THE COMPLIANCE DOCTOR, LLC

LASER SAFETY PROGRAM POLICIES

These are Laser Safety Policies for Surgery Ceters a! Me!ical Ceters that "ay #e use! as a te"$late for your
o% facilities $olicies& They are based on ANSI 136.3, 2005 e!o""ended s#andads& ANSI $ro'i!es "ay
o$tios for the Laser Safety Officer to iitiate cotrol "easures a! !eter"ie the No"ial Ha(ar! )oe *%here you
ha'e to %ear safety glasses+& These reco""e!e! $olicies ser'e si"$ly as a te"$late a! your facility shoul! !eci!e
ho% to chage $ro'isios of these $olicies to suit your o% circu"staces a! e'aluatio of the ha(ar! le'el&
,urther safety cosultig, safety au!its, a! i-house traiig o your o% e.ui$"et is a'aila#le fro" our
orgai(atio #y cotactig us through the %e#site %%%&theco"$liace!octor&co", or callig /0/-12/-3/// i the
4&S&
POLICY5 To esure the $ro$er a! safe use of this facilities "e!ical laser e.ui$"et, a! to
cre!etial $hysicias a! staff for use of lasers i this facility&
P$RPOSE% To $ro'i!e for $atiet a! $ersoel safety !urig laser $roce!ures
To $ro'i!e for o$ti"u" a! effecti'e use of the laser
To $ro'i!e for the $ro$er care of the laser a! relate! e.ui$"et&
PROCE&$RES%
I& A$$oit"et a! Res$osi#ilities of the Laser Safety Officer *LSO+
A i!i'i!ual shall #e a$$oite! #y the hos$ital a!"iistratio to ser'e as the facility
Laser Safety Officer, a! to ha'e cross-!e$art"etal authority throughout the facility
to "aage the Laser Safety Progra", as !escri#e! i A&N&S&I
6
& )6/1&/ sta!ar!s for
the Safe 4se of Lasers i Health Care ,acilities& They "ay elist the a!'ice or
assistace of laser "aufacturers, cosultats or 7o%le!gea#le i!i'i!uals to assist
i the "aage"et of this safety $rogra" %ithi the #u!getary gui!elies a!
$olicies of this facility&
a& Authority 8 The LSO shall ha'e the authority to sus$e!, restrict or ter"iate the
o$eratio of the Health Care Laser Syste" *HCLS+ if they !ee" that a ha(ar!ous
co!itio e9ists& They %ill a!!itioally otify the o$eratig $hysicia of such
ha(ar!& The LSO "ay !elegate this authority to the !e!icate! Laser Assistats
o$eratig the e.ui$"et&
#& Delegatio of Authority 8 it is u!erstoo! that the res$osi#ilities of the LSO i
eforcig the %ritte laser safety $olicies a! $roce!ures, a! "oitorig the
laser treat"et cotrolle! area for safety !urig $roce!ures, are !uly !elegate! to
the !e!icate! Laser Assistats %ho "ay #e o$eratig the laser e.ui$"et %hile
the LSO is ot actually i the treat"et roo"&
c& A$$oit"et of a A!-Hoc Laser Safety Co""ittee 8 The LSO "ay, fro" ti"e
to ti"e, o a as-ee!e! #asis, for" a Laser Safety Co""ittee co"$rise! of
"e"#ers of the $hysicia staff, !e$art"etal !irectors a! hos$ital e"$loyees for
the $ur$ose of colla#orati'ely a!!ressig s$ecific laser safety $rogra" issues& The
LSO "ay also !is#a! such te"$orary co""ittees %he its $ur$ose has #ee
"et&
6
A"erica Natioal Sta!ar!s Istitute
THE COMPLIANCE DOCTOR, LLC
!& Laser Safety Officer Cre!etialig Sta!ar!s&
i& The LSO shall #e a i!i'i!ual %ith the traiig, self stu!y a! resources
!ee"e! a$$ro$riate #y the hos$ital a!"iistratio to a!"iister the Laser
Safety Progra"& Their #ac7grou! "ay iclu!e, #ut shoul! ot #e li"ite!
to, urses, #io"e!ical egieers, or e'iro"etal health a! safety
officers, %ho ha'e o#taie! a$$ro$riate traiig to "aage the Laser
Safety Progra"&
ii& Traiig shall iclu!e5
6& geeral laser a! eergy coce$ts *$hysics+, tissue iteractios a!
laser safety&
0& ha!s-o orietatio to the Surgery Ceters s$ecific lasers
/& Laser Safety Progra" "aage"et iclu!ig fa"iliarity %ith
A&N&S&I& )6/1&/ reco""e!e! sta!ar!s for the Safe 4se of
Lasers i Health Care ,acilities&
The facility %ill also recogi(e i!i'i!uals certifie! #y the Natioal Coucil o
Laser E9cellece *a! the a!"iisterig :oar! of Laser Safety of the LIA+ as
Certifie! Me!ical Laser Safety Officer, as ha'ig "et these re.uire"ets&
e& Duties of the LSO5
i& The LSO shall "aage a! a!"iister the o'erall laser safety $rogra" of
this facility, #ase! u$o their ifor"e! ;u!g"et of the $otetial laser
ha(ar!s a! cotrol "easures %hich they choose to i"$le"et to $rotect
agaist these ha(ar!s, utili(ig the ANSI )6/1&/ reco""e!e! sta!ar!s
as a gui!elie&
ii& Esta#lish %ritte laser safety $olicies a! $roce!ures, %or7ig
colla#orati'ely %ith the $hysicia staff a! other !e$art"ets %here
ee!e!&
iii& A$$ro'e the HCLS istallatio, use a! o$eratio, iclu!ig the
suita#ility of the facilities for safe o$eratio&
i'& The LSO has the authority to allo% !e'iatio fro" these %ritte $olicies
a! $roce!ures o a s$ecific $er case #asis %he circu"staces i!icate
that this "ay #etter ser'e or facilitate the $atiet<s treat"et %ithout
co"$ro"isig safety, a! to re-e'aluate a! "o!ify safety $olicies a!
$roce!ures as ee!e! to effecti'ely "aage the laser safety $rogra" o a
ogoig #asis&
'& =or7 colla#orati'ely %ith the hos$ital $hysicia cre!etialig "echais"
to esure that $hysicias are $ro$erly cre!etiale! i the use of the
facilities laser e.ui$"et, a! to 7ee$ a curret list of authori(e!
