS, BIRTHMARKS) ND: YAG, CO2 (KELOIDS)

PROCEDURE/SERVICE USE OF LASERS F GASTROINTESTINAL -ND YAG (GI BLEEDING, POLYPS) F UROLOGY - CO2 (VENEREAL LESIONS) F CARDIOVASCULAR (OBSTRUCTIONS) F NEUROSURGERY - CO2(TUMORS, EXCISING TISSUE, EXCISING BONE)

STANDARDS & REGULATIONS SET BY: F OSHA F AORN F ANSI F STATE AND LOCAL POLICY - CREDENTIALING - EDUCATION PROGRAMS - QUALITY IMPROVEMENT - DOCUMENTATION

PATIENT SAFETY EYES AND EYELIDS MUST BE PROTECTED F WEAR GOGGLES (AWAKE) F EYES TAPED SHUT (ANESTHESIA) F MOISTENED EYEPADS (HEAD & NECK) F PROTECTIVE SHIELDS (OPTHALMIC)

PATIENT SAFETY ANTISEPTIC SHOULD BE NON FLAMMABLE F AQUEOUS SOLUTIONS (SAFEST) F SKIN SHOULD BE DRY F ALCOHOL AND TINCTURES ARE VOLATILE WHEN WET.

PATIENT SAFETY AREA AROUND INCISION MUST BE PROTECTED FROM THERMAL INJURY F DRAPES (FIRE RESISTANT) - METALLIC FOLD - POLYPROPYLENE - LASER RETARDENT F NO WOVEN TEXTILE TOWELS

PATIENT SAFETY F LASER HANDPIECE F MOISTENED SPONGES, TOWELS, OR COMPRESSED PATTIES - USED EXCEPT WITH ND:YAG F RECTUM MUST BE PACKED TO PREVENT METHANE GAS FROM ESCAPING

PATIENT SAFETY F ANESTHETIC AGENTS MUST BE NONCOMBUSTIBLE. F TEETH SHOULD BE COVERED F HIGH-FILTRATION MASK F INSTRUCTIONS SHOULD INCLUDE CARE OF HEALING THERMAL SKIN WOUND.

PERSONAL SAFETY F EXPOSURE CAN BE HAZARDOUS TO PERSONNEL F AVOID EYE AND SKIN EXPOSURE

PERSONAL SAFETY F EYE PROTECTION - MUST BE WORN AT ALL TIMES - GOGGLES SHOULD FIT OVER GLASSES - SCRATCHES NEGATE PROTECTION - LENS COVERS

PERSONAL SAFETY F SKIN PROTECTION - SKIN SENSITIVITIES - SKIN CAN BE BURNED - NO JEWELRY - WEAR FIRE RESITANT GOWN

PERSONAL SAFETY F LASER PLUME - TOXIC SUBSTANCES CAN BECOME AIRBORNE - USE MECHANICAL SMOKE EVACUATOR OR SUCTION -RUN DURING ACTIVATION AND FOR SECONDS AFTER - TIP IS PLACED 2 INCHES FROM SITE

ENVIRONMENTAL SAFETY F WARNING SIGNS (OUTSIDE DOOR) F WALLS (NONREFLECTIVE) F WARNING LABELS - AFFIXED BY MANUFACTURER F PREOPERATIVE CHECKS - PREOP CHECKLIST IS HELPFUL

ENVIRONMENTAL SAFETY F KEPT IN STANDBY POSITION - TURNED OFF AND LOCKED WHEN UNATTENDED - ONLY AUTHORIZED PERSONNEL HAVE ACCESS TO KEY F FOOTSWITCH SHOULD BE OPERATED BY SURGEON

ENVIRONMENTAL SAFETY F NONREFLECTIVE INSTRUMENTS - DULL BLUE TITANIUM ALLOY OR EBONIZED OR ADONIZED STAINLESS STEEL - DEFOCUS AND DISPERSE THE LASER BEAM

ENVIRONMENTAL SAFETY F FIRE HAZARD - ADHERE TO PRECAUTIONS AND SAFEGUARDS - BASIN OF STERILE WATER OR NORMAL SALINE - FIRE EXTINGUISHER - LOW OXYGEN CONCENTRATION - NO LIQUIDS ON MACHINE

ENVIRONMENTAL SAFETY F ELECTRICAL CODES AND STANDARDS MUST BE ENFORCED F INSTRUCTIONS FOR OPERATION, CARE, HANDLING, AND STERILIZATION OF LASER MUST BE FOLLOWED F ESSENTIAL TO PATIENT, PERSONNEL, AND ENVIRONMENTAL SAFETY

REVIEW F BASIC PRINCIPLE F CHARACTERISTICS F TYPES F SURGICAL PROCEDURES F SAFETY

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