Waste Anesthetic Gase: A Forgotten Problems

Waste anesthetic gas (WAG) is a small amount of inhaled anesthetic gas that comes out of the patient’s anesthesia breathing circuit into the envorinment air while the patient is under anesthesia. According to American Occupation Safety and HealthAdministration (OSHA) more than 200.000 healthcare workers especially aneaesthesiologist, surgery nurse, obstetrician and surgeons are at risk of developing work-related disease due to chronic exposure to WAG. Exposure to WAG in short time associated with multiple problems such as headaches, irritability, fatigue, nausea, drowsiness, decrease work efficiency and difficulty with judgment and coordination. While chronic exposure of WAG is associated with genotoxicity, mutagenicity, oxidative stress, fatigue, headache, irritability, nausea, nephrotoxic, neurotoxic, hepatotoxic, immunosuppressive and reproductive toxicological effect. Waste anesthetic gases are known as environmental pollutants and will be released from the OR to the outside environment then the substance will reach the atmosphere damaging ozone layer. Exposure to trace WAG in the perioperative environment cannot be eliminated completely,but it can be controlled. Controlling WAG can be achieve by using scavenging system, proper ventilation, airway management, ideal anesthetic choice, maintaining anesthesia machine and equipment, hospital regulation and routine healthcare workers health status examination.

Waste Anesthetic Gase : A Forgotten Problems

ABSTRACT Waste anesthetic gas (WAG) is a small amount of inhaled anesthetic gas that comes out of the patient’s anesthesia breathing circuit into the envorinment air while the patient is under anesthesia. According to American Occupation Safety and Health Administration (OSHA) more than 200.000 healthcare workers especially aneaesthesiologist, surgery nurse, obstetrician and surgeons are at risk of developing work-related disease due to chronic exposure to WAG. Exposure to WAG in short time associated with multiple problems such as headaches, irritability, fatigue, nausea, drowsiness, decrease work efficiency and difficulty with judgment and coordination. While chronic exposure of WAG is associated with genotoxicity, mutagenicity, oxidative stress, fatigue, headache, irritability, nausea, nephrotoxic, neurotoxic, hepatotoxic, immunosuppressive and reproductive toxicological effect. Waste anesthetic gases are known as environmental pollutants and will be released from the OR to the outside environment then the substance will reach the atmosphere damaging ozone layer. Exposure to trace WAG in the perioperative environment cannot be eliminated completely, but it can be controlled. Controlling WAG can be achieve by using scavenging system, proper ventilation, airway management, ideal anesthetic choice, maintaining anesthesia machine and equipment, hospital regulation and routine healthcare workers health status examination.

Upaya Penurunan Kejadian Kehilangan Gelas Berukuran Sedang Melalui Penerapan Metode Quality Control Circle (QCC) di Unit Gizi, RS ABC, Jakarta

Nutrition Department of ABC Hospital provides food and beverage for all inpatients based on nutrition standard from their practioners. Therefore, Nutrition Department needs several types of cutlery for serving them food and beverage as needed. The stock of these types of cutlery should be maintained by nutrionists. During August and September 2011, the stock of middle-sized glasses had been deficit. This condition made the Nutrition Department initiate a QCC group named Sushi to prevent the deficit by strengthening the control over the stock. After this improvement, they had successfully suppressed the deficit from 193 to 77 units or 60.10%. Due to hospital regulation that every lost should be redeemed by nutritionist, this improvement had also enable the department to suppreesed the cost of lost units (quality cost).

An Evolution Of Hospital Regulation: A Perspective

Hospital costs have remained a public concern during the last decade. As one delves into the discussion, a paradox quickly becomes evident; the hospital industry is becoming increasingly regulated while the economy in general undergoes deregulation.