NFPA 115 Recommended on Laser Fire Protection (1999 Edition)
5-4 Health Care.
5-4.1 Facility.
The health care facility where the medical laser is used should conform to ANSI Z136.3, Safe Use of Lasers in Health Care Facilities, NFPA 101®, Life Safety Code®, and NFPA 99, Standard for Health Care Facilities. These documents include requirements on entry and exit access, posted signs, limited access, and beam barriers at all windows and doors.
5-4.2 Combustible Substances.
It should be recognized that no materials, excepting the noble metals, can be categorically considered “fire safe” when impinged on by a laser beam in the presence of oxygen-enriched atmospheres. Potential fuels in health care facilities include but are not limited to the following:
(1) Patients. Hair, gastrointestinal gases (methane, hydrogen, and hydrogen sulfide)
(2) Prepping Agents. Degreasers (ether, acetone, aerosol adhesives, alcohol), tinctures (Hibitane™, Merthiolate™, collodion, benzoin)
(3) Fabric Products. Towels, surgical drapes, dressings, gowns, masks, shoe covers, caps/hoods, gauze, sponges, patient warming devices
(4) Plastic/Rubber Products. Surgical drapes, gloves, anesthesia masks, tracheal tubes, breathing circuits, patient warming devices
(5) Ointments. Petroleum-based jelly
(6) Laser Circuitry. Beam tubes, fiber-optic cables
5-4.3 Gases.
5-4.3.1 Flammable Gases.
Flammable gastrointestinal gases such as methane, hydrogen, and hydrogen sulfide present a unique hazard. Precautions to eliminate or manage these gases should be taken.
5-4.3.2 Oxidizing Gases.
Ignition can be enhanced by the use of oxygen-enriched atmospheres that are created by the use of respiratory or anesthetic gases, or both — for example, oxygen and nitrous oxide.
5-4.3.3 Nonflammable gases.
Nonflammable anesthetic gases and vapors have replaced flammable anesthetic gases and vapors in the United States.
5-4.4* Operating Room Environment.
If an oxygen-enriched atmosphere exists — that is, exceeds 21 percent oxygen — additional precautions should be taken, as the probability of ignition is increased.
5-4.5 Before Using Laser.
5-4.5.1 Beam Alignment.
If an alignment beam is present, proper coincident with the treatment beam should be verified before each use.
5-4.5.2 Beam Intensity Profile.
If the laser has been determined to be a beam ignition hazard, the intensity profile should be determined before each use.
5-4.6 Beam Stop Materials.
Before the laser is used, it should be determined that the appropriate beam stop materials are in place.
5-4.7 Education.
Education should be in accordance with that stated in ANSI Z136.3, Safe Use of Lasers in Health Care Facilities, Section 5. Detailed training in laser safety should be required for those health care personnel using a medical laser or responsible for patient care during the use of a medical laser. Those personnel include the surgeon or physician using the laser, the laser safety officer, anesthesia personnel, nursing staff, and other health care personnel as appropriate.