This program has been approved for 2.0 contact hours of continuing education (CRCE) by the American Association for Respiratory Care (AARC). AARC is accredited as an approver of continuing education in respiratory care.


Saxe Communications is approved as a provider by the Vermont State Nurses’ Association Inc. which is accredited as an approver of continuing education in nursing by the American Nurses’ Credentialing Center’s Commission on Accreditation.


To earn credit, do the following:

1. Read all the articles.

2. Complete the entire post-test.

3. Mark your answers clearly with an “X” in the box next to the correct answer. You can make copies.

4.  Complete the participant evaluation.

5.  Mail or fax the post-test and evaluation forms to address below.

6.  To earn 2.0 CRCEs or CEs, you must achieve a score of 75% or more. If you do not pass the test you may take it over one more time.

7.  Your results will be sent within 4-6 weeks after forms are received by mail or fax.

8.  Answer forms must be postmarked by Dec. 31, 2012 (RTs). Dec. 2, 2013 (Nurses).

9. This test can now be taken online. Go to and log in. Upon successful completion, your certificate can be printed out immediately. AARC members’ results are automatically forwarded to the AARC for accreditation.

10. Faculty Disclosure. Dr. Masud and Dr. Restrepo are paid consultants for Teleflex. No conflicts were disclosed for any other faculty.

11. VSNA and ANCC do not endorse any product mentioned.

Please consult  for current annual renewal dates.


Waste Anesthetic Gases (WAGs) among Employees

in the Healthcare Industry

James D. McGlothlin, MPH, PhD, CPE and John E. Moenning, DDS, MSD


The scavenging of waste anesthetic gases (WAGs) is recommended by every professional organization and government agency involved with anesthesia to reduce occupational exposure to health care personnel.1 WAGs in health care environments have been associated with adverse health outcomes in unscavenged situations.2-21 Operating rooms and dental operatories have developed techniques to decrease occupational exposure by scavenging the WAGs and minimizing potential health problems, but few studies have addressed WAGs in the post-anesthetic care unit (PACU).22,23 Monitoring of WAGs, primarily nitrous oxide, has been done using dosimetry badges, hand-held monitoring devices, and infrared spectrophotometry. While these measuring devices give readings in the part per million (ppm) ranges, they cannot visualize the gas during or following administration to a patient. This can be important when determining leaks or direct exposure from patients exhaling residual levels of the anesthetic gases. Recent advances in infrared (IR) videography technology have made it possible to visualize nitrous oxide leakage. Because these leak sources can be readily identified from infrared imaging, the WAGs can be more easily controlled through the elimination of leaks, especially to scavenging systems, so that occupational exposures to personnel in the PACU are decreased. In this article, Drs. McGlothlin and Moenning presents a brief overview of WAGs in the healthcare industry, with a focus on healthcare personnel in the PACU. Recent exposure and risk assessment studies using IR thermography cameras and IR sensors to identify and quantify WAG (i.e., N20) exposures among PACU employees are pointing toward an unidentified and relatively new health exposure concern for these employees.61


Panel Discussion: Waste Anesthetic Gases:

Opinions from the Experts

Panelists: David Farr, MD, Joni Brady, MSN, RN, CAPA, Jim McGlothlin, MD


Waste anesthetic gases (WAGs) pose a significant health hazard in the hospital setting and must be controlled to protect healthcare workers. In this panel discussion, three experts discuss the scope of WAGs as an acute and chronic health hazard, both in the operating room (OR) and post-anesthetic care unit (PACU) settings, and review the many health conditions associated with excess exposure to WAGs. Also discussed are the many government guidelines and other publications that outline exposure limits and offer practical solutions to the problem.