EXAM 3 REVIEW

Diagnostic Errors

Diagnostic errors mean a diagnosis that was either "wrong, missed, or unintentionally delayed."

Stability and Reactivity

describes conditions that could result in a hazardous chemical reaction. This might include contact and reaction with other substances, or environmental conditions to avoid

Who are MSDS's for?

Employees who may be occupationally exposed to a hazard at work. Employers who need to know the proper methods for storage etc. Emergency responders such as fire fighters, hazardous material crews, emergency medical technicians, and emergency room personnel. MSDS's are not meant for consumers.

class c

Energized electrical equipment (e.g., appliances); This tank is made from CO2 gas.

Falls

Falls are a common cause of injury, both within and outside of health care settings. According to the U.S. Centers for Disease Control and Prevention, more than one-third of adults over 65 fall each year. Injuries that result from falls can include bone fractures, excessive bleeding, or even death. Researchers estimate that more than 500,000 falls happen each year in U.S. hospitals, resulting in 150,000 injuries.

class b

Flammable liquids/gases (e.g., gasoline, oil, paint); This tank is made from CO2 gas.

Fluoroscopy

Fluoroscopy is a study of moving body structures‐‐similar to an X‐ray "movie." A continuous X‐ray beam is passed through the body part being examined. The beam is transmitted to a TV‐like monitor so that the body part and its motion can be seen in detail. Fluoroscopy, as an imaging tool, enables physicians to look at many body systems, including the skeletal, digestive, urinary, respiratory, and reproductive systems. Fluoroscopy may be performed to evaluate specific areas of the body, including the bones, muscles, and joints, as well as solid organs, such as the heart, lung, or kidneys.

caution sign

The following will introduce you to some of the most common hazard signs and symbol found in the health care setting. These are some of the most crucial signs because not following their warning could be deadly, to you and/or the patient.

The Label

The label itself consists of a diamond separated into foursections, each representing a differenttype of potentially hazardous situation,material or reaction. Eachsection is a different color: blue, red, yellowor white. Within each colored section is a number or a symbol that relates the severity and type of the potential hazard.

medical errors (also called adverse events)

happen when there is a single misstep in a chain of activities.

The National Fire Protection Association (NFPA

has a systemof labeling standards designed to provide clear visual signs to those who respond to fire or chemical emergencies. The signs clearly state the types of hazards present, while also providing a visual guideline of how to proceed with the emergency response.

2 types of evacuation:

horizontal (movement from different area of same floor) vertical (movement up or down - use stairs) Suffocation from smoke is the biggest dangerin a fire (toxic fumes). Stay low to the floor.

Composition

identifies the ingredients that contribute to hazards or are considered hazardous by OSHA. Also listed are the chemical and common names of hazardous components.

Physical and Chemical Properties i

identifies the substance's characteristics, such as odor and boiling or melting points

adverse event

is a harmful and undesired effect resulting from a medication or other intervention such as surgery

Extinguishment

is an option for staff members who are competent in using a fire extinguisher and are comfortable that building evacuation is underway and they have a clear, unobstructed exit. Do not force those who are uncomfortable with using a portable fire extinguisher to do so, as they can be of assistance in the previously mentioned items (Rescue, Alarm, and Confine), as well as keeping the group together and performing a head count to see if anyonemay be missing

Firefighting Measures

s lets you know the fire and explosive properties of the material, appropriate extinguishing devices, and basic firefighting guidelines

code gray/ code silver

sometimes called code silver, code gray refers to a combative person with a lethal weapon, it often indicated a violent situation and potential hospital lock down.

Airborne and Contact Isolation Sign

stop sign with list of precautions

Accidental‐Release Measures

tells how to contain and clean up a spill, leak, or other release

First‐aid Measures

tells you about emergency procedures—steps that you can take before professional medical assistance is available.

