7 Hazards in the Perioperative Environment
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 7.1: Risk and Fire Safety in the Operating Room
- 1. Identify the risks that are present in the operating room
- 2. Explain the importance of the fire triangle
- 3. Discuss fuels and sources of ignition commonly found in the operating room
- 4. Describe how to respond appropriately to a patient fire
- 5. Identify methods associated with preventing fires in the operating room
- 6. Describe measures to safely store, transport, and use compressed gas cylinders
- 7. Identify precautions to prevent exposure to ionizing radiation
Lesson 7.2: Principles of Handling Electricity, Injuries/Allergic Reaction, and Handling of Waste
- 8. Describe methods to avoid chemical injury
- 9. Describe toxic substances in smoke plumes
- 10. Describe Standard Precautions
- 11. Discuss techniques to prevent sharps injuries
- 12. Identify the practice for transmission-based precautions
- 13. Identify methods of properly handling and disposing of hazardous waste in the operating room
- 14. Describe the symptoms of true latex allergy
- 15. Identify necessary precautions to prevent latex reaction in allergic patients
- 16. Describe correct body mechanics for lifting, pulling, and pushing heavy equipment
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Classroom Preparation
Lesson 7.1: Risk and Fire Safety in the Operating Room
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 1. Identify the risks that are present in the operating room
- 2. Explain the importance of the fire triangle
- 3. Discuss fuels and sources of ignition commonly found in the operating room
- 4. Describe how to respond appropriately to a patient fire
- 5. Identify methods associated with preventing fires in the operating room
- 6. Describe measures to safely store, transport, and use compressed gas cylinders
- 7. Identify precautions to prevent exposure to ionizing radiation
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 7.1: Risk and Fire Safety in the Operating Room
STUDENT PREPARATION (1 hr)
| 1 | READ – Chapter Heading(s) • Introduction • Risk and Safety Human and Technical Factors that Contribute to Risk Safety Standards and Recommendations ANSWER – Textbook • Review Questions 1, 2 ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 2 | READ – Chapter Heading(s) • Fire ANSWER – Textbook • Review Question 3 ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 3 | READ – Chapter Heading(s) • Oxygen • Fuels Alcohol Rubber and Plastics Intestinal Gas • Sources of Ignition ANSWER – Textbook • Review Question 4 ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 4 | READ – Chapter Heading(s) • Patient Fire in the Operating Room What to Do in a Fire RACE Extinguishers ANSWER – Textbook • Review Questions 5, 6, 7 • Case Study 1 ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 5 | READ – Chapter Heading(s) • Fire Prevention • Electrical Hazards How to Prevent Electrical Accidents ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 6 | READ – Chapter Heading(s) • Compressed Gas Cylinders Gas Cylinder Hazards Preventing Cylinder Accidents ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 7 | READ – Chapter Heading(s) • Ionizing Radiation Safety Precautions During the Use of Ionizing Radiation ANSWER – Textbook • Review Question 9 ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 7.1: Risk and Fire Safety in the Operating Room
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 1 | RISKS IN THE OPERATING ROOM: SLIDE 4 | • Introduction • Risk and Safety Human and Technical Factors that Contribute to Risk Safety Standards and Recommendations |
| 2 | FIRE TRIANGLE: SLIDE 5 | • Fire |
| 3 | FUELS AND SOURCES OF IGNITION: SLIDES 6-7 | • Oxygen • Fuels Alcohol Rubber and Plastics Intestinal Gas • Sources of Ignition |
| 4 | PATIENT FIRE: SLIDES 8-9 | • Patient Fire in the Operating Room What to Do in a Fire RACE Extinguishers |
| 5 | FIRE PREVENTION: SLIDES 10-11 | • Fire Prevention • Electrical Hazards How to Prevent Electrical Accidents |
| 6 | COMPRESSED GAS CYLINDERS: SLIDES 12-13 | • Compressed Gas Cylinders Gas Cylinder Hazards Preventing Cylinder Accidents |
| 7 | IONIZING RADIATION: SLIDE 14 | • Ionizing Radiation Safety Precautions During the Use of Ionizing Radiation |
