9 Anesthetic Gases

MODULE G: Anesthetic Gases Approved

7/23/10 OMB No. 10AP-xxxx

Expiration Date: xx/xx/2011

PROGRAMMING INSTRUCTIONS APPEAR IN BLUE.

	Are you currently a dentist or other dental professional?		Yes No If Respondent marked ‘yes’ or is from the ADA, ADAA or ADHA è skip Questions 13, 18, 19, 20, 22, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36 If respondent marked ‘no’ èskip Questions 14, 15, 23, 24
	During your career (including residency, fellowship training, etc.), how long have you been personally administering anesthetic gases to patients? Please do not include instances where you supervise others who administer anesthetic gases. Note: Anesthetic gases include Desflurane, Sevoflurane, Halothane, Nitrous Oxide, Enflurane and Isoflurane.		Less than one year 1-5 years 6-10 years 11-20 years More than 20 years
	When was the last time you received training on the safe handling of anesthetic gases?		Within the past 12 months More than 12 months ago I never received training
If you work for more than one employer, the following questions apply to your primary employer, i.e., the one for which you typically work the most hours. If you are self- employed, consider yourself the employer.
	Does your primary employer have standard procedures to minimize worker exposure during administration of anesthetic gases?		Yes No I don’t know

			During the past 7 calendar days, which of the following anesthetic gases did you personally administer to patients? Please  all that apply. d isplay a calendar highlighting the past 7 calendar days. applies to all questions with ‘in the past 7 calendar day’			Desflurane Sevoflurane Halothane Nitrous oxide Enflurane Isoflurane If only one checked, Go to Question 9
			Of these gases you checked above, please indicate the one you most often administered.			list the anesthetic gases checked in Question 5 (use radio buttons)
	if respondent marked nitrous oxide in question 5 and at least one other anesthetic gas, go to question 7. otherwise, go to question 9.
			During the past 7 calendar days, did you simultaneously administer nitrous oxide with any of the following anesthetic gases? Please  all that apply.			(list all anesthetic gases checked in Question 5, except nitrous oxide) Yes {ANESTHETIC GAS 1 FROM QUESTION 5} Yes {ANESTHETIC GAS 2 FROM QUESTION 5} Yes {ANESTHETIC GAS 3 FROM QUESTION 5} …  No è go to question 9
	If Respondent marked more than one gas in 7 GO TO QUESTION 8 OTHERWISE è go to question 9
			Of the gases you checked above, please indicate the one you most often administered with nitrous oxide.			list the anesthetic gases checked in Question 7 (use radio buttons)
			During the past 7 calendar days, on how many days did you personally administer anesthetic gases?			1 day 2 days 3 days 4 days 5 days 6 days 7 days
		During the past 7 calendar days, in which of the following work settings did you administer anesthetic gases? Please  all that apply.			Hospital operating room Hospital Emergency Room Radiology/radiation therapy suite Catheterization laboratory Magnetic resonance imaging (MRI) suite GI endoscopy suite Labor and delivery suite Outpatient surgical center Office-based surgical suite Dental operatory/clinic Teaching facility Some other location (Please specify): ________________________________
If response marked in Question 10  Go to Question 12.
		Of the locations you checked above, please indicate the work setting where you most often administered anesthetic gases during the past 7 calendar days.							list locations checked in Question 10 (use radio buttons).
		During the past 7 calendar days, did you administer anesthetic gases to patients age 13 or older (non-pediatric patients)?						Yes No èGO to Question 21
The next questions address work practices and use of personal protective equipment (PPE). They will help us understand what is currently used and under what circumstances. Depending on your job and exposures, PPE may not be required.