$hysicia users for the $ur$ose of authori(ig the sche!ulig of laser
cases&
'i& Esure that $ro$er safety traiig is $ro'i!e! to all staff %or7ig i the
$resece of the HCLS&
'ii& Esure that $ro$er safety a! o$eratioal traiig is $ro'i!e! to the
!e!icate! Laser Assistats, a! to a$$ro'e the cre!etialig of such
assistats&
THE COMPLIANCE DOCTOR, LLC
'iii& Esure that the $ro$er $rotecti'e safety e.ui$"et, such as laser %arig
sigs, safety eye%ear, s"o7e e'acuatio e.ui$"et, etc&, is a'aila#le, i
goo! co!itio a! a$$ro$riate for the laser $roce!ure #eig $erfor"e!&
i9& I colla#oratio %ith the o$eratig $hysicias a! aesthesia, a$$ro'e
$atiet eye $rotectio "easures such as safety eye%ear, o$a.ue "etal eye
shiel!s, coreal shiel!s, "oistee! !ra$es or s$oges as !ee"e!
a$$ro$riate&
9& I'estigate all 7o% or sus$ecte! acci!ets resultig fro" the o$eratio
of a laser, a! iitiate a$$ro$riate actios iclu!ig co"$liace %ith the
hos$ital<s ici!et re$ortig $olicy&
9i& Esure that the laser e.ui$"et is $ro$erly "aitaie! #y .ualifie!
i!i'i!uals iclu!ig the facility #io"e!ical egieerig !e$art"et, thir!
$arty ser'ice agets, or the laser "aufacturer&
9ii& Esure that #oth Laser O$eratig Mauals a! Laser Ser'ice Mauals
*co"$lete %ith s$ecific alig"et a! cali#ratio ifor"atio+ are
o#taie! for each laser i use %ithi the facility&
9iii& Esure that laser retal grou$s or ay si"ilar cotract laser ser'ice that
o$erate %ithi this facility has su$$lie! to the LSO !ocu"etatio of
a$$ro$riate traiig of their $ersoel a! $erio!ic "aiteace of their
e.ui$"et& The LSO %ill also acce$t NCLE
0
Laser Safety Officer or
Laser O$erator certificatios as e'i!ece of a$$ro$riate traiig& The LSO
%ill su$$ly such retal>cotract ser'ice o$erators a co$y of the facilities
%ritte laser safety $olicies a! $roce!ures a! re.uire their co"$liace
%hile o$eratig %ithi the facility&
9i'& Co!uct a co"$rehesi'e Laser Safety Au!it>Is$ectio of the facilities
Laser Safety Progra", iclu!ig $hysical is$ectio of all HCLS a!
$rotecti'e safety e.ui$"et, o a aual #asis& This "ay #e $erfor"e!
!irectly #y the LSO or "ay #e !elegate! to cosultats or orgai(atios
$ro'i!ig such Laser Safety Au!its>Is$ectios&
9'& :eco"e a "e"#er of the A"erica Society for Laser Me!icie a!
Surgery *ASLMS+, i or!er to stay a#reast of !e'elo$"ets i the "e!ical
laser fiel!, a! to !istri#ute such co""uicatios to hos$ital $hysicias
a! staff as !ee"e! a$$ro$riate&
9'i& Maitai cotiuig e!ucatio o a aual #asis i the area of
"e!ical>surgical laser use or safety, such as the aual scietific "eetig
of the A"erica Society for Laser Me!icie ? Surgery or other laser
relate! $rogra"s or "eetigs&
II& Physicia Cre!etialig Sta!ar!s
a& Physicias %ishig to utili(e the 'arious lasers of this facility "ust #e $ro$erly
traie! i the use of such e.ui$"et a! su#"it their cre!etials for a$$ro'al to
their res$ecti'e !e$art"ets, through the Chief of Staff<s office& The Chief of
Staff<s office %ill the for%ar! a u$!ate! listig of a$$ro'e! $hysicia users to
0
Natioal Coucil o Laser E9cellece, a cre!etialig #oar! of the o-$rofit Professioal Me!ical E!ucatio
Associatio& 8 %%%&LaserCertificatio&org
THE COMPLIANCE DOCTOR, LLC
the Laser Safety Officer a! the O$eratig Roo" Coor!iator o a "othly #asis
*uless o a!!itioal a$$ro'als ha'e #ee grate! %ithi that ti"e+& A$$ro'al
%ill #e for each ty$e of laser i!i'i!ually& Such traiig shall iclu!e5
i& geeral laser a! eergy coce$ts *$hysics+, tissue iteractios a! laser
safety&
ii& cliical cosi!eratios for the s$ecific lasers a! a$$licatios iclu!ig
i!icatios, cotrai!icatios, $roce!ural techi.ues, co"$licatios a!
"aage"et of co"$licatios&
iii& ha!s-o traiig %ith the s$ecific ty$e of laser
i'& orietatio to the o$eratio a! user o$tios o the hos$ital<s s$ecific
laser syste" $ro'i!e! #y the Laser Safety Officer or their !esigee&
Such traiig "ay #e o#taie! through their resi!ecy $rogra", for"ali(e!
courses, or i!i'i!uali(e! stu!y iclu!ig i!i'i!ual re'ie% of the "e!ical
literature a! %or7 %ith the laser "aufacturer or $artici$atio i a co"#iatio
of stu!y e9$erieces that %ill "eet these re.uire"ets& It "ay also #e e'i!ece!
#y curret cre!etialig of the a$$licat #y other Surgery Ceters or "e!ical
ceters for the sa"e ty$e of lasers>a$$licatios&
#& Physicias %ill #e a$$ro'e! for $roce!ures oly %ithi their sco$e of "e!ical
$ractice&
c& The chief of their res$ecti'e !e$art"et %ill "a7e the fial reco""e!atio o
a$$ro'al of the a$$licatio&
!& A laser cre!etiale! $hysicia shall #e $reset for the first 0 cases&
e& E'i!ece of laser cre!etialig at aother accre!ite! "e!ical facility %ill #e
sufficiet for gratig of laser $ri'ileges at this facility&
f& Oce a iitial a$$ro'al for $ri'ileges of oe laser ty$e is grate!, $ri'ileges for
a!!itioal ty$es of lasers "ay o#taie! #y "a7ig si"ilar a$$licatio a!
