Author	Sliney, David H. author
Title	Medical Lasers and Their Safe Use [electronic resource] / by David H. Sliney, Stephen L. Trokel
Imprint	New York, NY : Springer New York, 1993
Connect to	http://dx.doi.org/10.1007/978-1-4613-9252-1
Descript	XII, 230p. 88 illus. online resource

This text was designed for the physicians, nurses, technical personnel, and staff members of medical facilities using lasers for surgical, therapeutic, and diagnostic purposes. The objective is to provide an understanding of the potential health and safety hazards associated with the use of medical laser systems and the precautions needed to use them safely. To do this, it is necessary to have an awareness of applicable standargs and regulaยญ tions that apply to laser use. This book is not intended as a substitute for the American National Standards Institute (ANSI) Z-136. 3, "Safe Use of Lasers in Health Care Facilities," but to facilitate its implementation as well as the implementation of the many other related regulations and guidelines that are pertinent. These other regulations include the Medical Device Amendments to the Food and Drug Act, the Federal Laser Product Performance Standards issued under the Radiation Control for Health and Safety Act, and applicable regulations of the Occupational Safety and Health Administration (OSHA). The text is organized to provide first an overview of laser hazards, laser surgical applications, and laser biological effects. General safety control measures and safety standards are then presented. Because laser techยญ nology is rapidly evolving, these general guidelines will allow safe use of new laser systems as they become available. Finally, specific safety guideยญ lines and precautions are provided for specialized laser applications in the different health care specialties

1. Introduction to Medical Laser Systems -- Light and Electromagnetic Radiation -- Lasers and How They Work -- Properties of Laser Light -- Pulsed and Continuous-Wave Lasers -- Beam Profiles -- Delivery Systems -- Laser System Control -- 2. Laser Systems -- Categories of Lasers -- Specific Lasers Used in Medical Practice -- 3. Laser-Tissue Interactions -- Terminology -- Categories of Laser-Tissue Interaction -- 4. Laser Applications in Medical Practice -- General Surgery -- Dermatology -- Ophthalmology -- Cardiovascular and Chest Surgery -- Gynecologic Lasers -- Otolaryngology and Head and Neck Surgery -- Neurosurgery -- Tumor Surgery -- Urology -- Anesthetic Considerations -- Biostimulation or โ{128}{156}Softโ{128}{157} Lasers -- Diagnostic Lasers -- 5. Laser Injury and Potential Hazards -- Hazards to the Eye -- Skin Hazards -- Personnel Susceptibility -- 6. Safety Standards and Laser Exposure Limits -- National and International Standards -- Laser Safety Exposure Limits -- Laser Hazard Classification -- Laser Hazard Assessment -- 7. Ancillary Hazards of Laser Use -- Electrical Hazards -- Airborne Contaminants (Vaporized Target Tissue) -- Chemical Hazards -- 8. Investigational and Research Lasers -- Introduction: Investigational and Prototype Lasers -- Investigational Lasers and the FDA -- The 1990 Amendments to the Medical Device Act -- Use of Approved Lasers in a Nonapproved Manner -- Laser Safety in the Experimental Environment -- Equipment Safety: Ancillary Hazards -- Laser Eye Protection -- Laser Accident History -- Hazard Evaluation Report for New Laser Systems -- 9. Engineering Control Measures -- Concepts of Engineering Controls -- Laser System Design and Required System Safety Features -- Ancillary Hazards -- The Nominal Hazard Zone and Focused Beams -- Laser Room Design and Controlled Areas -- Controlling Reflections -- Software and Electronic Failures -- 10. Personnel Protective Equipment -- Eye Protection -- 11. Administrative Control Measures -- Laser Safety Program -- Examples of Standard Practice -- Hospital Laser Safety Regulations -- FDA Administrative Controls -- Appendix 1 -- Appendix 2 -- Appendix 3 -- Appendix 4 -- Appendix 5 -- Appendix 6 -- Appendix 7 -- Appendix 8 -- Appendix 9 -- Appendix 10 -- Appendix 11 -- 12. Medical Surveillance -- Population to be Monitored -- Medical Examinations -- Lesions that Mimic Laser Injuries -- Laser-Specific Testing -- 13. Laser Checkout and Demonstration Procedures -- Simple Tests of Laser Operation -- Safeguards During Demonstrations and Training -- Installation of Lasers at Medical Equipment Exhibitions and Training Sites -- Appendices: Useful Reference Information