potential burns and electrical shock. Another hazard tokeep in mind is that of fire. Ensure that the bedding andthe heat source do not come in direct contact and causethe bedding to ignite. Occasionally, heat lamps areused to accomplish the same results as a heat cradle.Do not use towels, pillow cases, or linen of any kind todrape over heat lamps. In fact, no lamps of any kindshould be draped with any kind of material, regardlessof the purpose of the draping.STEAM VAPORIZERS AND HOT FOODSAND LIQUIDS.—Steam vaporizers and hot foodsand liquids are common causes of patient burns. Whenusing steam vaporizers, ensure that the vapor of steamdoes not flow directly on the patient as a result of theinitial positioning of the equipment or by accidentalmovement or bumping. Patients sensitive to hot foodsand liquids are more likely burned. Also, because oflack of coordination, weakness, or medication,patients may be less able to handle hot foods andliquids safely without spilling them.In the direct patient care units as well as indiagnostic and treatment areas, there is unlimitedpotential for inflicting burns on patients. When themodern electrical and electronic equipment and thepotent chemicals used for diagnosis and treatment areused properly, they contribute to the patient’s recoveryand rehabilitation. When they are used carelessly orimproperly, these same sources may cause patientsadditional pain and discomfort, serious illness, and, insome cases, death.Fire and Explosion PrecautionsOften when we speak of safety measures, one ofour first thoughts is of a fire or an explosion involvingthe loss of life or injury to a number of people. Goodhousekeeping, maintenance, and discipline helpprevent such mishaps. Remember that buildingsconstructed of fire-resistant materials may not befireproof, and they are certainly not explosion proof.Good maintenance includes checking, reporting, andensuring correct repair of electrical equipment, androutine checking of fire fighting equipment byqualified personnel. The education and training ofpersonnel are the most effective means of preventingfires. Used in the context of fire safety measures, gooddiscipline means developing a fire plan to use asoutlined in a fire bill, having periodic fire drills, andenforcing no-smoking regulations.FIRE EVACUATION PROCEDURES.—Staffmembers should be familiar with the fire regulations attheir duty station and know what to do in case of fire.Staff should know how to report a fire, use a fireextinguisher, and evacuate patients. When a fireoccurs, there are certain basic rules to follow: Thesenior person should take charge and appoint someoneto notify the fire department and the officer of the dayof the exact location of the fire. Everyone shouldremain calm. All oxygen equipment and electricalappliances must be turned off unless such equipment isnecessary to sustain life. All windows and doorsshould be closed and all possible exits cleared. Whennecessary and directed by proper authority, patientsshould be removed in a calm and orderly fashion andmustered outside.SMOKING REGULATIONS.—By regulation(BUMEDINST 6200.12, Tobacco Use in NavyMedical Department Activities), smoking is no longerpermitted in Navy hospitals. To ensure general safetyand awareness of this prohibition, inform patients,visitors, and staff of the facility’s no-smoking status byprominently displaying “No Smoking” signsthroughout the hospital—especially in rooms andareas where oxygen and flammable agents are used andstored.Safety Precautionsin the Operating RoomSince safety practices are important to emphasize,this section will cover some of the situations that arepotentially hazardous in the operating room anddiscuss what might be done to eliminate the hazard.All personnel should know the location of allemergency medications and equipment in theoperating room. This includes drugs, cardiac arrestequipment, and resuscitators. All electrical equipmentand plugs must be of the explosion-proof type and beara label stating such. There should be written schedulesof inspections and maintenance of all electricalequipment. Navy regulations prohibit the use ofexplosive anesthetics in the operating room. Theseregulations, however, do not mean we can lessen ourconcern for fire and explosion hazards. The surface ofall floors in the operating room must provide a path ofelectrical conductivity between all persons andequipment making contact with the floor to prevent theaccumulation of dangerous electrostatic charges. Allfurniture and equipment should be constructed ofmetal or of other electrically conductive material andshould be equipped with conductive leg tips, casters, orequivalent devices. Periodic inspections should bemade of leg tips, tires, casters, or other conductive2-26
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