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ABSTRACT
* SAFETY HAZARDS are inherent in laser use, but they can be eliminated or significantly reduced with adherence to proper procedures.
* THIS ARTICLE reviews beam-related and nonbeam-related safety hazards, including eye injuries, fire and thermal injuries, smoke plume, and electrical hazards, as well as safety measures to avoid these hazards.
* EDUCATION IN LASER SCIENCE and safety is key to recognizing potential hazards and ensuring that safety parameters are followed. AORN J 79 (January 2004) 171-188.
Every year, laser accidents occur that could have been prevented if appropriate policies and procedures had been followed. The primary responsibility of a perioperative nurse during a laser procedure is keeping the patient safe. Safety hazards are inherent in laser use, but they can be eliminated or significantly reduced with adherence to proper procedures. When perioperative nurses are educated in laser science and safety, they can recognize potential hazards and ensure that safety parameters are followed. This article details the current standards for laser safety and addresses both beam-related and non-beam-related hazards.
STANDARDS AND REGULATIONS
There are no federal requirements for safety during laser procedures, but there are recognized national standards. The key source of safety standards for laser use is the American National Standards Institute (ANSI) which publishes standard Z136.3, "Recommended practices for laser safety for health care facilities."1 All facility policies and procedures should be based on ANSI standards. Hospital ORs, surgery centers, and physician practice-based surgery suites are expected to comply with the recommended safety standards.
The Occupational Safety and Health Administration (OSHA) also has an interest in laser safety, particularly concerning the safe evacuation of smoke created by lasers. Only OSHA has the full force of the law behind its regulations. The General Duty Clause permits OSHA to cite employers for not providing "employment and a place of employment which are free from recognized hazards."2 This agency also has the authority to regulate smoke in the workplace under the respiratory protection program (ie/ 29 CFR 1910.134), which addresses personal protection equipment and engineering controls, such as smoke evacuators and ventilation systems.3 The Occupational Safety and Health Administration has established maximum permissible levels or threshold limit values of surgical smoke and aerosol based on the recommendations of the American Conference of Government and...