Precautionary practices for administering anesthetic gases: a survey of physician anesthesiologists, nurse anesthetists and anesthesiologist assistants

Details

• Personal Author:
  Boiano, James M. ; Steege, Andrea L.
• Description:
  Scavenging systems and administrative andwork practice controls for minimizing occupational exposure to waste anesthetic gases have been recommended for many years. Anesthetic gases and vapors that are released or leak out during medical procedures are considered waste anesthetic gases. To better understand the extent recommended practices are used, the NIOSH Health and Safety Practices Survey of Healthcare Workers was conducted in 2011 among members of professional practice organizations representing anesthesia care providers including physician anesthesiologists, nurse anesthetists, and anesthesiologist assistants. This national survey is the first to examine self-reported use of controls to minimize exposure to waste anesthetic gases among anesthesia care providers. The survey was completed by 1,783 nurse anesthetists, 1,104 physician anesthesiologists, and 100 anesthesiologist assistants who administered inhaled anesthetics in the seven days prior to the survey.Working in hospitals and outpatient surgical centers, respondents most often administered sevoflurane and, to a lesser extent desflurane and isoflurane, in combination with nitrous oxide. Use of scavenging systems was nearly universal, reported by 97% of respondents. However, adherence to other recommended practices was lacking to varying degrees and differed among those administering anesthetics to pediatric (P) or adult (A) patients. Examples of practices which increase exposure risk, expressed as percent of respondents, included: using high (fresh gas) flow anesthesia only (17% P, 6% A), starting anesthetic gas flow before delivery mask or airway mask was applied to patient (35% P; 14% A); not routinely checking anesthesia equipment for leaks (4% P, 5% A), and using a funnel-fill system to fill vaporizers (16%). Respondents also reported that facilities lacked safe handling procedures (19%) and hazard awareness training (18%). Adherence to precautionary work practices was generally highest among nurse anesthetists compared to the other anesthesia care providers. Successful management of waste anesthetic gases should include scavenging systems, hazard awareness training, availability of standard procedures to minimize exposure, regular inspection of anesthesia delivery equipment for leaks, prompt attention to spills and leaks, and medical surveillance. [Description provided by NIOSH]
• Subjects:
  Anesthesia Environmental Exposure Health Personnel Nitrous Oxide Occupational Health Risk Assessment Risk Factors Safety Solvents Staff Development
• Keywords:
  Anesthetic Gases Anesthetics Author Keywords: Anesthesia Care Providers Exposure Controls Exposure Levels Gases Hazards Health Care Personnel Medical Personnel Nitrous Oxide Nurses Physicians Precautionary Practices Risk Factors Safety Measures Statistical Analysis Surveillance Training Vapors Waste Anesthetic Gases Web Survey

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• ISSN:
  1545-9624
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Ohio ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DSHEFS - Division of Surveillance, Hazard Evaluations, and Field Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  13
• Issue:
  10
• NIOSHTIC Number:
  nn:20048527
• Citation:
  J Occup Environ Hyg 2016 Oct; 13(10):782-793
• Contact Point Address:
  James M. Boiano, National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations and Field Studies, 1090 Tusculum Ave., MS R-17, Cincinnati, OH 45226-1998
• Email:
  jboiano@cdc.gov
• CAS Registry Number:
  Nitrous oxide (CAS RN 10024-97-2) ; Sevoflurane (CAS RN 28523-86-6)
• Federal Fiscal Year:
  2017
• NORA Priority Area:
  Healthcare and Social Assistance
• Peer Reviewed:
  True
• Source Full Name:
  Journal of Occupational and Environmental Hygiene
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:9525981af3e27ad657eeb4d9f5b6784e2fa350676bee60edbd7b41f1912ca206f2dbfa570e2ab974924c85c7ddf359f648dae5ff9e9265bf2929d37255aa8389
• Download URL:
  https://stacks.cdc.gov/view/cdc/203267/cdc_203267_DS1.pdf
• File Type:
  [PDF - 692.03 KB ]