Learning Activities (choose one or more to equal 50 min)
| 1 | RESEARCH (50 min) • Students should research the different types of types of risks that are present in the operating room and include suggestions for prevention in presentations to the class. You should assign particular risk factors for the students to research or develop so that the in-class activity is more tailored and varied among student groups. Appropriate Settings: Traditional/online/flipped classroom |
| 2 | DISCUSS (30 min) • Discuss with the class the importance of the fire triangle and what each triangle represents in the operating room. Use the image of a campfire to reinforce the three components of the fire triangle. First ask the students what it takes to start such a fire; classify each of these components as “ignition or heat,” “oxygen,” or “fuel.” Then ask how the fire can be put out (or what would make it go out), and classify each of these answers under the same categories. • Appropriate Settings: Traditional/online/flipped classroom |
| 3 | DISCUSS (30 min) • Divide the class into small groups. Have each group discuss one of the potential sources of ignition in the operating room and the precautions used to minimize the risk from that source. Have each group present a summary to the class. Appropriate Settings: Traditional classroom |
| 4 | DISCUSS (30 min) • Students should review the appropriate response to a fire in the operating room using RACE and PASS. Appropriate Settings: Traditional/online/flipped classroom DEMONSTRATE (50 min) • Have students demonstrate appropriate response to a fire in the operating room using RACE and PASS. Appropriate Settings: Traditional classroom |
| 5 | ANALYZE (30 min) • Divide the students into groups and have them discuss why the OR is at such risk for electrical fire. Students should critically think about electricity and the surgical patient. Appropriate Settings: Traditional/online/flipped classroom |
| 6 | DEMONSTRATE (30 min) • Students should review the proper way to transport an empty gas cylinder. They will be asked to demonstrate the technique in class. Appropriate Settings: Traditional classroom |
| 7 | DISCUSS (20 min) • Discuss the precautions to prevent exposure to ionizing radiation. Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
What are some of the risk factors a surgical technologist faces in the workplace?
Discussion Guidelines: Some of the risk factors faced by a surgical technologist include exposure to sharp objects, exposure to body fluids and other infectious agents, the need to lift objects and move patients, and use of electrical devices.
What is meant by risk management? What are some ways to manage risk in a surgical setting?
Discussion Guidelines: Risk management is taking specific precautions to reduce the probability of harm arising from a risk factor. To manage a risk, it must first be recognized and understood. Once a risk is recognized, appropriate precautions can then be identified and put in place. Ways to manage risk include highlighting the danger of a particular chemical or piece of equipment with signs, replacing a risky technique with a safer one (e.g., using no-hands sharps transfer), using equipment with safeguards in place (e.g., self-sheathing needles), and using personal protective equipment (e.g., gloves, masks).
Your supervisor asks you to prepare a presentation on fire prevention for your coworkers. You prepare information showing the locations of fire extinguishers, alarms, escape routes, procedures to follow during a patient fire, and so on. Your supervisor tells you that the information is useful but that it doesn’t really cover what she is looking for. What do you think was missing from the presentation?
Discussion Guidelines: Students might discuss the difference between prevention of a fire (or other emergency) and intervention in an emergency once it arises. It is critical for personnel to respond to an emergency in a way that minimizes injury and property damage, but it is far better to prevent the emergency in the first place. Procedures for fire prevention would include such actions as identifying and replacing frayed electrical cords, keeping combustible materials away from electrosurgical units, and other similar measures.
