Clinical assignment
1. Johanna, CST, is scheduled to be the first scrub on a procedure at 8:00 AM in which a laser will be used to obliterate abnormal tissue in the larynx. She is preparing for the case.

Clinical assignment
● What specific safety issues should she consider in preparing for this case?
● What procedures should be in place to ensure the patient’s safety?
● Are there any anesthetic concerns?
Clinical Assignment:

Title: Preparing for a Larynx Procedure Using Laser

Introduction:
In this clinical assignment, we will discuss the specific safety considerations that Johanna, a Certified Surgical Technologist (CST), should take into account as she prepares for a larynx procedure scheduled at 8:00 AM, where a laser will be employed to remove abnormal tissue. Additionally, we will explore the procedures essential for ensuring patient safety and address any anesthetic concerns that may arise during the procedure.

Safety Considerations for Johanna:
Johanna’s role as the first scrub in a procedure involving a laser demands meticulous attention to safety. Here are some specific safety issues she should consider:

a. Laser Safety: Laser equipment poses potential risks, including eye damage and skin burns. Johanna must ensure that laser safety protocols are strictly followed, which may involve wearing appropriate laser safety goggles, knowing the laser classification, and understanding the beam’s path.

b. Fire Hazard Mitigation: Laser procedures can generate heat, and there is a risk of surgical drapes or materials catching fire. Johanna should be prepared with fire extinguishing equipment and be aware of fire prevention measures.

c. Smoke Evacuation: Laser plume or smoke produced during the procedure can contain harmful substances. Proper smoke evacuation systems and personal protective equipment should be in place to safeguard against exposure.

Ensuring Patient Safety:
Maintaining patient safety is paramount during surgical procedures involving a laser. To ensure this, the following procedures should be in place:

a. Patient Assessment: A thorough pre-operative assessment of the patient’s medical history, allergies, and potential contraindications to laser use must be conducted.

b. Surgical Team Communication: Clear communication among the surgical team, including the anesthesiologist, surgeon, and CST like Johanna, is essential to coordinate actions and address any emerging concerns promptly.

c. Emergency Response Plan: An emergency response plan should be in place, outlining procedures for unexpected events such as equipment malfunction or patient complications.

d. Infection Control: Strict adherence to infection control protocols, including proper sterilization of equipment and maintaining a sterile field, is crucial.

Anesthetic Concerns:
Anesthesia management is a critical component of any surgical procedure. While this is primarily under the purview of the anesthesia provider, Johanna should be aware of any potential anesthetic concerns, such as:

a. Anesthesia Induction: The timing of anesthesia induction and its coordination with the surgical start time is crucial to ensure the patient is adequately anesthetized before the laser procedure begins.

b. Monitoring: Continuous monitoring of the patient’s vital signs, including oxygen saturation and end-tidal CO2, is essential during the procedure.

c. Emergency Medications: Access to emergency medications and equipment for managing potential anesthetic complications should be readily available.

Conclusion:
In summary, Johanna’s role as the first scrub in a larynx procedure involving a laser necessitates a keen focus on safety considerations, effective communication, and awareness of potential anesthetic concerns. By adhering to established protocols and procedures, the surgical team can work together to ensure a safe and successful procedure for the patient.

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