Workplace Safety and Environment of Care
Core concepts
Environment-of-care safety covers electrical safety (grounding, leakage current, patient care categories), fire safety (device ignition sources, oxygen-enriched environments), hazardous materials, radiation safety (ALARA, shielding, dosimetry), and physical hazards (lifting, slips, sharps). Know the concept of patient care electrical categories and why leakage current limits are stricter for devices connected to patients. Understand medical gas systems and the hazards of oxygen-enriched atmospheres near electrosurgery. Know the role of life safety surveys and documentation of drills and inspections.
Traps
A frequent trap is assuming any outlet is acceptable for patient-connected equipment - leakage current limits and grounding requirements differ. Another is ignoring oxygen-enriched environments when discussing fire risk with electrosurgery or defibrillation. Watch for questions that conflate electrical shock risk with microshock risk (catheter-connected patients are far more vulnerable).
Rule of thumb
For electrical safety, remember: patient-connected devices have lower allowable leakage current than non-patient devices, and microshock thresholds are far lower than macroshock thresholds.
Worked example
An electrosurgical procedure is scheduled near an open oxygen source. The safety review identifies fire risk from oxygen enrichment plus an ignition source; mitigation includes reducing FiO2 where clinically appropriate, using appropriate dispersive electrode placement, and keeping flammable materials away.