CSFA Operating Room Safety and Environmental Hazards

Question 1

Which three elements make up the surgical fire triangle?

Accepted Answer

Ignition source, fuel and oxidizer

Answer

A surgical fire needs an ignition source (for example an electrosurgical unit or laser), a fuel (drapes, alcohol-based prep, hair, gauze) and an oxidizer (oxygen or nitrous oxide). Prevention means controlling each of these, for instance letting alcohol prep dry and keeping FiO2 low near the airway.

Question 2

To limit occupational radiation exposure during intraoperative fluoroscopy, the first assistant should rely primarily on which three principles?

Accepted Answer

Time, distance and shielding

Answer

ALARA (as low as reasonably achievable) relies on minimizing time near the beam, maximizing distance (exposure falls with the inverse square of distance) and using shielding such as lead aprons and thyroid collars.

Question 3

Before a laser is activated near the airway during ENT surgery, which precaution is most important?

Accepted Answer

Using a laser-resistant endotracheal tube with a saline-filled cuff and keeping wet sponges nearby

Answer

Airway fires are a major laser hazard. A laser-resistant tube with a saline-filled (often dye-tinted) cuff, the lowest safe oxygen concentration, and moist sponges or towels around the field all reduce fuel and ignition risk.

Question 4

Surgical smoke plume produced by electrosurgery is best controlled with which method?

Accepted Answer

A smoke evacuator with ULPA filtration and the capture device within about 2 inches of the source

Answer

Surgical plume can contain toxic gases, viable viral material and particulates. A dedicated smoke evacuator with ULPA filtration, placed close to the site, removes plume effectively. Wall suction and standard masks are inadequate.

Question 5

When passing and handling sharps during closure, which practice best reduces percutaneous injuries to the surgical team?

Accepted Answer

Using a designated neutral zone for passing sharps

Answer

A neutral (hands-free) zone, where sharps are set down and picked up rather than passed hand to hand, is a recommended practice for reducing needlestick and sharps injuries. Other recommended measures include blunt suture needles and one-handed recapping devices.

CSFA - Certified Surgical First Assistant Practice Test

CSFA - Certified Surgical First Assistant Practice Test

CSFA Operating Room Safety and Environmental Hazards