By Erica Holman, NHA, MSW & Angie Szumlinski, NHA, RN-BC, RAC-CT, BS
Sometimes Risk Management involves delivering an unpopular message with a limited number of options. That’s the dilemma faced when Assisted Living and Skilled Nursing Facilities try to manage risk exposures related to the use of electric hair dryers when oxygen is in use. Having a routine or an occasional outing to the beauty shop is something many of our residents look forward to; however, if the resident requires continuous oxygen there are safety risks.
The good news is that the majority of our residents requesting salon services do not rely on oxygen for life support and do not rely on continuous access to oxygen. For these residents the facility should:
- Verify the physician order for oxygen administration and consult the physician for clarification as needed.
- The physician order for oxygen administration should clearly state the oxygen may be intermittently discontinued to minimize the fire hazard exposure to the resident during hair care services.
Things to remember:
- Combustible oxygen remains in the air and on a person's clothes, hair and body for a period of time after the oxygen is turned off.
- Manufacturers recommend a wait time of 15 – 20 minutes once oxygen is removed before allowing access to areas where electric hair dryers are used.
- Facilities should also instruct salon staff to keep hair dryer settings on low heat to minimize a potentially hazardous situation.
Another option facilities may consider is the use of battery-operated hair dryers. The Ohio State University Medical Center advises that battery-operated hair dryers of less than 10 volts are safer, but recommends checking the appropriate conditions of use with the resident's physician.
If the resident cannot be placed on intermittent oxygen use for hair care services, consider styling hair in another location and using setting gels and rollers/hair styling equipment that does not require electricity.
It is also recommended that the use of petroleum-based lotions or creams on the face and/or upper body (i.e., Vaseline) be avoided. Petroleum is highly combustible however cocoa butter, aloe vera or other similar products may be used. For lubrication or rehydration of dry nasal passages, the use of water-based products is recommended. When in doubt consult with the pharmacist, physician or physician extender for recommended products.
- Caregivers should review the manufacturer's recommended instructions for use and handling of oxygen on a regular basis to assist in ensuring compliance with all applicable requirements.
- The facility should have a system for routine maintenance of hair dryers to assist in ensuring the machines, electrical cords, etc. are in good operating condition.
- Electric razors also pose a risk when oxygen is in use as they may cause sparks. It is recommended that the same precautions be followed when electric razors are used.
- Post signs in every room where oxygen is in use and do not allow ANY SMOKING in these areas. THE RESIDENT MUST WAIT 20 MINUTES ONCE OXYGEN IS REMOVED PRIOR TO ENTERING A SMOKING AREA. This will assist in ensuring that all free oxygen has dissipated from clothing, hair, etc.
- Oxygen cylinders should be solidly fixed to avoid creating a missile effect if the tank combusts. This could happen if the tank is accidentally knocked over and gas escapes.
- Oxygen canisters should be kept away from fireplaces, candles and open flame.
- Follow manufacturer guidelines for servicing oxygen equipment and do not use oil, grease or petroleum-based products on the equipment.
- Remember, “empty” cylinders still contain oxygen. All empty cylinders should be stored in secure racks in a separate, secure area.
If you need assistance in developing or implementing a safe use policy in your home please feel free to contact your HealthCap Risk Manager.