Authors (including presenting author) :
Wong CY(1), Wong KY(1), Wong MN(1), Wong YH(1), Leung TF(1), Chu KW(1)
Affiliation :
(1)Operating Room, United Christian Hospital
Introduction :
Cryosurgery for Head and Neck (H&N) team is newly introduced in Operating Theatre (OT), which involves using extremely cold liquid nitrogen (-196°C) to destroy abnormal tissues. Safe handling of liquid nitrogen for operational personnel is essential. It can rapidly cause cryogenic burns and asphyxiation hazards even by brief exposure. In alignment with Occupational Safety and Health (OSH) Ordinance and Material Safety Data Sheet (MSDS) recommendations, a guideline for safe handling liquid nitrogen in OT should be developed. It is imperative to ensure staff safety by providing comprehensive and practical training before implementing cryosurgery.
Objectives :
1.To develop a guideline for safe handling liquid nitrogen in OT.
2.To implement an “Enhance, Practise, Create” (EPC) training approach for perioperative nurses and Theatre Assistants (TAs). 3.To create a sense of awareness on handling liquid nitrogen.
Methodology :
1.Develop Guideline
-In 1Q 2024, a workgroup was formed to cooperate with surgeons and pathologists to conduct the risk assessments in OT context, collected feedback from involved personnel on safety measures and developed the workflow of transport, storage, handling, and disposal of liquid nitrogen.
2.EPC Training Approach Enhance staff knowledge
-In 3Q 2024, lecture-based training on perioperative knowledge and safe handling, accompanied by manufacturer and homemade training videos, was conducted. A quick reference was developed to provide the key highlights for the crucial details. Practise safety measures
-In 1Q 2024, a drill was conducted with Kowloon East Cluster OSH team and Pathology Department on handling and decanting liquid nitrogen. Create safety awareness
-In 2Q 2024, a tailor-made liquid nitrogen trolley was implemented to facilitate safe and secure transportation. The self-designed safety cards were displayed to enhance staff awareness.
Result & Outcome :
1.In 3Q 2024, a guideline for safe handling liquid nitrogen in OT was successfully implemented.
2.All trained perioperative nurses and TAs agreed that the EPC training approach was systematic and provided clear guidance.
3.In 4Q 2024, 100% perioperative nurses and TAs in H&N Team successfully passed the competency audit.
4.All H&N Team perioperative nurses were trained as trainers to monitor and supervise the practice of handling liquid nitrogen.
5.As at January 2025, five operations were completed, safety measures were implemented successfully, no hazards occurred.
