**Author details**

Everyone in the team should be made aware that it is their responsibility to assertively raise their voice at least two times to ensure they are heard, that the member being challenged must acknowledge, and that if the outcome is not acceptable, a stronger action should be taken with the supervisor and that there should be stop the line in issues about safety including cessation of the process. While conflicts are common, that about 40% of the leader's time is spend on this, solving is critical to becoming productive and increase possibility of satisfaction of the

**Before anesthesia Before skin incision Before patient leaves operating room**

Nurse verbally confirms with the team: The name of the procedure recorded the instrument, sponge and needle counts are

How specimen is labeled (Including

Whether there are any equipment problems to be addressed.

Surgeon, anesthesia professional and nurse review the key concerns for recovery and management of this patient

• *Roles and responsibilities understood?* • *Situation awareness maintained?*

• *Did we ask for or offer assistance?* • *Were errors made or avoided?* • *What went well, what should change,* 

correct (or not applicable)

patient name).

(Debrief).

• *Communication clear?*

• *Workload distribution?*

*what can improve?*

Confirm all team members have introduced themselves by name

and nurse verbally confirm

• Surgeon reviews: what are the critical or unexpected steps, operative duration, and anticipated blood loss. Anesthesia team: Are there any patient-specific concerns • Nursing team reviews: Has sterility (including indicator results) been confirmed? Are there equipment issues or

Has antibiotic prophylaxis been given within the last 60 minutes?

Is essential imaging displayed

Sign in Time out Sign out

and role

• Patient • Site • Procedure

concerns?

Yes/Not applicable

Yes/Not applicable.

Site marked/not applicable Surgeon, anesthesia professional

Anesthesia check list completed Anticipated critical events

Patient has confirmed

50 Vignettes in Patient Safety - Volume 4

Pulse oximeter on patient and

• Identity • Site • Procedure • Consent

functioning

Does the patient have • Known allergies: Yes/No • Difficult airway/aspiration risk No/Yes, and equipment assistance

• Risk of >500 ml of blood loss (7 ml/Kg for children) No/Yes and adequate intravenous access and fluid available

**Table 1.** WHO safety checklist.

available

physician and patient [37].

Daniel Kinyuru Ojuka1 \*, Lydia Okutoyi2 and Frederick C. Otieno3

\*Address all correspondence to: danielojuka@gmail.com


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**Chapter 4**

**Provisional chapter**

**Fundamentals of Medical Radiation Safety: Focus on**

This chapter provides an overview of key topics in the area of radiation safety. Three clinical vignettes will serve to frame the review of the literature around both diagnostic radiation exposure and the risk of radioisotope contamination. Advancement in medical technology is rarely innocuous, and the use of radiation as both means to diagnose and treat certain conditions is not an exception. It is very important for clinicians to review the basics of harmful medical radiation exposure since, although seldom encountered, treatment, and outcomes are time sensitive. The advent of newer technology and the widespread availability of equipment will only serve to increase the prevalence of potentially harmful medical radiation exposure. Moreover, this chapter aims to explore current multidisciplinary endeavors to provide safe and efficient use of radiation in medicine. Solely relying on the medical profession for development of safeguards against harmful medical radiation exposure would be an impossible task. This is why it is crucial for professionals such as health physicists, radiation safety enforcement officers, and policy-makers at the state, national, and international level to establish consensus guidelines aimed toward safe, reliable utilization of radiation in medicine. Part of this interdisciplinary approach needs to focus on accurate education of patients. A thorough assessment of acute radiation syndrome, including diagnosis, treatment, and prognostic indicators is also part of this chapter. Furthermore, principles of screening for, and protection from, radiation contamination are outlined. Finally, areas for further research are identified throughout the chapter. The discussion takes into account both US-based and International research and practice guidelines.

**Keywords:** diagnostic radiation exposure, patient safety, radiation exposure, radiation

safety, radioisotope contamination, safety protocols

**Fundamentals of Medical Radiation Safety: Focus** 

**on Reducing Short-Term and Long-Term Harmful** 

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: 10.5772/intechopen.85689

**Reducing Short-Term and Long-Term Harmful**

Alex Alers, Philip Salen, Vikas Yellapu, Manish Garg, Charles Bendas, Nicholas Cardiges, Gregory Domer, Timothy Oskin, Jay Fisher and Stanislaw P. Stawicki

Alex Alers, Philip Salen, Vikas Yellapu, Manish Garg, Charles Bendas, Nicholas Cardiges, Gregory Domer, Timothy Oskin, Jay Fisher and Stanislaw P. Stawicki

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.85689

**Exposures**

**Abstract**

**Exposures**


#### **Fundamentals of Medical Radiation Safety: Focus on Reducing Short-Term and Long-Term Harmful Exposures Fundamentals of Medical Radiation Safety: Focus on Reducing Short-Term and Long-Term Harmful Exposures**

DOI: 10.5772/intechopen.85689

Alex Alers, Philip Salen, Vikas Yellapu, Manish Garg, Charles Bendas, Nicholas Cardiges, Gregory Domer, Timothy Oskin, Jay Fisher and Stanislaw P. Stawicki Alex Alers, Philip Salen, Vikas Yellapu, Manish Garg, Charles Bendas, Nicholas Cardiges, Gregory Domer, Timothy Oskin, Jay Fisher and Stanislaw P. Stawicki

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.85689

#### **Abstract**

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[40] Van Klei WA, Hoff RG, Van Aarnhem E, Simmermacher RKJ, Regli LPE, Kappen TH, et al. Effects of the introduction of the WHO "surgical safety checklist" on in-hospital mortality: A cohort study. Annals of Surgery. 2012;**255**(1):44-49. DOI: 10.1097/

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& Bartlett Publishers; 2010. ISBN 13: 9780763755447

681-692. DOI: 10.1016/S0277-9536(96)00221-3

Centered Care. N Engl J Med. 2012 Feb 29;**366**(9):780-1

2000;**5**(4):302-311. DOI: 10.1634/theoncologist.5-4-302

Jun 3, 2018]

54 Vignettes in Patient Safety - Volume 4

NEJMp1109283

San Francisco; 2002

SLA.0b013e31823779ae

This chapter provides an overview of key topics in the area of radiation safety. Three clinical vignettes will serve to frame the review of the literature around both diagnostic radiation exposure and the risk of radioisotope contamination. Advancement in medical technology is rarely innocuous, and the use of radiation as both means to diagnose and treat certain conditions is not an exception. It is very important for clinicians to review the basics of harmful medical radiation exposure since, although seldom encountered, treatment, and outcomes are time sensitive. The advent of newer technology and the widespread availability of equipment will only serve to increase the prevalence of potentially harmful medical radiation exposure. Moreover, this chapter aims to explore current multidisciplinary endeavors to provide safe and efficient use of radiation in medicine. Solely relying on the medical profession for development of safeguards against harmful medical radiation exposure would be an impossible task. This is why it is crucial for professionals such as health physicists, radiation safety enforcement officers, and policy-makers at the state, national, and international level to establish consensus guidelines aimed toward safe, reliable utilization of radiation in medicine. Part of this interdisciplinary approach needs to focus on accurate education of patients. A thorough assessment of acute radiation syndrome, including diagnosis, treatment, and prognostic indicators is also part of this chapter. Furthermore, principles of screening for, and protection from, radiation contamination are outlined. Finally, areas for further research are identified throughout the chapter. The discussion takes into account both US-based and International research and practice guidelines.

**Keywords:** diagnostic radiation exposure, patient safety, radiation exposure, radiation safety, radioisotope contamination, safety protocols

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