sho%ig e'i!ece of icre"etal traiig %ith the @e%A ty$e of laser& The e9tet
of this icre"etal traiig %ill #e !eter"ie! #y their !e$art"et chief #ase! o
ho% si"ilar the laser a!>or $roce!ure is to those alrea!y a$$ro'e!, #ut at a
"ii"u" %ill re.uire a #rief orietatio to the s$ecific laser e.ui$"et&
III& Sche!ulig Proce!ure
a& The curret list of .ualifie! $hysicias, su$$lie! #y the Chief of Staff<s office to
the O$eratig Roo" Coor!iator shall ser'e as the #asis for $hysicia sche!ulig
of laser use&
#& Sche!ulig %ill #e o a first sche!ule!, first ser'e! #asis&
IB& Presece of the res$osi#le Physicia 8 The $hysicia %ho has #ee cre!etiale! for
the laser use "ust re"ai i the treat"et roo" at all ti"es !urig laser use& A
resi!et, fello% or aother staff $hysicia #eig $rece$tore! "ay utili(e the laser
u!er their !irectio, #ut the res$osi#le $hysicia "ust #e $reset at all ti"es&
B& Selectio of Laser Treat"et Para"eters, Mo!es of O$eratio a! E.ui$"et
Cofiguratios 8 It is the sole res$osi#ility of the o$eratig $hysicia to select the
laser $ara"eters a! e.ui$"et cofiguratio #y %hich the $atiet is treate!& The
$hysicia shall re.uest these $ara"eters fro" the !e!icate! Laser Assistat %ho shall
THE COMPLIANCE DOCTOR, LLC
cofigure a! set the laser e.ui$"et as re.ueste!& Ay suggestios or
reco""e!atios #y the Laser Assistat are to #e for ifor"atioal $ur$oses oly
a! the sole res$osi#ility for the settigs shall #e the o$eratig $hysicia<s&
BI& De!icate! Laser Assistats
a& A !e!icate! laser assistat shall #e assige! to set u$ a! o$erate the laser
e.ui$"et, a! "oitor the laser treat"et cotrolle! area for safety !urig the
$roce!ure& ,ro" the ti"e the laser 7ey s%itch is acti'ate!, to the ti"e it is ture!
off, the laser assistat shall ha'e o other !uties e9ce$t for !irect o$eratio of the
laser cotrol $ael a! to "oitor the roo" for co"$liace %ith safety $olicies ?
$roce!ures&
BII& Laser Assistat Cre!etialig Sta!ar!s
a& Nurses>Techicias %ho ha'e #ee selecte! to o$erate the laser e.ui$"et !urig
surgical $roce!ures shall #e $ro$erly traie! i laser safety, o$eratio of the
s$ecific laser uits a! the facilities s$ecific laser safety $olicies a! $roce!ures&
Cre!etialig of such assistats is through a$$ro'al of the Laser Safety Officer
*LSO+& Laser assistats "ay #e RN<s, LPN<s, PA<s, Surgical Techicias or other
i!i'i!uals !ee"e! .ualifie! #y the LSO& The LSO shall "aitai a curret list of
cre!etiale! Laser Assistats %ith the O$eratig Roo" Coor!iator for the
$ur$ose of coor!iatig sche!ules for laser cases&
#& Traiig shall iclu!e5
i& geeral laser a! eergy coce$ts *$hysics+, tissue iteractios a! laser
safety&
ii& ha!s-o traiig %ith the facilities s$ecific laser*s+
iii& Istructio i the hos$ital<s %ritte laser safety $olicies a! $roce!ures&
Such traiig "ay #e o#taie! fro" the "aufacturer or aother cre!etiale!
laser assistat or the LSO, for"ali(e! courses, or i!i'i!uali(e! stu!y iclu!ig
i!i'i!ual ho"e stu!y $rogra"s, i ay co"#iatio that "eets these three
re.uire"ets& The facility %ill also recogi(e i!i'i!uals certifie! #y the Natioal
Coucil o Laser E9cellece as Certifie! Laser O$erators>Surgical or Certifie!
Me!ical Laser Safety Officer as ha'ig "et these re.uire"ets&
c& Aother cre!etiale! assistat, or the Laser Safety Officer, shall #e $reset for the
first 0 cases&
!& Oce a iitial a$$ro'al for oe laser ty$e is grate!, a$$ro'al for a!!itioal
ty$es of lasers "ay o#taie! #y icre"etal istructio i the o$eratio of the
a!!itioal Laser syste"*s+ as !eter"ie! #y the LSO&
BIII& Maiteace of Laser Log for each case 8 The use of a laser log shall #e at the sole
!iscretio of the LSO as they "ay fro" ti"e to ti"e re.uire& This laser log shall #e
"aitaie! #y the !e!icate! Laser Assistat accor!ig to the $ara"eters o the
$rite! for"& The LSO "ay chage, a!! or eli"iate ifor"atio or this log as they
!ee" a$$ro$riate& The use of a laser log !oes ot $reclu!e or re$lace the ee! for
$atiet chartig as re.uire! #y la%, a! such a Laser Log is ot a re.uire"et of
ANSI 6/1&/&
THE COMPLIANCE DOCTOR, LLC
IC& Laser Safety>O$eratioal Chec7lists 8 A a##re'iate! chec7list for $ro$er laser setu$,
o$eratio a! safety shall #e utili(e! #y the !e!icate! laser assistat for each laser
case& The chec7list shall #e as !eter"ie! #y the LSO, a! "ay #e altere! #y the
LSO o a as ee!e! #asis&
C& Laser Treat"et Cotrolle! Area, No"ial Ha(ar! )oes a! use of Laser Safety
Eye%ear&
a& The Laser Treat"et Cotrolle! Area *LTCA+ shall #e the etire treat"et roo"&
Cotrol "easures to "aitai laser safety shall iclu!e5
i& A$$ro$riate %arig sigs %ill #e $oste! o each etrace to the roo",
a! re"o'e! %he the laser cases are ot #eig co!ucte!& These sigs
shall "eet ANSI reco""e!atios a! iclu!e the a$$ro$riate laser
%a'elegth*s+ so that staff %ill 7o% %hich eye%ear is a$$ro$riate&
ii& :e su$er'ise! #y the !e!icate! Laser Assistat assige! to the case to
"oitor the roo" for co"$liace %ith laser safety $olicies a!
