Biomedical Engineering Reference
In-Depth Information
Table 17.5
Test Firing the CO
2
Laser
Purpose
: To determine the operational and safe functional status, beam alignment (infrared and visible aiming beam), and the beam profi le
(TEM00), of the CO
2
laser, prior to use.
Policy
: CO
2
laser will be test fi red each day it is to be used, prior to a scheduled laser procedure. It will also be tested if it is moved from
room to room, used for demonstrations, or involved in service or other nonsurgical uses.
Procedure
:
1. Set up a room according to controlled access procedures.
2. Drape Mayo stand with wet cloth towels (no exposed metal).
3. Follow all safety policies and procedures.
4. Set up laser with delivery systems to be used in surgery (handpiece, microscope, etc.)
5. Place wet wooden tongue depressor on wet towel surface, at the same angle as the delivery system so beam is emitted at a
perpendicular angle.
6. Set laser for 5 W, single pulse, and fi re onto the wet target.
Never fi re the laser if you do not see the aiming beam
7. Examine the test spot for alignment and beam profi le.
8. Repeat the test in all modes (repeat, continuous wave, superpulse, etc.).
9. Turn laser to standby if ready to begin, to off if leaving the room.
10. Document test results in the laser log.
11. For questionable results, request repeat test by the LSO.
Date Approved:
Approved By:
Table 17.6
Flammability Hazards and Fire Safety
Purpose
: To prevent the risk of incidents and accidents involving laser ignition of materials, tissues, or other substances.
Policy
: All procedures regarding safe application of laser energy will be adhered to during clinical use, demonstrations, service, and all
other laser operations.
Procedures
:
1. Laser personnel will know the location of the nearest fi re extinguisher.
2. Water will be readily available during all laser procedures.
3. Nonrefl ective instruments and/or devices will be used in the path of the beam and in the operative fi eld.
4. No alcohol-based solutions will be used in the beam path, or on target tissue.
5. Iodophor-based solutions will be allowed to dry thoroughly before the laser is activated.
6. Wet cloth towels will be used to drape the tissues immediately adjacent to the treatment site that may be exposed to direct or diffuse
laser energy.
8. The anus will be protected with a wet sponge, during perianal procedures, to prevent ignition of methane gas.
9. No disposable or dry materials will be used near the treatment site or near the path of the laser beam.
10. Nail polish in the treatment area will be removed prior to treatment or covered with wet cloth material throughout the procedure.
Date Approved:
Date Reviewed:
Table 17.7
Handling of Fiber Delivery Systems
Purpose
: To promote safe and appropriate handling of laser fi ber delivery systems and to limit the potential for fi ber breakage, damage, and
reduced effi ciency during clinical laser procedures.
Policy
: Personnel handling laser fi bers will assure compliance with all safety procedures, and will consider the fi ber an extension of the laser
system, governed by all standards and regulations.
Procedures
:
1. Examine the fi ber for breaks, kinks, or other obvious damage, along the length of the sheath, at the proximal end and at the distal end,
prior to attaching to the laser.
2. Insert connector into the laser, taking care not to scratch the optical surface of the proximal end of the cable.
3. Calibrate the fi ber according to the manufacturer's directions and chart the results on the laser log.
4. Never fi re the laser if you do not observe the aiming beam.
5. Position the fi ber on the fi eld and secure safely. Do not use clamps or other instruments to secure the fi ber to the operative site.
6. Secure the fi ber in the antenna, when it is not in use.
7. Monitor the fi ber during use for: distortion of the beam, accumulation of debris on the tip, or decreased power transmission.
8. Never place a hot fi ber on the drapes. Wait until the tip is cool, before placing it in contact with potentially fl ammable materials.
9. When fi ber is removed from the unit, the dummy plug must be inserted into the fi ber connector port.
Date Approved:
Approved By: