�LASER SAFETY - AKUHN

Lilian Masai

Operating Room Nurse

Date: 15^th November 2023

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INTRODUCTION

• LASER- Light Amplification by Stimulated Emission

of radiation.

• Light emitted by Laser is non ionizing, electromagnetic radiation

Why Laser safety program

Purpose and scope

• Management of classes 3B and 4 which carry the

most significant risk for harm to minimize risks

• Cause electrical, skin and eye injuries

TEAM

• Laser safety committee - overall policy and operational oversight over the laser safety program
• LSO – coordinates the program and reports to laser safety committee
• Biomedical engineering - responsible for equipment requisition, evaluation, installation, operator training, preventive and corrective maintenance
• Line staff (Users) comply during use and reporting of incidences

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Laser safety officer

• Conduct laser audits
• Ensure valid credentials for RNS and physicians
• Education sessions has been planned
• Laser operating manuals and policy are easily accessible
• PPEs are maintained and stored appropriately

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CLASSES OF LASER

Laser injuries

• Classes 3B and 4 are related with significant safety risks, ocular injury, dermal injury and fire.
• Effects to the eye - Retinal burns, corneal burns, photo keratitis, visual effect (blindness).
• Skin injury –Can result direct or from reflected laser light, Skin may become dry, itchy or charred.
• Include – erythema, delayed effects e.g. CA skin, thermal skin burns.

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Non beam hazards

• Non direct exposure to laser beam
• Electrical hazards
• Fire
• Noise especially pulsed lasers
• Collateral radiation
• Cryogenics
• Plasma radiation
• Explosions

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Model for Improvement: PDSA Cycle

Establish the objectives and processes necessary to deliver results in accordance with Laser safety requirements

• Risk assessment
• Purpose
• Objective setting

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Monitor and measure those objectives and processes and report the results: KPI i.e trained staff,compliance ,fire incidences,injury ,infections

Take the actions needed to continually improve the process performance: Report incidences,RCA

Implement those objectives and processes

• Train OR Personel
• Avail appropriate PPE

To patient and staff

• Signage

Laser intraop form

Laser log

Source: Quality Improvement, First Steps; Family Practice, Management March 1999

DO & DON’TS

1.Patient eye protection:

• Spinal/L/A : laser googles
• G/A: saline moistened eye pads secured with tape

2.Skin protection:

• Do not use alcohol-based skin preparation solution
• Use saline wet packs to protect adjacent tissues and absorb laser energy when in cavities
• Physician to wear gloves and a gown to prevent chronic skin exposure
• Do not touch the tip of the accessory may become hot during surgery causing tissue damage
• Do not put on reflective jewelry – both user and patient

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DO: Electric hazards

DO & DON’TS :Environmental safety

Types of Laser controls

1.Engineering - in-built safety features supplied by manufacture.

• Guarded foot switch/Housing interlocks
• stand by controls and emergency switch.

2.Procedural - policies and procedures in facilities.

• Operational activities specific to equipment and practice.
• E.g. Ocular protection, controlled access to the OR.

3.Administrative controls:

Development of documentation tools,LSO appointment ,Compliance with occupational health and safety rules and training of personnel.

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MONITORING:

• Quarterly report from the LSO to facility Management services which includes:
• Monthly KPI report( training, injury and other incidences)
• Audits
• Spot-checks on compliance during laser use

References

• Denver, C.O.(2011) Recommended practices for laser safety in perioperative practice setting. AORN .
• JCI(2021) joint commission international accreditation standards for hospitals .7^th Edition.
• Smalley P.J.(2011) Laser Safety; Risks hazards and control measures. Laserther.2011;20(2):95106.doi:10.5978/islsm.20.95.

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Q & A

End