$roce!ures& Such su$er'isio is re.uire! oly %he the laser 7ey is i the
acti'e @oA $ositio&
iii& Laser Safety Eye%ear, a$$ro$riate for the laser i use, shall #e "a!e
a'aila#le to $ersoel u$o etrace to the roo", regar!less of %here the
No"ial Ha(ar! )oe is !eclare!& All safety eye%ear shall #e la#ele!
accor!ig to the %a'elegth a! O$tical Desity *e9ce$t $atiet "etal eye
shiel!s, %hich $ro'i!e $rotectio agaist all laser %a'elegths+ The
!efault $olicy %ill #e for the etire roo" to #e !ee"e! the No"ial
Ha(ar! )oe *NH)+ for all laser cases, so that $ersoel %ill also ee! to
%ear their eye%ear u$o etry& The LSO !oes ha'e fle9i#ility i
cotractig this NH) for certai cases as e9$laie! else%here i this
safety $olicy, at %hich ti"e the glasses %ill ee! to #e %or oly %he i
the NH) a! ot the etire roo"&
i'& Laser Safety Eye%ear %ill #e %ithout !efect, a! %ill #e re"o'e! fro"
ser'ice if !efects are ote! i the fra"es, the filter "aterial or o$tical
coatigs&
'& The roo" %ill #e occu$ie! oly #y those $ersoel %ho ha'e ha!
!ocu"ete! traiig or orietatio to laser safety& If a $erso %ho has ot
ha! such !ocu"ete! safety traiig is re.uire! to #e i the roo", the the
laser assistat "ay $ro'i!e a .uic7 'er#al orietatio to laser safety a!
use of $rotecti'e e.ui$"et such as eye%ear a$$ro$riate to the laser case,
a! !ocu"et this orietatio i the laser log or i the $atiets chart&
'i& All %i!o% o$eigs ito the laser treat"et roo" *%he the NH) has
#ee !eclare! the etire roo"+ shall #e co'ere! %ith o$a.ue fla"e-
retar!at "aterial to #loc7 'ie%ig of the laser light fro" the outsi!e&
Such co'erigs %ill ot #e ecessary for the Car#o Dio9i!e Laser sice
that %a'elegth %ill ot $ass through the glass&
#& No"ial Ha(ar! )oe shall #y !efault iclu!e the etire Laser Treat"et
Cotrolle! Area *laser treat"et roo"+ so that laser safety eye%ear "ust #e %or
#y all $ersoel %ithi the roo" %he the laser is acti'e&
THE COMPLIANCE DOCTOR, LLC
c& No"ial Ha(ar! )oe "ay #e "a!e s"aller tha the etire treat"et roo"
/
, as
!eter"ie! #y the LSO *a! this authority !elegate! to the !e!icate! Laser
Assistat+ o a case #y case #asis utili(ig the follo%ig criteria& The LSO or the
!e!icate! laser assistat "ay co'ert the NH) #ac7 to the etire treat"et roo"
at ay ti"e if they #eco"e uco"forta#le %ith the situatio or e'iro"et of the
laser use&
i& Car#o Dio9i!e Laser use! i La$arosco$y& 8 The NH) "ay #e !eclare!
totally %ithi the #o!y ca'ity that is e!osco$ically accesse! so that o
$ersoel i the roo" are re.uire! to %ear laser safety eye%ear& This is
cotiget u$o the !e!icate! Laser Assistat #eig $reset at the cotrol
$ael of the laser at all ti"es that the 7ey is @oA, a! esurig that the
laser is $lace! i the sta!#y "o!e %he the la$arosco$ic laser !eli'ery
!e'ice is outsi!e of the #o!y ca'ity& If the $hysicia is ot utili(ig 'i!eo
for 'ie%ig through the e!osco$e a! is loo7ig !irectly through the
o$tics of the la$arosco$e, the glass i these o$tics $ro'i!es sufficiet eye
$rotectio a! o further $rotecti'e eye%ear is re.uire!& The laser
assistat a! $hysicia %ill re.uire the use of glasses oly %he test firig
the laser outsi!e of the $atiet<s #o!y ca'ity i %hich case the NH) %ill
#e cosi!ere! three feet i the !irectio of laser out$ut for the $ur$oses of
the test firig& *others i the roo" ee! ot %ear glasses+
ii& Car#o Dio9i!e Laser use! %ith the focusig ha!$iece *60D"" or
shorter focal legth les+& 8 The NH) "ay #e !eclare! the surgical ta#le
so that oly those $ersoel sta!ig at the surgical ta#le are re.uire! to
%ear laser safety eye%ear& Sice the NH) has #ee cotracte! to a area
s"aller tha the etire roo", a a!!itioal laser %arig sig %ill #e
$oste! o a IB $ole or other cos$icuous "aer at the ta#le to re"i!
$ersoel eterig the fiel! to %ear their $rotecti'e eye%ear& This is
cotiget u$o the !e!icate! Laser Assistat #eig $reset at the cotrol
$ael of the laser at all ti"es that the 7ey is @oA, a! esurig that the
laser is $lace! i the sta!#y "o!e %he it is ot actually #eig use!, a!
to closely "oitor $ersoel eterig the fiel! at the ta#le to esure that
they are %earig the $rotecti'e eye%ear&
iii& Hol"iu"5Eag Laser 8 use! e!osco$ically i urology or other e!osco$ic
$roce!ures& 8 The NH) "ay #e !eclare! totally %ithi the #o!y ca'ity
that is e!osco$ically accesse! so that o $ersoel i the roo" are
re.uire! to %ear laser safety eye%ear
F
& This is cotiget u$o the
!e!icate! Laser Assistat #eig $reset at the cotrol $ael of the laser at
all ti"es that the 7ey is @oA, a! esurig that the laser is $lace! i the
sta!#y "o!e %he the laser fi#er is outsi!e of the #o!y ca'ity& If the
$hysicia is ot utili(ig 'i!eo for 'ie%ig through the e!osco$e a! is
loo7ig !irectly through the o$tics of the la$arosco$e, the Ho5Eag laser
safety eye%ear or e!osco$ic filter %ill #e re.uire! for 'ie%ig& If the
/
Referece ANSI )6/1&/ Sectio F&F %hich states that the LSO "ay !eter"ie that so"e cotrol "easures i
Sectio F are ot re.uire! *cross refereces Sectio 6&/&0&F+, $articularly %he a sterile fiel! e9ists so that "o'e"et
i a! out of a cofie! NH) is "ii"al or a#set *Sectio F&F&6+&
F
Referece ANSI )6/1&/ Sectio F&1&0&6&0, seco! $aragra$h @The LSO "ay !eter"ie that the use of $rotecti'e
eye%ear !urig a e!osco$ic $roce!ure is ot re.uire!A&
THE COMPLIANCE DOCTOR, LLC
$hysicia is 'ie%ig etirely through 'i!eo attache! to the e!osco$e,
the o a!!itioal $rotecti'e eye%ear is re.uire!&
i'& Dio!e Laser 8 use! e!osco$ically i urology& 8 The NH) "ay #e
!eclare! totally %ithi the #o!y ca'ity that is e!osco$ically accesse! so
that o $ersoel i the roo" are re.uire! to %ear laser safety eye%ear
D
&
This is cotiget u$o the !e!icate! Laser Assistat #eig $reset at the
cotrol $ael of the laser at all ti"es that the 7ey is @oA, a! esurig that
the laser is $lace! i the sta!#y "o!e %he the laser fi#er is outsi!e of
the #o!y ca'ity& If the $hysicia is ot utili(ig 'i!eo for 'ie%ig through
the e!osco$e a! is loo7ig !irectly through the o$tics of the
la$arosco$e, the Dio!e laser safety eye%ear or e!osco$ic filter %ill #e
re.uire! for 'ie%ig& If the $hysicia is 'ie%ig etirely through 'i!eo
attache! to the e!osco$e, the o a!!itioal $rotecti'e eye%ear is
re.uire!&
'& D/0" a! 362" O$thal"ic Dio!e lasers %he use! through the i!irect
laser o$hthal"osco$e, or itra-ocular $ro#es for itraocular use 8 The
NH) "ay #e !eclare! the $roce!ure ta#le so that oly those $ersoel
%or7ig at or !irectly arou! the $roce!ural ta#le are re.uire! to %ear
laser safety eye%ear& Sice the NH) has #ee cotracte! to a area
s"aller tha the etire roo", a a!!itioal laser %arig sig %ill #e
$oste! o a IB $ole or other cos$icuous "aer at the ta#le to re"i!
