Second OpinionsNail Polish Remover in a Surgical Enviro...

Nail Polish Remover in a Surgical Environment

On occasion, we have the need to remove nail polish from the patient's finger in order to get a good pulse ox reading.
Since acetone is known to be extremely flammable,
we were told by a consultant that we could use "non-acetone nail polish remover." However,on the outside of the non-acetone container, it also states that the chemicals contained are "highly flammable."
Can anyone weigh in on this for us?
1) Can nail polish remover be kept in Pre-Op only?
2) Is there any "safe" nail polish remover that can be kept in the OR?
3) Should we eliminate nail polish remover all together due to flammability?
Thank you!

Started by: Carol Fischer (Other) at February 22, 2017 (3:13 pm)

Comments and Responses

 

Perhaps the best thing to consider is patient safety. Keeping a highly flammable item in the OR poses a very high risk to everyone. I agree that it must be kept in the Pre-op area only.

Blessie Deguit (Other) at May 19, 2017 (6:26 am)

So I have published and spoken quite a bit on surgical fire prevention and I will give my 2 cents. First understand that the fire triangle does have 3 sides, fuel, oxidizer, and heat. Without all 3, you have no worries. Now lets apply some analysis. Acetone is a fuel which is either stored or used. In storage, I would recommend acetone wipes (same packing as alcohol preps) as they are single use and the foil lined packet is not subject to burning. Now in use, with this prep, you are going to have very little acetone volume and acetone evaporates quickly and will not pool. So at this point, it is "extremely flammable" but there should be no ignition source nor open delivery of oxygen at this time. So without ignition source, the fire risk is essentially zero. Has about the same fire risk as alcohol prep which are pretty ubiquitous. So order the little preps and send the consultant packing. (or ask them to explain why alcohol preps are safe). Now there are risks with large bottles of acetone, but there are logical and safe means of solvents and cleaners in the form of wipes. Hope this helps.

Charles Cowles (Anesthesiologist/Nurse Anesthetist) at February 22, 2017 (10:25 pm)

So I have published and spoken quite a bit on surgical fire prevention and I will give my 2 cents. First understand that the fire triangle does have 3 sides, fuel, oxidizer, and heat. Without all 3, you have no worries. Now lets apply some analysis. Acetone is a fuel which is either stored or used. In storage, I would recommend acetone wipes (same packing as alcohol preps) as they are single use and the foil lined packet is not subject to burning. Now in use, with this prep, you are going to have very little acetone volume and acetone evaporates quickly and will not pool. So at this point, it is "extremely flammable" but there should be no ignition source nor open delivery of oxygen at this time. So without ignition source, the fire risk is essentially zero. Has about the same fire risk as alcohol prep which are pretty ubiquitous. So order the little preps and send the consultant packing. (or ask them to explain why alcohol preps are safe). Now there are risks with large bottles of acetone, but there are logical and safe means of solvents and cleaners in the form of wipes. Hope this helps.

Charles Cowles (Anesthesiologist/Nurse Anesthetist) at February 22, 2017 (10:00 pm)

You can use Vegan Nail Polish Remover or this brad called 10-Free:

About our 10-Free™ brand

Why 10-Free™ I hear you ask? The answer is simple. We strip out a lot of bad stuff. While no nail polish can ever be fully free of chemicals, our 10-Free™ brand does not contain formaldehyde, toluene, DBP, camphor, formaldehyde resin, xylene, parabens, fragrances, phthalates and animal derived or tested ingredients.

Kester Black has also never used ingredients ethyl tosylamide, triphenyl phosphate or xylene.

Cruelty free, vegan, made in Australia.

Donna Tiberi (Other) at February 22, 2017 (4:26 pm)

We don't always worry about the nail polish either but in an instance where we have to remove it, we do use nail polish remover pads. The packaging looks just like alcohol pads but it is instead nail polish remover. Although you should be aware of all fire risks in the OR, you probably have alcohol containing prep agents that carry the same risk and we use them every day safely. Just follow fire risk precautions and you should be fine.

Jaqulyne G. (Director, Surgical Services/Director of Nursing) at February 22, 2017 (4:22 pm)

I don't worry with the nail polish. Simply rotate the oximeter probe 90 degrees so that it is oriented from side to side on the finger. It doesn't matter what orientation the probe is for the light to pass thru the finger.

Jeffrey S. (Anesthesiologist/Nurse Anesthetist) at February 22, 2017 (4:07 pm)

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