Confining

the fire can be a quick and simple procedure resulting in saved occupant evacuation time and in locating the fire when fire strikes. Suggest closing doors behind the last person leaving an area and closing every door on the way out. Confining the fire limits the migration of heat and smoke as residents are moved horizontally on the floor or out of the building.

recognize radioactive materials

the signs have magenta, red or black symbol, called a trefoil, on a yellow background. Each room that has x ray equipment us use will also have a sign hanging above the door that lights up when an exposure is occurring. never enter these doors, find an alternative entrance or knock until someone opens the door.

Radioactivity; X-rays

yellow and black sign

Magnet In Use (Particularly an MRI magnet)

yellow triangle with magnet

oxidizing; or oxygen in use

yellow triangle with this sign

Order of patient evacuation:

1. Ambulatory patients/visitors 2. Semi‐ambulatory patients 3. Non‐ambulatory patients

fire escape

rectangle with fire sign and a person running towards a door

electric shock hazard

the yellow flashing sign

common electrical hazards can be broken into three broad categories:

1) electric shock causing injury or death: the electric shock may be received by direct contact, tracking through or across a medium, or by an arch flash or arcing 2) arcing, explosion or fire causing burns: explosion or all occur often when high fault currents are present 3) toxic gases causing illness or death: burning and arcing associated with electrical equipment causes a range of gases and contaminants to be present. compounds ranging from ozone to cyanide and sulphuric acids can be present as well as the hazards such as low oxygen content in the air

Health Care-Acquired Infections

A health care-acquired infection (HAI) is an infection a person gets while being treated for a medical condition. HAIs may occur in patients who are treated at a medical facility or in their homes. An infection is considered to be an HAI when it occurs after treatment begins. HAIs are often discovered within 48 hours of admission to a health care facility, but other infections may also be considered HAIs.

AED (automated external defibrillator)

ALL Automated External Defibrillator (AED) stations must be properly identified so that those in need of the unity can find it. An automated external defibrillator (AED) is a portable device that checks the heart rhythm. If needed, it can send an electric shock to the heart to try to restore a normal rhythm. AEDs are used to treat sudden cardiac arrest (SCA) and are critical elements when performing CPR.

class abc

All of the above applications: This tank is a dry chemical.

SAFETY CONCERNS OF CT'S

As in many aspects of medicine, there are risks associated with the use of CT. The main risk associated with CT is:An increased lifetime risk of cancer due to x‐ray radiation exposure. Under some rare circumstances of prolonged, high‐dose exposure, x‐rays can cause other adverse health effects, such as skin reddening (erythema), skin tissue injury, hair loss, cataracts, and potentially, birth defects (if scanning is done during pregnancy). Radiation exposure is a concern in both adults and children. However, these concerns are greater for children because they are more sensitive to radiation and have a longer life expectancy than adults. As a result, accumulated exposures over a child's lifetime are more likely to result in an adverse health effect. A child's smaller size also has an impact on the radiation dose they receive. For example, if a CT scan is performed on a child using the same parameters as those used on an adult, an unnecessarily large dose will be delivered to the child. CT equipment settings (exposure parameters such as, x‐ray tube current, slice thickness, or pitch) can be adjusted to reduce dose significantly while maintaining diagnostic image quality

Your Personal Fire Plan should include:

Check door to see if it's hot. Check to see if any patient is in danger. Activate the alarm. Report the fire (location [room#], your name, what is burning). Stay on the line untiltold to hang up.

class bc

Combines B and C and uses C02 gas as well.

Computed Tomography (CT)

Computed tomography (CT) has transformed diagnostic radiology by providing three‐dimensional views of an organ or body region. CT is a medical imaging procedure that utilizes computer‐ processed X‐rays to produce tomographic images or 'slices' of specific areas of the body. These cross‐sectional images are used for diagnostic and therapeutic purposes in various medical disciplines

medical error

If the adverse event was caused by an unsuitable or incorrect medication dosage or procedure

emergency eye wash station

In case of a chemical splash to the eyes, these mark emergency eye was stations that are made to deliver the water to your eyes specifically if necessary. On occasion, the chance of accidental full body exposure to a chemical or hazardous fluid (including human body fluids) is high, this sign marks the emergency show locations for you to use if the need is there.

