LASER APPLICATIONAND SAFETY

TERMINAL OBJECTIVESTATE THE STANDARD SAFETY

MEASURES FOR PATIENT AND STAFF SAFETY IAW THE MANUFACTURER’S MANUAL

MAIN TEACHING POINTS

BASIC PRINCIPLECHARACTERISTICSTYPESSURGICAL PROCEDURESSAFETY

BASIC PRINCIPLES

BEGAN IN 1917 WITH EINSTEIN’S THEORY OF “STANDARD EMISSION”

TOWNES DEVELOPED PRINCIPLES OF LASER

LIGHTAMPLIFICATION BY THESTIMULATEDEMISSION OFRADIATION

L. A. S. E. R.

LASERLIGHT, CONCENTRATED AND

FOCUSED, STIMULATES ATOMS TO EMIT RADIANT ENERGY WHEN ACTIVATED.

CHARACTERISTICS

LIGHTELECTROMAGNETIC ENERGY- RANGES FROM VISIBLE TO INVISIBLE

AND TRAVELS IN WAVES- CHARACTERIZED BY WHERE IT FALLS

ON ELECTROMAGNETIC SPECTRUM (VISIBLE LIGHT ONLY SMALL PART)

CHARACTERISTICS

PULSED- EMIT IN BRIEF, REPEATED EMMISSIONS THAT HAVE A DURATION OF SMALL FRACTION OF SECOND

CONTINUOUS-PRODUCES CONTINUOUS LIGHT BEAM

CHARACTERISTICS OF LASER

FOUR PROPERTIES–WAVELENGTH - THE DISTANCE

TRAVELED ALONG THE ELECTROMAGNETIC SPECTRUM

CHARACTERISTICS OF LASER

FOUR PROPERTIES– AMPLITUDE - HEIGHT OF WAVE FROM

PEAK TO BOTTOM

CHARACTERISTICS OF LASER

FOUR PROPERTIESVELOCITY - RATE OF SPEEDWAVE TRAVELS

CHARACTERISTICS OF LASER

FOUR PROPERTIESFREQUENCY - THE NUMBEROF WAVES PER SECOND(CYCLES PER SECOND)

TYPES OF LASERS

CARBON DIOXIDE (GAS)ARGON (GAS)ND YAG (SOLID)DYE

PROCEDURE/SERVICE USE OF LASERS

OPTHAMOLOGY– ARGON (DETACHED RETINAS, NARROW

ANGLE GLAUCOMA)GYNECOLOGY

– CO2 (EROSION OF CERVIX, BLEEDING, ADHESIONS, IMPLANTS)

ND: YAG AND ARGON

PROCEDURE/SERVICE USE OF LASERS

OTORHINOLARYNGOLOGY– C02 (LESIONS), ND: YAG (TUMORS),

ARGON (EPISTAXIS)PLASTIC/RECONSTRUCTIVE

ARGON (PORTWINE HEMANGIOMAS,TATTOOS, BIRTHMARKS)ND: YAG, CO2 (KELOIDS)

PROCEDURE/SERVICE USE OF LASERS

GASTROINTESTINAL- ND YAG (GI BLEEDING, POLYPS)

UROLOGY- CO2 (VENEREAL LESIONS)

CARDIOVASCULAR (OBSTRUCTIONS)NEUROSURGERY

- CO2(TUMORS, EXCISING TISSUE, EXCISING BONE)

STANDARDS & REGULATIONSSET BY:OSHAAORNANSISTATE AND LOCAL POLICY

- CREDENTIALING- EDUCATION PROGRAMS- QUALITY IMPROVEMENT- DOCUMENTATION

PATIENT SAFETY

EYES AND EYELIDS MUST BE PROTECTED

WEAR GOGGLES (AWAKE)EYES TAPED SHUT (ANESTHESIA)MOISTENED EYEPADS (HEAD & NECK)PROTECTIVE SHIELDS (OPTHALMIC)

PATIENT SAFETY ANTISEPTIC SHOULD BE NON

FLAMMABLEAQUEOUS SOLUTIONS (SAFEST)SKIN SHOULD BE DRYALCOHOL AND TINCTURES ARE

VOLATILE WHEN WET.

PATIENT SAFETY

AREA AROUND INCISION MUST BE PROTECTED FROM THERMAL INJURY

DRAPES (FIRE RESISTANT) - METALLIC FOLD- POLYPROPYLENE - LASER RETARDENT

NO WOVEN TEXTILE TOWELS

PATIENT SAFETY

LASER HANDPIECEMOISTENED SPONGES, TOWELS, OR

COMPRESSED PATTIES- USED EXCEPT WITH ND:YAGRECTUM MUST BE PACKED TO

PREVENT METHANE GAS FROM ESCAPING

PATIENT SAFETYANESTHETIC AGENTS MUST BE

NONCOMBUSTIBLE.TEETH SHOULD BE COVEREDHIGH-FILTRATION MASK INSTRUCTIONS SHOULD INCLUDE

CARE OF HEALING THERMAL SKIN WOUND.

PERSONAL SAFETY

EXPOSURE CAN BE HAZARDOUS TO PERSONNEL

AVOID EYE AND SKIN EXPOSURE

PERSONAL SAFETYEYE PROTECTION- MUST BE WORN AT ALL TIMES- GOGGLES SHOULD FIT OVER

GLASSES- SCRATCHES NEGATE PROTECTION- LENS COVERS

PERSONAL SAFETY

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

PERSONAL SAFETYLASER PLUME- TOXIC SUBSTANCES CAN BECOME AIRBORNE- USE MECHANICAL SMOKE EVACUATOR OR

SUCTION- RUN DURING ACTIVATION AND FOR 20-30 SECONDS AFTER- TIP IS PLACED 2 INCHES FROM SITE

ENVIRONMENTAL SAFETYWARNING SIGNS (OUTSIDE DOOR)WALLS (NONREFLECTIVE)WARNING LABELS

- AFFIXED BY MANUFACTURERPREOPERATIVE CHECKS

- PREOP CHECKLIST IS HELPFUL

ENVIRONMENTAL SAFETY

KEPT IN STANDBY POSITION- TURNED OFF AND LOCKED WHEN UNATTENDED- ONLY AUTHORIZED PERSONNEL HAVE ACCESS TO KEY

FOOTSWITCH SHOULD BE OPERATED BY SURGEON

ENVIRONMENTAL SAFETY

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

ENVIRONMENTAL SAFETYFIRE HAZARD

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

ENVIRONMENTAL SAFETYELECTRICAL CODES AND STANDARDS

MUST BE ENFORCED INSTRUCTIONS FOR OPERATION, CARE,

HANDLING, AND STERILIZATION OF LASER MUST BE FOLLOWED

ESSENTIAL TO PATIENT, PERSONNEL, AND ENVIRONMENTAL SAFETY

REVIEW

BASIC PRINCIPLECHARACTERISTICSTYPESSURGICAL PROCEDURESSAFETY

LASER APPLICATIONAND SAFETY

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