FEATURE


plumes and are considered ignition sources. As ignition sources, Class 4 lasers can cause fires when used carelessly or without proper safety precautions in place.”


Laser Show


Wider use of the technology calls for stringent safety requirements BY ROBERT KURTZ


L


aser safety is an issue more ASCs need to address as the use of


lasers grows and expands into vari- ous surgical specialties, says Leslie Pollard, a board liaison to the Wash- ington, DC-based American National Standards Institute (ANSI) and owner of Southwest Innovative Solutions, a Richardson, Texas-based company that provides laser education and training. Some of the common specialty- specific ways that ASCs are using lasers, Pollard says, include: ■


Urology—during lithotripsy, treat- ment of strictures, benign bladder lesions and other endoscopic as well as external soft tissue proce- dures;


■


Ophthalmology—in retinal work, treatments for glaucoma or poste- rior capsulotomies;


16 ASC FOCUS JUNE/JULY 2014 ■


Gynecology—in the treatment of human papillomavirus and cervical cones and as a useful tool for opera- tive laparoscopy;


■ ENT—for ■ applications such as


microlaryngoscopy and endosinus work; and


Podiatry—for the treatment of con- ditions such as toenail fungus. In addition, lasers are used fre-


quently in many plastic surgery and dermatology procedures and in the treatment of small vascular anomalies and larger vascular pathologies.


Learn the Rules “Most


medical/surgical lasers are classified as Class 3b or Class 4 laser devices, and this means there is enough laser energy coming out of that device to cause serious eye injuries or skin burns,” Pollard says. “In addition, Class 4 lasers can create dangerous smoke


When assessing the use of lasers, there are three areas of safety ASCs must focus on, says Vangie Dennis, RN, administrative director for Spivey Station Surgery Center in Jonesboro, Georgia, and board liaison to ANSI. “From a patient perspective, the dangers incorporate eye safety and risk of fire, just like electrosurgery,” she says. “From a staff safety per- spective, it is primarily eye injuries. It could be fire, but that is remote unless something is performed incor- rectly. Then there is equipment safety, which entails proper assessment of the equipment and an understanding of the impact of the laser energy to tissue.”


The first step to ensuring laser safety is to understand the rules and recommended practices for laser use, says Pollard. “There are many guidelines available to help facilities develop a compliant program. These resources include the ANSI z136.3 document, the Association of periOperative Registered Nurses’


(AORN) Laser


Safety Recommended Practices, the Laser Institute of America’s (LIA) medical laser safety officer (MLSO) best


practices and the Occupational Safety and Health Administration’s (OSHA) laser safety guidelines.” Lasers are federally regulated.


“People may think that there are just recommendations from AORN and ANSI for laser use, but LIA has an alignment with OSHA,” Dennis says. Some states have requirements as


well, Pollard says, including special laser safety awareness, laser device registration, laser facility registration and possibly even documentation showing proper training of a facility medical laser safety officer onsite.


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