Mandatory

Indicates that a specific course of action must be taken.

WHAT IF I HEAR THE FIRE ALARM AND SEE FLASHING LIGHTS?

Listen for the "CODE RED" announcement to identify the location of the fire alarm. Each facility may have a different code name for fire alarm ‐Close patient, office, laboratory and utility room doors throughout the hospital. ‐Clearthe corridors and elevatorlobbies on the floor of the fire alarm and the floor above. ‐Remain alert and await furtherinstructions on the announcement system. ‐Do not evacuate unlessspecifically instructed to do so. ‐When the fire alarm stops sounding, the lights stop flashing and you hear the "CODE RED All Clear" ("Dr. Clearwater") announcement, you may resume with your normal activities.

A BRIEF TOUR OF RADIOLOGY MODALITIES AND SAFETY CONCERNS MRI

Magnetic resonance imaging, or MRI, is a way of obtaining very detailed images of organs and tissues throughout the body without the need for x‐rays or "ionizing" radiation. Instead, MRI uses a powerful magnetic field, radio waves, rapidly changing magnetic fields, and a computer to create images that show whether or not there is an injury, disease process, or abnormal condition present. For the MRI procedure, the patient is placed within the MR scanner—typically a large, tunnel or doughnut‐shaped device that is open at both ends. The powerful magnetic field aligns atomic particles called protons that are present in most of the body's tissues. The applied radio waves then cause these particles to produce signals that are picked up by a receiver within the MR scanner. The signals are specially characterized using the rapidly changing magnetic field, and, with the help of computer processing, very sharp images of tissues are created as "slices" that can be viewed in any orientation.

Medication Errors

Medication errors are when a patient receives the wrong medication, or when he or she receives the right medication but in the wrong dosage or manner. Medication errors are unfortunately very common

What type of FIRE EXTINGUISHER should I use?

ONLY use fire extinguishers if you are trained and confident about using them!

class a

Ordinary combustible (e.g., wood, paper, cloth); This tank is water under pressure.

x ray in use

Over EVERY room that utilizes x-rays to obtain their diagnostic exams, this sign or something very close to it is lit up. This tells you to NEVER enter that particular door. Find an alternate route into the area or knock until someone answers. white sign with red letters x ray in use

how to use a fire extinguisher properly

P-pull the pin A-aim at the base of the fire S-squeeze S-sweep side to side most dry chemical fire extinguishers have a built in pressure gauge, if the gauge indicator is pointing to recharge, the pressure in the extinguisher may be too low to expel the contents The operating lever pushes down on an actuating rod (the blue piece). The metal safety pin prevents the operating lever from closing accidentally.

radiation

Radiation is used for several purposes such as providing an image of internal organs as well as killing cancer and sterilizing equipment. Radiation may be defined as energy traveling through space.

What if I DISCOVER A FIRE OR SMOKE condition in the Hospital?

Remember "RACE"!!

Additional Information in Case of Fire

Telephone lines should be kept clear. During a "Code Red" or a FIRE DRILL, patient doors should be closed and the fire doors should close automatically. The elevators should not be used during a "Code Red". Only the Fire Department may operate the elevators. Evacuation - The Administrator, Safety Officer, or Fire Department will determine if an evacuation is necessary. You may initiate an evacuation of the immediate area if patients or personnel are in an unsafe area. KNOW YOUR EVACUATION ROUTES AND ALTERNATIVE EVACUATION ROUTES WHERE YOU ARE WORKING!

