Chemical & Biological Hazards in Operating Room

Hazardous materials are the substances that on contact cause harm to a person or the environment. Chemical hazards form the broadest category among the potential hazards in the OT. These hazards furthermore:

Solid: found primarily in the chemical disinfectants.

Liquid: used as medication, for tissue preservation, as agents in sterilization process.

Gas/vapor: usage is associated with anesthesia, sterilization, and disinfection process of both the surgical equipment and the OT.

For the Patient

Faulty connection or labeling of anesthetic gas cylinders and wrongly calculated dose of anesthetic agents.

For the Team

Dermatitis and eczema to the extent of T–cell-mediated delayed type IV or IgE-mediated type I reaction with gloves powder, handwashing sterilizing agents, local anesthetics as procaine, xylocaine, and tetracaine solution, and cement or acrylic monomer used in joint replacement surgery.

PRECAUTION

  • Repeated pre-use verification of all anesthetic equipment and drugs.
  • NIOSH recommends steps against latex gloves use.
  • Avoid all agents that cause itching on contamination.

BIOLOGICAL HAZARDS

Related to Patient

Nosocomial infection from a carrier in the OT team or seedling of microflora from the OT environment can cause postoperative surgical site infection. The patient may acquire an infection of HIV, HBsAg, HCV, and even Legionella pneumophila present on air-conditioner duct from OT itself.

Related to Team

Blood-borne diseases because of HBsAg, HCV, and HIV due to the known infected patient through accidental needle prick. New strains of tuberculosis, vancomycin and methicillin-resistant bacteria, and prion disease protein, which are resistant to standard sterilization processes, are threats to the team. Increased incidence of miscarriage among lady personnel.

PRECAUTION

  • The practice of universal precautions for protection from fluid and blood-borne pathogens, recommended by the Centre for Disease Control in 1985.
  • Linen and contaminated theater clothes change at the end of the case and sent for proper disposal or decontamination.
  • The endoscope and accessories sent to a central reprocessing unit after use.
  • Periodic surveillance and OT fumigation and sterilization with recommended agents at regular intervals and swab culture confirmation for no contaminant help in early detection of an organism.

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