$ersoel eterig the fiel! to %ear their $rotecti'e eye%ear& This is
cotiget u$o the !e!icate! Laser Assistat #eig $reset at the cotrol
$ael of the laser at all ti"es that the 7ey is @oA, a! esurig that the
laser is $lace! i the sta!#y "o!e %he it is ot actually #eig use!, a!
to closely "oitor $ersoel eterig the fiel! at the ta#le to esure that
they are %earig the $rotecti'e eye%ear, a! to closely "oitor the
$hysicia user to esure that the out$ut of the i!irect o$hthal"osco$e is
!irecte! solely to%ar!s the $atiet %he the laser is i the rea!y "o!e, or
si"ilarly esure that the laser is i the sta!#y "o!e if a itra-ocular
$ro#e *fi#er+ is ot cotaie! %ithi the eye&
!& Patiet Eye Protectio 8 $atiet<s eyes %ill #e $rotecte! for all laser cases, as
!eter"ie! colla#orati'ely #y the LSO, o$eratig $hysicia a! aesthesiologist&
Such $rotectio "ay ta7e the for" of laser safety eye%ear, $rotecti'e "etal eye
shiel!s "a!e for laser safety, or "oistee! s$oges, !ra$es or to%els as !ee"e!
a$$ro$riate& The "etho! of eye $rotectio shall #e charte! i the $atiet<s chart&
i& Laser $roce!ures $erfor"e! %ithi the #oy or#it of the eye *i&e&
#le$har$lasty+ shall re.uire the use of $rotecti'e coreal shiel!s
s$ecifically "a!e for laser eye $rotectio&
ii& Laser safety eye%ear, as use! #y $ersoel, "ay #e use! #y the $atiet
!urig cases i'ol'ig oly local aesthesia, if the laser use is ot !irectly
o or arou! the face, i %hich case "ore thorough $rotectio shoul! #e
$ro'i!e!&
D
Referece ANSI )6/1&/ Sectio F&1&0&6&0, seco! $aragra$h @The LSO "ay !eter"ie that the use of $rotecti'e
eye%ear !urig a e!osco$ic $roce!ure is ot re.uire!A&
THE COMPLIANCE DOCTOR, LLC
e& Testig of auto"atic safety shutters 8 O e.ui$"et that icor$orates auto"atic
safety shutters to $rotect the o$eratig $hysicia<s eyes !urig laser use *i&e&
certai !io!e a! GTP lasers, or others+, the Laser Assistat shall test the shutter
"echais" for $ro$er o$eratio $rior to use #y the $hysicia&
f& No $erso %ho is cotrollig the out$ut e! of the laser !e'ice shall $oit the
!e'ice *e'e %he the laser is i sta!#y or ot firig+ i the !irectio of
ayoe<s face& This is to #e rigi!ly eforce! #y the Laser Assistat, recogi(ig
the fact that laser safety eye%ear !oes ot guaratee eye $rotectio fro" a !irect
i"$act of the laser through the glasses&
g& Sus$ecte! Persoel Eye I;uries 8 i the e'et of a sus$ecte! eye i;ury a re$ort
%ill #e "a!e i""e!iately to the Laser Safety Officer, a! a hos$ital ici!et
re$ort co"$lete! $er hos$ital $olicies& A eye e9a"iatio %ill #e re.uire! u$o
a sus$ecte! eye i;ury, although routie or #aselie eye e9a"iatios are ot
re.uire! of ay $ersoel&
CI& Laser Safety Traiig for all $eri-o$erati'e $ersoel 8 All $ersoel %ho "ay ha'e
the occasio to %or7 %ithi a laser treat"et roo" *LTCA+ shall #e $ro'i!e! %ith
#asic laser safety istructio& This %ill iclu!e at a "ii"u" the 7o%le!ge of
"atchig a$$ro$riate laser safety eye%ear #y %a'elegth %ith the $oste! laser
%arig sigs, the ty$es of ha(ar!s that laser "ay $reset, a! a%areess of the
fuctios of the facilities Laser Safety Officer a! !e!icate! laser assistats& Such
#asic safety traiig %ill #e icor$orate! ito e"$loyee orietatio traiig& Sig-i
sheets for laser iser'ices %ill #e acce$ta#le !ocu"etatio of such traiig, or ay
for"al certificate of laser traiig that iclu!es safety&
CII& Secure storage of laser 7eys 8 The 7ey to each laser shall #e store! se$arately fro"
the laser i a secure locatio, a! oly .ualifie! $ersoel shall ha'e access to this
7ey&
CIII& ,oot$e!al safety 8 #ecause of the $ossi#ility of cofusig foot$e!als #et%ee the
laser a! other surgical e.ui$"et !urig cases, the laser foot$e!al shall #e 7e$t o a
se$arate si!e of the surgeo *either right or left fro"+ fro" foot$e!als for other
e.ui$"et such as electrosurgery or "icrosco$es& Oly the $hysicia !irectig the
out$ut of the laser to the treat"et site shall o$erate the laser foot$e!al&
CIB& S"o7e E'acuatio 8 %hee'er a laser $lu"e
1
is geerate! fro" the use of the laser,
a!e.uate s"o7e e'acuatio %ill #e utili(e! to ca$ture the e"itte! laser $lu"e& The
e'acuator collector ti$ %ill #e hel! as close as $ractical so the site of $lu"e e"issio
8 geerally %ithi a#out 0 iches 8 i or!er to collect all of the $lu"e as it is
geerate!& =he the s"o7e geeratio is "ii"al or geerate! %ithi a ca'ity such
as 'agial s$eculu" or "icrolarygosco$e, s"all #ore suctio "ay #e $ro'i!e! i
lieu of or i a!!itio to the large #ore suctio&
1
Laser $lu"e5 also calle! Laser Heerate! Air#ore Cota"iats *LHAC+, s"o7e, or laser s"o7e& It shoul! #e
ote! that $lu"e geerate! fro" electrosurgical uits cotais the sa"e cota"iats a! to9is as that $ro!uce! #y
lasers&
THE COMPLIANCE DOCTOR, LLC
a& =he usig the s"all #ore suctio tu#ig, fro" regular %all suctio, a s"o7e
filter shall #e $lace! #et%ee the flui! collectio #ottle a! the %all suctio
source to $reclu!e !a"age to the suctio syste"&
#& All suctio tu#ig a! filters are to #e treate! as cota"iate! "aterial a!