Blue Section

The blue section of the NFPA labelrepresents a health hazard. The numeric scale ranges from zero to four, with zero meaning there is no hazard and four meaning that there is a significantrisk,such that even a short exposure could result in death.

safety concerns for MRI's

The powerful magnetic field of the MR system will attract iron‐containing (also known as ferromagnetic) objects and may cause them to move suddenly and with great force. This can pose a possible risk to the patient or anyone in an object's "flight path." Great care is taken to be certain that objects such as ferromagnetic screwdrivers and oxygen tanks are not brought into the MR system area. It is vital that you remove all metallic belongings in advance of an MRI exam, including watches, jewelry, and items of clothing that have metallic threads or fasteners. The powerful magnetic field of the MR system will pull on any iron‐containing object in the body, such as certain medication pumps or aneurysm clips. Every MRI facility has a comprehensive screening procedure and protocol that, when carefully followed, ensures that the MRI technologist and radiologist knows about the presence of metallic implants and materials so that special precautions can be taken.

Red Section

The red section of the NFPA label represents flammability. Using the same zero to four scale, low numbers in this section would represent something that does not burn or will not easily ignite. Higher numbersindicate that the material can ignite under appropriate conditions or can be vaporized rapidly, or it is capable of being dispersed through the air and is highly combustible.

Fluoroscopy safety concern

The two major risks associated with fluoroscopy are radiation‐induced injuries to the skin and underlying tissues ("burns") and the small possibility of developing a radiation‐induced cancer some time later in life. Again, practice time, distance, and shielding and you will limit your exposure to radiation.

White Section

The white section, known as the "Specific Hazards" section, is the only portion of the NFPA labelthat usessymbols.Unlike the zero to fourscale, there are only two symbols approved by the NFPA. "OX" represents an oxidizer, which can quickly increase the rate of combustion in a fire. The second symbol is a "W" with a line through center. It meansthat the substance has abnormal reactions with water,so watershould not be used.

Yellow Section

The yellowsection of the NFPA labelrepresentsinstability. Materials,substances or chemicalsthat are highly unstable will have a three or four on the scale. Matter of thissort is readily able to detonate and will explode. It also has a bad response to water, and can form potentially explosivemixtures when wateris added. More stable matter will have a lower number on the scale, and even though it might still ignite, it will not detonate. Low level substances are also water‐tolerant.

NPO sign

This tells you that the patient is to have "nothing by mouth" (NPO): No food or drinks. red and white sign NPO restriction

evacuation plan

Throughout all health care facilities, there are evacuation routes posted which help to guide you to the nearest exit in case of emergency.

time, distance, and shielding

Time: Limit your time around the area Distance: Maximize your distance from the area to at least 6 feet. Shielding: Keep a wall or door between you and the radiation area.

prohibited

To indicate that a certain behavior is prohibited.

fire

To point out the location of fire equipment

safety

To provide information about safe conditions.

Warn

To warn of any type of hazard.

Wrong-Site Surgery

Wrong-site surgery means an operation done on the wrong part of the body or on the wrong person. It can also mean the wrong surgery was performed. It is a rare occurrence but it does happen.

HAZARDS AND CONTROL

You can think of radiation like a sun lamp or tanning bed. Skin will burn if exposed to a sun lamp too long, or is too close, or is not protected by sun block. Similarly, we can use three basic radiation safety techniquesto control exposures. They are Time, Distance, and Shielding.

Where will I find MSDS sheets?

