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KEY POINTS

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KEY POINTS

  1. Periprocedural environmental risk factors include electrical, fire, radiation, and chemotherapeutic considerations along with occupational risks, including needlesticks, bodily fluid exposure, and slips, trips, and falls.

  2. Anesthesia providers must have a general understanding of these risks and preventive measures to serve as effective advocates for patients, colleagues, and themselves.

  3. Many regulatory bodies, professional societies, and standards organizations provide guidelines for environmental safety in anesthetizing locations.

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INTRODUCTION

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Health care providers recognize patient safety as a primary area of concern. Anesthesia providers must take this responsibility especially seriously because they practice in an environment of increased patient risk and do so with the intent of reducing the patient’s ability to respond to stimulus on his or her own. Increasingly, as anesthesia services move out of the operating room (OR) and into other procedural areas within the hospital, knowledge of these environmental risks becomes even more critical. Perioperative and periprocedure teams led by anesthesiologists must act as the patient’s steward in both risk avoidance and crisis management. In addition to the patient’s safety, the anesthesia provider must consider the safety of periprocedural colleagues and himself or herself. Many decisions as simple as draping technique, electrical outlet connection, supply selection, and equipment positioning can have serious implications for all persons in the vicinity of care.1,2

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As minimally invasive interventions increase in popularity, anesthesia care is more frequently pulled out of the relatively highly regulated OR and into procedure rooms, intensive care unit (ICU) bed spaces, and physician offices. To provide safe and effective care in these areas, it is important that anesthesia providers understand the origins of OR safety requirements so that they can apply them as needed during remote anesthetics. Attention is often given to electrical and fire safety. It is important to recognize that environmental safety in the periprocedural space also includes chemical, radiation, and other occupational risks. Regulatory bodies oversee management of many of these risks and therefore the risks must be well understood.

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General knowledge of the potential environmental safety hazards associated with anesthesia and its related equipment will help providers protect themselves and their clinical colleagues and act as effective advocates for their patients. This chapter reviews several common environmental risk factors associated with anesthesia care and discusses infrastructure, equipment, and procedures used to prevent and react to critical events. These common risks include electrical safety, fire safety, occupational safety, risk of exposure to chemotherapeutics and radiation, and the interface of regulatory bodies in oversight of the environment.3 Regulatory bodies provide guidance on environmental safety, and they serve as additional resources for the safe design, construction, and maintenance of anesthetizing locations and are reviewed for reference and to familiarize providers with the bodies that encourage safety in their clinical space.

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ELECTRICAL SAFETY

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As electronic and, more recently, computerized equipment becomes more prevalent in anesthetizing locations, ...

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