!is$ose! of $ro$erly&
c& Biral $rotectio "as7s 8 Surgical "as7s that $ro'i!e 'iral le'el filtratio shall
NOT #e re.uire! !urig laser cases, a! s"o7e e'acuatio %ill #e utili(e! as the
sole cotrol "easure for eli"iatig the laser $lu"e& These 'iral "as7s %ill #e
"a!e a'aila#le o the laser su$$ly cart for $ersoel %ho %ish to use the"&
!& Laser $roce!ures $erfor"e! u!er flui! !o ot geerate a laser $lu"e a! s"o7e
e'acuatio %ill ot #e ecessary *i&e& Ho5Eag laser lithotri$sy, I!igo !io!e
cystosco$y, etc&+
CB& Ai"ig #ea" alig"et 8 the ai"ig #ea" a! the surgical #ea" fro" the car#o
!io9i!e or Er5Eag lasers %ill #e chec7e! #y the laser assistat $rior to each case to
esure alig"et #y test firig of the laser oto a "oistee! togue !e$ressor& This
alig"et %ill #e further cofir"e! #y the o$eratig $hysicia $rior to laser use o
the $atiet& The laser %ill ot #e utili(e! if the ai"ig #ea" a! surgical #ea"s are
ot coici!et& Testig of the alig"et shoul! occur %ith the !eli'ery !e'ice use!
for the $roce!ure %here $ossi#le *i&e& la$arosco$e, "icrosco$e, etc+&
CBI& Lac7 of Ai"ig #ea" o fi#ero$tically !eli'ere! lasers 8 =he the ai"ig #ea"
caot #e see e"ittig fro" the fi#er %he the laser is $lace! i the rea!y "o!e
*#oth lasers %ith se$arate ai"ig #ea" lasers a! those that use lo% $o%er 'ersios
of the sa"e laser for ai"ig& This a$$lies to Dio!e lasers, the Ho5Eag, N!5Eag, GTP,
a! others+ the the laser %ill ot #e test fire! util the e.ui$"et has #ee chec7e!
#y ser'ice $ersoel& This is to $reclu!e !a"age to the laser fro" alig"et
$ro#le"s&
CBII& 4se of lo% reflectace istru"ets & Metal surgical istru"ets "ay #e ao!i(e! to
re!uce their reflectace of laser light a! shoul! #e cosi!ere! %he the o$eratig
$hysicia !ee"s a$$ro$riate& They are ot a re.uire"et for all laser use ho%e'er
a! "ost surgical $roce!ures "ay #e safely $erfor"e! %ith sta!ar! istru"ets&
Care shall #e ta7e to a'oi! !irectly firig oto "etal istru"ets& S$ecial lo%
reflectace istru"ets shall #e use! !urig "icrolarygosco$y cases %ith the CO0
laser&
CBIII& Protectio of rigi! a! fle9i#le e!osco$es 8 :oth rigi! *i&e& cystosco$es,
arthrosco$es, hystersoco$es+ a! fle9i#le *i&e& #rochosco$es, gastrosco$es,
coloosco$es+ e!osco$es "ay #e !a"age! #y firig the laser fi#er %he it is %ithi
the chael of the e!osco$e or i close $ro9i"ity to the o$tics of the e!osco$e&
a& ,le9i#le e!osco$ies 8 the laser shall ot #e $lace! i the rea!y "o!e util the
fi#er is sufficietly a!'ace! fro" the chael of the e!osco$e 8 a$$ro9i"ately
6&D c"& This is to #e !eter"ie! either #y "ar7ig the $ro9i"al e! of the fi#er
%here it eters the e!osco$e %ith the correct $ositioig so that the laser
assistat ca see 'isually that the fi#er ti$ is sufficietly a!'ace!I or #y loo7ig
THE COMPLIANCE DOCTOR, LLC
at the 'i!eo scree %ith the fi#er ti$ sufficietly a!'ace! $rior to use i the
$atiet, so that the fi#er ti$ $ositioig "ay #e 'isually !eter"ie! #y its $ositio
o the 'i!eo scree&
#& Rigi! e!osco$ies - the laser shall ot #e $lace! i the rea!y "o!e util the fi#er
is sufficietly a!'ace! $ast the !istal o$tic of the rigi! e!osco$e #y
a$$ro9i"ately 6&D c"& This is to #e !eter"ie! either #y "ar7ig the $ro9i"al
e! of the fi#er %here it eters the e!osco$e %ith the correct $ositioig so that
the laser assistat ca see 'isually that the fi#er ti$ is sufficietly a!'ace!I or #y
loo7ig at the 'i!eo scree %ith the fi#er ti$ sufficietly a!'ace! $rior to use i
the $atiet, so that the fi#er ti$ $ositioig "ay #e 'isually !eter"ie! #y its
$ositio o the 'i!eo scree&
i& Arthrosco$ies 8 the laser fi#er is geerally iserte! se$arately fro" the
rigi! arthrosco$ic telesco$e& Care %ill #e ta7e #y the o$eratig $hysicia
to a'oi! $lacig the laser fi#er ti$ i close $ro9i"ity to the telesco$e o$tic
!urig the $roce!ure, to a'oi! !a"age to the e!osco$e&
CIC& ,ire Protectio 8 the LSO %ill esure that the follo%ig fire safety $recautios are
ta7e !urig laser cases5
a& ,ire E9tiguishers 8 the !e!icate! Laser Assistats %ill #e "a!e a%are of the
locatio of ear#y fire e9tiguishers that are re.uire! #y N,PA regulatios&
#& A cotaier of %ater *ay o-fla""a#le flui!+ %ill #e a'aila#le !urig all laser
cases for i""e!iate !ousig of fla"es if ee!e! *irrigatig solutios o the
#ac7sta! %ill suffice+&
c& The !e!icate! Laser Assistat %ill $lace the laser i the sta!#y "o!e %he it is
ot acti'ely #eig use! to treat the $atiet& The Laser Assistat %ill 'er#ally
otify the o$eratig $hysicia each ti"e the laser is $lace! i the @rea!yA "o!e,
a! is a#le to #e fire!&
!& Ay s$oges or !ry "aterials !irectly i the surgical fiel! %ill #e "oistee!
