ANSWERS

1. Under what regulations does an employer have a duty to assess the risk of exposure to anaesthetic gases to his or her employees and take the appropriate measures to protect their health?
   The COSHH (Control of Substances Hazardous to Health) Regulations 1988.
2. In addition to the COSHH Regulations, list other legislation relating to veterinary anaesthesia.
   • The Health and Safety at Work Act 1974.
   • The Control of Pollution Act 1974.
   • RIDDOR (Reporting of Diseases and Dangerous Occurrence Regulations) 1980.
   • Manual Handling Operations Regulations 1992.
3. What protective clothing must be available to staff working in the theatre?
   
   • Gowns or theatre suits.
   • Theatre headwear.
   • Footwear such as clogs or wellington boots.
   • Surgical gloves.
   • Facemasks.
   • Goggles.
   • Disposable aprons.
4. List 10 ways in which theatre anaesthetic pollution may be minimised.
   • Avoid administering anaesthetic gases via face masks.
   • Use correctly fitting endotracheal tubes.
   • Inflate the cuffs of endotracheal tubes.
   • Employ an effective scavenge system (active scavengers are generally considered the most efficient).
   • Do not turn on the nitrous oxide and volatile agent until the circuit is connected to the patient.
   • Flush the patient circuit with oxygen for at least 30 seconds before disconnection.
   • Flush the circuit with oxygen beforehand if the patient requires disconnection during anaesthesia.
   • Fill vaporisers at the end of the operating session in a well ventilated area.
   • Check all anaesthetic equipment daily and ensure that professional servicing of the anaesthetic machine is carried out every 6 months (keep a maintenance log book).
   • Monitor anaesthetic gas pollution levels every 6 months.
5. What health problems are associated with prolonged exposure to anaesthetic gases?
   • Neoplasia.
   • Neuropathy.
   • Bone marrow toxicity.
   • Infertility.
   • Miscarriage.
   • Congenital abnormalities in the offspring of theatre personnel.
6. Name a potentially hazardous carrier gas.
   Nitrous oxide; this is particularly harmful to expectant mothers since it crosses the placenta.
7. Why is the recovery area likely to prove more hazardous to personnel with regard to anaesthetic pollution than the theatre?
   Animals exhale waste anaesthetic gases upon recovery and good ventilation is therefore vital in this area.
8. In addition to the health risks associated with anaesthetic gases (see Q5), what other hazards may be encountered relating to the subject of veterinary anaesthesia?
   • Back injuries as a result of moving heavy patients or gas cylinders.
   • Self-injection of harmful drugs.
   • Zoonoses from handling patients.
   • Fire/explosion risk from volatile gases.
   • Bites and scratches during restraint for anaesthesia.
9. Describe how self-injection may be avoided.
   • Ensure that animals are adequately restrained particularly during recovery.
   • Avoid unnecessary handling of patients making an excitable recovery.
   • Dispose of needles in sharps containers immediately after use.
   • Never carry syringes and needles in pockets.
   • Never walk around with a loaded syringe and needle unless it is securely sheathed.
10. List safety measures taken to avoid accidents involving gas cylinders.
    • A hazard warning notice should be clearly displayed in the gas storage area.
    • A "No Smoking" sign should be clearly displayed in the gas storage area.
    • Cylinders should be handled carefully using a trolley if necessary.
    • Cylinders should be stored in a cool, dry area in such a way that they will not fall or become damaged.
    • Cylinders should not be exposed to high temperatures or sunlight.