Classroom Preparation
Lesson 7.2: Principles of Handling Electricity, Injuries/Allergic Reaction, and Handling of Waste
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 8. Describe methods to avoid chemical injury
- 9. Describe toxic substances in smoke plumes
- 10. Describe Standard Precautions
- 11. Discuss techniques to prevent sharps injuries
- 12. Identify the practice for transmission-based precautions
- 13. Identify methods of properly handling and disposing of hazardous waste in the operating room
- 14. Describe the symptoms of true latex allergy
- 15. Identify necessary precautions to prevent latex reaction in allergic patients
- 16. Describe correct body mechanics for lifting, pulling, and pushing heavy equipment
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 7.2: Principles of Handling Electricity, Injuries/Allergic Reaction, and Handling of Waste
STUDENT PREPARATION (1 hr)
| 8 | READ – Chapter Heading(s) • Magnetic Resonance Imaging • Toxic Chemicals Exposure Prevention ANSWER – Textbook • Review Question 10 ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 9 | READ – Chapter Heading(s) • Smoke Plume ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 10 – 13 | READ – Chapter Heading(s) • Standard Precautions ANSWER – Textbook • Review Question 8 • Case Study 2 ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 14 | READ – Chapter Heading(s) • Latex Allergy ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 15 | READ – Chapter Heading(s) • Latex Allergy Prevention and Risk Reduction ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 16 | READ – Chapter Heading(s) • Musculoskeletal Risks Risk Prevention Body Mechanics ANSWER – Workbook • Chapter 7 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 7.2: Principles of Handling Electricity, Injuries/Allergic Reaction, and Handling of Waste
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 8 | ENVIRONMENTAL HAZARDS: SLIDE 6 | • Magnetic Resonance Imaging • Toxic Chemicals Exposure Prevention |
| 9 | SMOKE PLUMES: SLIDE 6 | • Smoke Plume |
| 10 – 13 | STANDARD PRECAUTIONS AND HAZARDOUS MATERIALS: SLIDES 18-19 | • Standard Precautions |
| 14 | SYMPTOMS OF LATEX ALLERGY: SLIDE 18 | • Latex Allergy |
| 15 | LATEX REACTION PREVENTION: SLIDE 20 | • Latex Allergy Prevention and Risk Reduction |
| 16 | BODY MECHANICS: SLIDES 21-22 | • Musculoskeletal Risks Risk Prevention Body Mechanics |
Learning Activities (choose one or more to equal 50 min)
| 8 | DISCUSS (30 min) • Students should review the methods to avoid chemical injury and discuss as a class. Appropriate Settings: Traditional/online/flipped classroom |
| 9 | RESEARCH (50 min) • Students should research the different substances present in a smoke plume created during laser or electrosurgery. Identify which components of the plume are toxic, and the effects they have on the body when inhaled. • Appropriate Settings: Traditional/online/flipped classroom |
| 10 | PRESENT (50 min) • Students should research Standard Precautions. They will use this information in class to complete a presentation. You may wish to assign particular scenarios for the students to research or develop so that the presentations are more tailored and varied among student groups. • Appropriate Settings: Traditional/online/flipped classroom |
| 11 | DISCUSS (30 min) • Discuss as a class methods of preventing sharps injuries. • Appropriate Settings: Traditional/online/flipped classroom |
| 12 | REVIEW (50 min) • Students should review the practice for transmission-based precautions for an in-class discussion on the topic. • Appropriate Settings: Traditional/online/flipped classroom |
| 13 | DISCUSS (30 min) • Discuss as a class methods of properly handling and disposing of hazardous waste in the operating room. • Appropriate Settings: Traditional/online/flipped classroom |
| 14 | REVIEW (50 min) • Students should review the symptoms of a true latex allergy for an in-class discussion on the topic. • Appropriate Settings: Traditional/online/flipped classroom |
| 15 | PREPARE (50 min) • Students should prepare a two-page written paper on precautions to prevent latex reaction in allergic patients. They will present a synopsis of their paper to the class. • Appropriate Settings: Traditional/online/flipped classroom |
| 16 | DEMONSTRATE (50 min) • Have students demonstrate proper technique for lifting, pulling, and pushing heavy objects. • Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
You notice a new colleague at a sink busily washing his hand, which appears to be bleeding. He tells you that he suffered a needle-stick injury while cleaning up an operating room after a surgical case involving a young girl. When you ask him whether he has reported the injury, he tells you that he really doesn’t want to report it and will see how he feels in a few weeks. What do you do?
Discussion Guidelines: Students might talk about the policies that could govern whether to report the injury of another person. (For example, the employee’s supervisor might be obligated to report the injury, whereas it might be inappropriate for another colleague to do so.) Students might also discuss the need for the injured worker to begin prophylactic treatment quickly, especially if the patient might be HIV-positive. In this scenario, the injured worker is making assumptions about the patient’s disease status that might not be true. By not reporting the injury, the coworker might spare himself embarrassment today, but he is denying himself access to testing and treatment that could preserve his health or even his life. Students might also note that if this needle-stick was caused by improper sharps handling on the part of the worker or a surgical team member, reporting the incident can highlight the need for additional training or a change in procedure that could prevent future injuries.
Assessments
Chapter 7: Hazards in the Perioperative Environment
ASSESSMENTS BY OBJECTIVE
| 1-16 | Workbook • Chapter 7 Evolve Instructor Resources • Test Bank Create a quiz using ExamView; sort by objective. Evolve Student Resources • Mock Certification Exam • Review Questions |
| All | Elsevier Adaptive Quizzing • Chapter 7 – Graded quizzes (Mastery Levels 1, 2, and 3) |