*#loo!, salie, %ater or ay ofla""a#le a! oto9ic flui! "ay #e use!+& This
a$$lies $ri"arily to the Car#o Dio9i!e Laser #ut ca a$$ly to other lasers if use!
i o$e cases %ith !ry "aterials $reset& S$oge couts %ill #e "a!e after CO0
laser cases that cout the u"#er of s$oges a! e9a"ie each oe to esure that
it is itact a! has ot #ee cut ito s"aller $ieces #y the laser& Surgical cotrol
techi.ues %ith laser !eli'ery syste"s offer cotrol i situatios %here $ac7ig
%ith "oistee! "aterials is ot feasi#le& A$$ro$riate #ac7sto$s or guar!s shoul!
#e use! !urig so"e laser cases %here it is a$$ro$riate& Laser use u!er flui!
$resets o fire ha(ar! %hile the laser out$ut is u!er the flui! *i&e& cystosco$y+&
e& ,la"e retar!at !ra$es %ill #e use! for surgical laser cases, or regular !ra$es "ay
#e "oistee! i the area arou! the surgical fiel! or area %here the laser
ha!$iece or fi#er is $lace! o the !ra$es&
f& Laser Igitio of itestial gases 8 "ethae gas *flatus+ fro" a $atiet is
co"#usti#le, a! $eri-aal $roce!ures %ith laser "ay $reset a fire ha(ar!&
A$$ro$riate "etho!s to cotrol this $otetial ha(ar! %ill #e ta7e to iclu!e
#o%el $re$s, suctio a! irrigatio, or co'erig of the aus %ith a %et s$oge at
the !iscretio of the o$eratig $hysicia& Dee$ $ac7ig of the aus %ith %et
s$oges u$ $ast the iteral aal s$hicter is to #e !iscourage! #ecause of the
THE COMPLIANCE DOCTOR, LLC
li7elihoo! of s$rea!ig 'irus fro" $eriaal areas !ee$er ito the aus, %hich "ay
create "e!ical co"$licatios that ha'e a!'erse "e!ical cose.ueces& The
o$eratig $hysicia "ay choose the a$$ro$riate "etho! of $rotectio, iclu!ig
the !ee$ aal $ac7ig %he so i!icate!&
g& ,la""a#le $re$s 8 the use of fla""a#le $re$s is ot $reclu!e! %he usig the
laser, #ut a$$ro$riate $recautios %ill #e ta7e such as airig out !ra$es to
$re'et collectio of co"#usti#le fu"es u!ereath& Pre$$e! areas shoul! #e
!rie! #efore usig the laser !irectly %ithi that area& S$ecial e"$hasis shoul! #e
$lace! o hairlies such as facial or $u#ic hair that ca retai $re$ solutios
*iclu!ig fla""a#le hairs$ray+ i the hair lie& =he utili(ig the laser i these
areas the hairlie %ill #e $rotecte! %ith a "oistee! to%el hel! o'er the hairlie,
or #y utili(ig a %ater solu#le lu#ricat such as G-E ;elly to $ro'i!e a #arrier
#et%ee the hair a! area of laser use&
h& Ba$ori(atio of Poly"ethyl"ethacrylate *PMMA+ 8 4se of the CO0 laser to
re"o'e $oly"ethyl"ethacrylate fro" %ithi #oe is a useful techi.ue !urig
;oit re'isios& PMMA $ro!uces to9ic fu"es %he 'a$ori(e! a! is highly
fla""a#le, so that a$$ro$riate s"o7e e'acuatio a! fire $recautio techi.ues
%ill #e utili(e!&
i& S"o7e e'acuatio 8 i a!!itio to the use of the large #ore, high flo%
s"o7e e'acuatio, %hich filters out $articulate "atter, a!!itioal tu#ig
%ill #e coecte! fro" the out$ut 'et of the s"o7e e'acuator a! le! to
the egati'e $ressure air 'et i the treat"et roo" *'ete! to the outsi!e
8 ot to aother roo"+&
ii& ,ire $recautios 8 irrigatig solutio %ill #e use! iter"ittetly to cool the
area %he the PMMA is #eig 'a$ori(e! fro" the #oe, a! a cotaier of
solutio %ill #e i""e!iately a'aila#le i the sterile fiel! to !ouse ay
fla"e that "ight #e create!&
i& Air%ay Laser Proce!ures 8 the follo%ig s$ecific $recautios %ill #e ta7e to
$reclu!e a! "aage air%ay fires !urig laser use& This is a issue $ri"arily %ith
the CO0 laser use! for "icrolarygosco$y #ut to so"e !egree ca #e a issue
%ith Ho5Eag or N!5Eag lasers !urig fle9i#le #rochosco$y, or ay case %here a
laser is use! i or arou! the $atiet<s air%ay5
i& Aesthesia "ust "ii"i(e cocetratios of ,IO
0
a! N
0
O as "uch as
$ossi#le %he $erfor"ig air%ay laser $roce!ures& As lo% a ,IO
0
as ca
#e a!"iistere! %ithout co"$ro"isig the $atiet<s res$iratory status is to
#e use!& Patiet O0 saturatio le'els shall #e "oitore!& Co"$resse! air,
Nitroge, or Heliu", at the !iscretio of the Aesthesiologist, is to #e use!