	When administering anesthetic gases to patients age 13 or older (non-pediatric patients) during the past 7 calendar days, how often did you use…
			Every time	Most times	Sometimes		Rarely		Never	Device Not Available
	a. …a face mask only?									
	b. …a face mask then switched to an airway device (i.e., endotracheal tube, tracheostomy tube or laryngeal mask)?									
	c. …an airway device only?									
	When administering anesthetic gases to patients age 13 or older (non-pediatric patients) during the past 7 calendar days, how often did you use a patient nasal mask with scavenging system designed to remove waste anesthetic gases?							Every time Most times Sometimes Rarely Never
	When administering anesthetic gases to patients age 13 or older (non-pediatric patients) during the past 7 calendar days, how often did you use a local exhaust hood placed near the patient’s mouth?		Every time Most times Sometimes Rarely Never

	When administering anesthetic gases to patients age 13 or older (non-pediatric patients) during the past 7 calendar days, how often did you use…
		Every time	Most times		Some times	Rarely	Never	Not Available
	a.  …High flow anesthesia only (on average 3-6 L/min of fresh gas)?	¦		¦	¦	¦	¦	¦
	b. …Low flow anesthesia only (on average less than 3 L/min of fresh gas)?	¦		¦	¦	¦	¦	¦
	c. …High flow anesthesia during induction phase and low flow anesthesia during remainder of administration	¦		¦	¦	¦	¦	¦
	d. …Closed system anesthesia technique?	¦		¦	¦	¦	¦	¦

	When administering anesthetic gases to patients age 13 or older (non-pediatric patients) during the past 7 calendar days, how often did you…
	Note: Check ‘Not Applicable’ if others are responsible for the practice specified below.		Every time	Most times	Some times	Rarely	Never	Not Applicable
	a. …check the anesthesia machine(s), breathing circuit(s), vaporizer(s) and other components for leaks?		¦	¦	¦	¦	¦	¦
	b. …start the anesthetic gas flow after delivery mask or airway device is applied?		¦	¦	¦	¦	¦	¦
	c. …turn off the anesthetic gas before turning off the flow of carrier gas to the breathing system?		¦	¦	¦	¦	¦	¦
	During the past 7 calendar days, how often was a waste gas scavenging system used when you administered anesthetic gases to patients age 13 or older (non-pediatric patients)?		Every time èGO to Question 21. Most times Sometimes Rarely Never

What were the reason(s) you did not always use a waste gas scavenging system while administering anesthetic gases to patients age 13 or older (non-pediatric patients)? Please  all that apply.

Administration method(s) alone keeps waste anesthetic gases to a minimum Effective general room ventilation alone keeps waste anesthetic gases to a minimum Administration method(s) and effective general room ventilation keep waste anesthetic gases to a minimum Not part of our protocol Not provided by employer No one else who does this work uses them Too difficult to use Not readily available in work area Other (Please specify): ________________________­­­­____

If only one reason marked in Question 19  Go to Question 21.

Of the reasons you checked above, please indicate the most important reason a waste gas scavenging system was not always used.

list reasons marked in Question 19 (use radio buttons)

During the past 7 calendar days, did you administer anesthetic gases to patients age 12 or younger (pediatric patients)?

Yes No èGO to Question 30

When administering anesthetic gases to patients age 12 or younger (pediatric patients) during the past 7 calendar days, how often did you use…

Every time

Most times

Some times

Rarely

Never

Device Not Available

face mask only?

¦

¦

¦

¦

¦

¦

face mask then switched to an airway device (i.e., endotracheal tube, tracheostomy tube or laryngeal mask)?

¦

¦

¦

¦

¦

¦

airway device only?

¦

¦

¦

¦

¦

¦

When administering anesthetic gases to patients age 12 or younger (pediatric patients) during the past 7 calendar days, how often did you use a patient nasal mask with scavenging system designed to remove waste anesthetic gases?

Every time Most times Sometimes Rarely Never

	When administering anesthetic gases to patients age 12 or younger (pediatric patients) during the past 7 calendar days, how often did you use a local exhaust hood placed near the patient’s mouth?		Every time Most times Sometimes Rarely Never

When administering anesthetic gases to patients age 12 or younger (pediatric patients) during the past 7 calendar days, how often did you use…..

Every time

Most times

Some times

Rarely

Never

Not Available

…High flow anesthesia only (on average 3-6 L/min of fresh gas)?

¦

¦

¦

¦

¦

…Low flow anesthesia only (on average less than 3L/min of fresh gas)?

¦

¦

¦

¦

¦

…High flow anesthesia during induction phase and low flow anesthesia during remainder of administration

¦

¦

¦

¦

¦

…Closed system anesthesia technique?

¦

¦

¦

¦

¦

¦

When administering anesthesia as a gas to patients age 12 or younger (pediatric patients) during the past 7 calendar days, how often did you…..

