NONIONIZING

RADIATION
Prepared by
Tufail Ahmad
NONIONIZING RADIATION
 any type of electromagnetic radiation that does not carry enough energy
to ionize atoms or molecules
 Radiant energy in the form of heat and/or light is emitted from radiowaves,
microwaves, televisions, computers, radiant warmers, and light sources.
 For example, overhead operating lights produce heat.
 Fibreoptic light cables are cool, but the light transmitted is intense and can
produce heat.
 Radiation from these sources is nonionizing (with the exception of
ultraviolet lights, which can produce radiant energy in wavelengths and
intensity sufficient to alter DNA in cells, burn tissue, and damage the eyes).
 Nonionizing radiation does not accumulate in the body and therefore does
not require monitoring.
 NONIONIZING RADIATION
 Lasers, one form of nonionizing radiation, concentrate very-high-energy light
beams within a small circumference to produce intense heat. (Laser is an
acronym for light amplification by stimulated emission of radiation.)
 Laser equipment should be used in accordance with established regulatory
standards and guidelines and the manufacturer’s instructions for laser safety.
 Lasers can vaporize, cut, or coagulate tissues directly exposed to the beams.
 They can cause thermal burns from indirect exposure. Fire, explosion, eye and
skin exposure, and laser plume (smoke) also are potential hazards for patients
and personnel.
NONIONIZING RADIATION
 Eyewear of the correct optical density is required and reflective surfaces
should be covered.
 Safety measures should be taken.
 A laser warning sign is prominently displayed outside the door where a
laser is in use.
 Correct eyewear should be available outside the door in case authorized
personnel must enter the room when the laser is active.
MAGNETIC RESONANCE
IMAGING
 The first human testing of magnetic imaging took place in 1977.
 It took more than 5 hours to accomplish.
 Today this technology is becoming a diagnostic and interventional
standard.
 Patients with implanted stainless steel clips and other components, such as
older-style pacemakers, can suffer injury in the presence of magnetic
resonance imaging (MRI).
 Implanted clips may be attached to intracranial vessels or other structures
that could be injured if exposed to extreme magnetic forces.
MAGNETIC RESONANCE
IMAGING
 Patients with stimulator leads are at risk because the metal in the leads will
become superheated, causing tissue injury.
 Examples of implanted stimulators include pacer wires, spinal or neurologic
stimulators, and internal defibrillator wires.
 No magnetic metal object can be used within the MRI environment.
 Items have been pulled from caregivers’ pockets, including scissors.
 Instrument tables, IV poles, oxygen tanks, instrumentation, and OR
furniture cannot be composed of any magnetic substance.
 Titanium or plastic is commonly used in this environment because it is inert
and nonmagnetic.
 ELECTRICITY
 The appropriate use of electronic devices is a prime concern of health care
providers and industry personnel who seek safer patient care.
 Underlying this concern is the rapidly expanding use of electronic equipment.
 The marketing and safety standards of medical electronic devices used in
the perioperative environment are federally regulated.
 The standards and practices recommended by the Association for the
Advancement of Medical Instrumentation (AAMI) are helpful to both
manufacturers and users.
 Inadequately trained personnel or the malfunctions of devices such as
electrosurgical units (ESUs), defibrillators, and radiograph machines are
responsible for the fatalities and near fatalities that occur.
 Parameters of Electricity Electricity is the flow of electrons along a path. It
consists
of three basic parameters: voltage, resistance, and current.
 Voltage Voltage forces electrons to move through material in one direction
and causes current to flow. It is measured in volts.
 The greater the number of volts, the more direct is the path of the current.
 Resistance Resistance is the measurement of opposition to the flow
of electrons through material. It is measured in ohms.
 Electricity flows easily through conductors (e.g., metals, carbon, water); flow is
minimized by insulators (e.g., rubber, plastic, glass) that prevent the flow of
electricity.
 The resistance of the human body is more similar to a conductor than an
insulator.
 Current Current is the rate of flow of electrons through a conductor.
 It is measured in amperes—the number of electrons passing a given point
each second. Current flow is proportional to voltage and inversely
proportional to resistance.
 Current may be one of two types:
1. Direct current (DC), as from a battery. This is a lowvoltage current.
2. Alternating current (AC), as from a 110- or 220-volt line.
 This type of current has an alternating directional flow.
 AC is considered low voltage, but it is three times more powerful than low-
voltage DC
GROUNDING
 The grounding of all electrical equipment is essential for safety and the
prevention of stray current leakage.
 Grounding systems are designed to discharge any harmful electricity
directly to the ground without including the patient in the circuit.
 This prevents the inadvertent passage of electric current through the
patient, thereby preventing shock or burn.
 ESUs are grounded. When using a monopolar ESU a return electrode or
dispersive electrode is positioned on the patient to disperse the electrical
energy and return it to the generator.
 The pad itself is not a ground, but a path for the current to return back to
the machine.
 Electrical power is supplied through two wires—hot and neutral—that
transmit current to the three-wire outlets in the building.
 The third wire is the ground wire.
 When the cord from an electrical device is plugged into an outlet, the
hot and neutral wires deliver the current.
 The ground wire is attached to a copper pipe that is driven into the ground
at the point where power enters the building.
 An electrical connection to the ground provides a means for current to
flow through the ground wire (or any other conductive surface) to the
ground rather than going to the neutral wire.
 The copper ground wire is used to prevent the metal housings of electrical
equipment from becoming electrically “hot.”
 The ground wire within the three-wire power plug and cord connects the equipment
(instrument) housing to the ground contact in the receptacle (wall outlet).
 This provides a constantly available return path for current to the electrical source.
 When an instrument is grounded, leakage current returns through the ground wire
to earth, causing no damage.
 However, if the ground path is absent or broken, leakage current will seek another
path to ground.
 For example, if the insulation on wires is defective (e.g., broken or frayed cords or
plugs), some current will leak or flow to other nearby conductors, such as the
equipment housing.
 The same is true of endoscopic instrumentation with fractured insulation. The
current will pass into the patient’s tissues, causing an inadvertent injury.