Your laboratory or workplace should have a collection of MSDS that came with the hazardous chemicals you have ordered (don't throw them away!) Most universities and businesses have a collection somewhere on site. You can also find them on the internet and in some software applications. You department or HR division will inform you during your employment orientation exactly where these are located...IT IS YOUR RIGHT TO THIS INFORMATION!

hospital codes

are short phrases usually named after colors, it is an easy way to ensure all workers are using the same term, which makes the workers respond to emergency situations quickly, reduce errors, and improve care at the same time. Codes are also useful in alerting staff without alarming visitors and patients.

safe location

green rectangle sign with person running towards a arrow which is pointing to a door

code black

code black often indicates impending severe weather or tornadic activity has been spotted

code brown

code brown indicates that there has been a legitimate bomb threat made towards the facility

code pink

code pink is announced to inform the hospital of an infant abduction withing the hospital

code red

code red indicates fire in the building

code yellow

code yellow is to inform the staff of a possible external/internal disaster with multiple casualties involved

Hazards

describes the substance's appearance, any hazards associated with emergency response situations, and potential health effects and symptoms of exposure.

Handling and Storage

discusses safe practices that minimize contact between you and the substance. These guidelines include risks from fire or reactions with incompatible substances.

rescue

e includes assisting those in need from the fire area to an area of safety, which may be the closestfire zone away from the fire or outside of the building. This may also include the moving of large numbers of people who may need additional staff assistance out of an area. Such assistance ranges from opening doors and windows to providing a shoulder for someone to lean on, as well as performing various lifts, drags, and carries necessary to remove people who cannot remove themselves. Many beds have wheels on them; unlocking wheels can move people quickly and comfortably. Many floors are tiled, making blanket drags quick and easy to accomplish

electrical hazards

electricity may form the most dangerous safety hazard in a hospital, and is probably the most misunderstood and underrated area of safety training using electrical equipment can lead to several hazards including electric shock, heat and fire

Non‐ionizing radiation

essential to life, but excessive exposures will cause tissue damage. All forms of ionizing radiation have sufficient energy to ionize atoms within cells and lead to tissue damage.

Exposure Controls and Personal Protection

explains any engineering controls, such as proper ventilation, and personal protective equipment (PPE), such as respiratory protection

Fire requires 3 ingredients (fire triangle)

fuel source of ignition oxygen

Sentinel Event

is defined by The Joint Commission (TJC), responsible for accrediting more than 19,000 health care organizations and programs in the United States and is recognized as a condition of licensure and the receipt of Medicaid reimbursement, as any unanticipated event in a healthcare setting resulting in death or serious physical or psychological injury to a patient or patients, not related to the natural course of the patient's illness. Sentinel events include: Surgery on the wrong individual or wrong body part, Surgical instrument or object left in a patient after surgery or another procedure, Rape in a continuous care setting, and radiation therapy to the wrong body region or 25% above the planned dose to list only a few.

What is a Material Safety Data Sheet (MSDS)?

is designed to provide both workers and emergency personnel with the proper procedures for handling or working with a particular substance. MSDS's include information such as physical data (melting point, boiling point, flash point etc.), toxicity, health effects, first aid, reactivity, storage, disposal, protective equipment, and spill/leak procedures. These are of particular use if a spill or other accident occurs. The length of the MSDS can run from 1 to 10 pages long depending on the substance. Each MSDS may look a little different, but all give you the same basic information.

Chemical Identification

lists the name of the substance and the company that developed the MSDS. Also listed are hazardous components—by generic or specific name.

Alarm or Alert

may be assimple as telling a fellowworkerto callthe fire department, activating a manual pullstation, orsending out a code over the public address system. The plan must include early fire department notification. We all know how the first few minutes of a fire can be the difference between life and death.

code blue

one of the more serious codes, code blue is used to indicate a patient needs immediate life saving assistance, usually as the result of cardiac arrest.

RACE

r: rescue a: alarm c: contain e: extinguish or evacuate In an idealsituation,the R (rescue) and the A (alarm or alert) will occursimultaneously. If not, the workersmust make an informed decision on which order they will perform them based on the situation.

radiation exposure

radiation is a form of energy. no matter what we do or where we live, we have exposure to background radiation. BACKGROUND RADIATION comes from the sun, stars, rocks, soil, and the food we eat. Wireless technologies have greatly increased public exposure to non iodizing radiation, which is associated with a number of health risks, including cancer.