Note: Check ‘Not Applicable’ if others are responsible for task specified below.

Every time

Most times

Some times

Rarely

Never

Not Applicable

a. check the anesthesia machine(s), breathing circuit(s), vaporizer(s) and other components for leaks?

¦

¦

¦

¦

¦

¦

b. start the anesthetic gas flow after delivery mask or airway device is applied?

¦

¦

¦

¦

¦

¦

turn off the anesthetic gas before turning off the flow of carrier gas to the breathing system?

¦

¦

¦

¦

¦

¦

During the past 7 calendar days, how often was a waste gas scavenging system used when you administered anesthetic gases to patients age 12 or younger (pediatric patients)?

Every time èGO to Question 30 Most time Sometimes Rarely Never

What were the reason(s) you did not always use a waste gas scavenging system while administering anesthetic gases to patients age 12 or younger (pediatric patients)? Please  all that apply.

Administration method(s) alone keeps waste anesthetic gases to a minimum Effective general room ventilation alone keeps waste anesthetic gases to a minimum Administration method(s) and effective general room ventilation keep waste anesthetic gases to a minimum Not part of our protocol Not provided by employer No one else who does this work uses them Too difficult to use Not readily available in work area Other (Please specify): _________________

If only one response marked in Question 28  Go to Question 30.

Of the reasons you checked above, please indicate the most important reason a waste gas scavenging system was not always used.

list reasons marked in Question 28 (use radio buttons)

During the past 7 calendar days, did you personally fill anesthesia vaporizers?

Yes No èGO to Question 34

When filling anesthesia vaporizers during the past 7 calendar days, how often did you use…

Every time

Most times

Some times

Rarely

Never

System Not Available

a.     …a “key-filler” or other closed system

 èGO to Question 33 after allowing response to 31b

¦

¦

¦

¦

¦

b.   …a “funnel-fill” system (also called “pour fill” or “screw cap fill” systems)

¦

¦

¦

¦

èGO to Question 33

¦

How often did you fill the vaporizer (using the “funnel-fill” system) in a location where fugitive vapors are controlled? (e.g., exhaust hood, ventilated enclosure)?

Every time Most times Sometimes Rarely Never

In the past year, did any large spills (e.g., contents of at least one bottle of liquid anesthetic agent) occur during filling or draining of vaporizers?

Yes No I don’t know

Who is responsible for cleanup of large spills (e.g., contents of one bottle) of liquid anesthetic agents?

Designated spill cleanup team Person causing the spill, but only if properly trained Person causing the spill, even if untrained Other (Please specify): ________________________________ I don’t know

During the past 7 calendar days, how often was the patient …

Note: Check ‘Not Applicable’ if practice specified below is not part of protocol.

Every Time

Most times

Some times

Rarely

Never

Not Applicable

…extubated (using endotracheal tube) in the operating room as they awakened from anesthesia?













b. …transferred to the recovery area while still anesthetized and intubated with endotracheal tube, and allowed to wake up in recovery area?













c. …extubated (using laryngeal tube) in the operating room as they awakened from anesthesia?













d. …transferred to the recovery area while still anesthetized and intubated with laryngeal mask, and allowed to wake up in recovery area?













Has air monitoring for anesthetic gases been conducted on a continuous or periodic basis in the operating room to detect anesthetic gas leaks?

Yes No I don’t know

Has exposure monitoring (using badges or other air sampling devices) been conducted in the past 12 months to assess your exposure or your co-workers’ exposure to anesthetic gases?

Yes No I don’t know

During the past 7 calendar days, what was the average amount of time you spent each work day with patients in recovery area(s)?

No time spent in patient recovery area(s) è Go to Core Module if this is the first hazard module completed. if this is the second hazard module completed, end survey. end with ‘Thank you’ statement. Less than 1 hour 1 hour or more

Was the patient recovery area where you spent the most time during the past 7 calendar days adequately ventilated?

Yes No I don’t know all responses: è Go to Core Module if this is the first hazard module completed. if this is the second hazard module completed, end survey. end with ‘Thank you’ statement.

Thank you for participating in the NIOSH Health and Safety Practices Survey of Healthcare Workers. Your answers have been submitted.

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