as the #alace gas rather tha icreasig the $ercetage of N
0
O
J
for the
#alace&
ii& E9$losi'e aesthetic agets such as Cyclo$ro$ae %ill ot #e use! !urig
laser air%ay cases&
iii& A e"ergecy tracheoto"y 7it>tray %ill #e "a!e a'aila#le i the
treat"et roo" for all laser air%ay cases for use i the e'et of a
e"ergecy& The 7it ee! ot #e o$ee! uless it is re.uire!&
J
Nitrous O9i!e su$$orts co"#ustio e.ually as %ell as o9yge
THE COMPLIANCE DOCTOR, LLC
i'& I the e'et a fire has occurre! the first $riority %ill #e to re-esta#lish the
$atiet<s air%ay a! 'etilatio, iclu!ig the use of e"ergecy
tracheoto"y if re.uire!& The laser $roce!ure is the ter"iate! a! all
efforts %ill #e "a!e to assess a! "aage the i;ury to the $atiet&
'& CO0 Laser Microlarygosco$y5
6& The $atiet<s etire face>hea!, iclu!ig li$s a! teeth shall #e
totally $rotecte! #y $ac7ig %ith %et to%els or co'erigs
0& Sta!ar! PBC e!otracheal tu#es *ET tu#es+ shall ot #e use!&
/& Alterati'e air%ays>'etilatio that "ay #e use!, as !eter"ie! #y
the o$eratig $hysicia a! aesthesiologist, iclu!e5
a& Co""ercially a'aila#le laser resistat e!otracheal tu#es,
use! accor!ig to "aufacturer<s reco""e!atios& =he
use!, the follo%ig $roce!ures %ill a$$ly5
i& After itu#atio, iflate the cuff %ith sterile %ater
to %hich a s"all a"out of !ye solutio has #ee
a!!e!&
ii& After the cuff is iflate! %ith !ye! flui!, $ac7 off
the cuff for a!!itioal $rotectio %ith
s$oges>cottooi!s that ha'e #ee "oistee!&
iii& After itu#atio, ta$e the E&T& tu#e to the $atiet<s
face>ec7 to "aitai $ro$er $ositioig, utili(ig a
"ii"u" a"out of ta$e, so that the E&T& tu#e "ay
#e ra$i!ly $ulle! fro" the $atiet !urig a
e"ergecy&
i'& Maitai a $ail of %ater o the floor #esi!e the
o$eratig $hysicia i %hich to thro% a #urig
E&T& tu#e !urig a e"ergecy&
'& At ay sig that the tu#e cuff has #urst
*!iscoloratio fro" the !ye see i the air%ay+, the
$atiet %ill #e e9tu#ate! a! $ro$erly re-itu#ate!
#efore $rocee!ig %ith ay laser use if the cuff has
#ee #urst&
'i& At ay i!icatio of a fire i the air%ay the
o$eratig $hysicia %ill i""e!iately !iscoect the
'etilatio circuit fro" the E&T& tu#e %hile
si"ultaeously a! ra$i!ly $ullig the E&T& tu#e
fro" the $atiet, thro%ig the tu#e ito the $ail of
%ater, a! alertig all $ersoel&
#& Norto ,le9i#le Metal tu#es 8 aother alterati'e, %here
agree! u$o #y aesthesia a! the o$eratig $hysicia, is
the use of the all "etal fle9i#le e!otracheal tu#es, %hich
are si(e! to fit the $atiet<s air%ay so that o e9teral
ru##er cuff is $lace! o the tu#e& If a ru##er cuff is utili(e!
the it %ill #e treate! the sa"e as the cuff i laser resistat
tu#es as !escri#e! a#o'e&
THE COMPLIANCE DOCTOR, LLC
c& Ket Betilatio is aother alterati'e "etho! of 'etilatio,
$ro'i!e! that a all "etal caula is use! i $lace of the
$lastic caulas so that o co"#usti#le "aterials are i the
air%ay&
'i& ,le9i#le #rochosco$y 8 %ith either Ho5Eag, N!5Eag or GTP lasers&
6& The laser %ill #e $lace! i the @rea!yA "o!e oly %he the laser
fi#er has #ee sufficietly a!'ace! fro" the chael of the
#rochosco$e *6-0c"+, #oth to a'oi! !a"age to the e!osco$e a!
to $re'et igitig the $lastic>ru##er "aterials i the
#rochosco$e&
0& The laser %ill ot #e use! i the !irect 'iciity of the ti$ of the
e!otracheal tu#e& The laser *a! hece ti$ of the #rochosco$e+
%ill #e use! oly $ast the !istal e! of the ET tu#e, a! the ET
tu#e $lace! as high as $ractical i the air%ay %he usig the laser
at or ;ust $ast the caria& Alterati'es to %or7 at the caria or
%ithi the trachea %ill iclu!e ot usig a ET tu#e at all, or the
use of a rigi! laser #rochosco$e i lieu of a fle9i#le
#rochosco$e&
/& Pro$er coolig of the fi#er ti$ %ill #e $ro'i!e! through the laser
fi#er>catheter, such as co"$resse! air or flui! !ri$s, accor!ig to
the "aufacturer<s reco""e!atio&
F& Ehace! coolig of the fi#er>catheter ti$ %ill #e $ro'i!e! %he
utili(ig the laser i the area of "etal "esh air%ay stets& ,lui!
!ri$ is $referre! #ut ay aggressi'e "etho! of ti$ coolig is
acce$ta#le, to $re'et the laser fi#er>catheter ti$ fro" igitig fro"
the heat create! i the "esh stet !urig 'a$ori(atio&
D& Although this $olicy "aitais that the ty$e of e!otracheal tu#e
use! !urig fle9i#le #rochosco$ies %he usig the laser $ast the
"aiste" #rochi is ot the sigificat fire ha(ar! it is %ith CO0
laser "icrolarygosco$y, our $olicy %ill #e to use oly laser
resistat tu#es, fle9i#le "etal tu#es, or o ET tu#es, !urig fle9i#le
laser #rochosco$ies, as !eter"ie! #y the o$eratig $hysicia a!
aesthesiologist&
CC& Laser Maiteace a! Ser'ice 8 shall #e $erfor"e! #y .ualifie! $ersoel as
!eter"ie! #y the LSO&
a& Lualifie! ser'ice $ersoel "ay iclu!e the "aufacturer<s ser'ice techicias,
thir! $arty ser'ice agets, or the hos$ital<s #io"e!ical egieers& Such ser'ice
$ersoel shall ha'e !ocu"ete! laser safety traiig, a! !ocu"ete! ser'ice
traiig co""esurate %ith the le'el of %or7 they are $erfor"ig o the laser&
The facility shall also acce$t NCLE Laser Certificatio as a re$air techicia as
e'i!ece of "eetig this traiig re.uire"et&
#& Perio!ic Maiteace, iclu!ig cali#ratio chec7s, shall #e $erfor"e! at si9
"oth iter'als& =ritte ser'ice re$orts shall #e "aitaie! #y the Laser Safety
Officer a!>or the hos$ital #io"e!ical egieerig !e$art"et&