Warming blankets used to drape the head and maintain normothermia during surgery may increase the risk of fire, but there are steps the surgical team can take to minimize this risk, according to a quality improvement study conducted by a team of Milwaukee nurses.
Using an intubation mannequin, Katie Chapp, RN, and Linda Lange, RN, of Froedtert Hospital examined how the use of a polyethylene warming blanket head drape would impact the risk of ignition in the case of an undetected anesthesia system gas leak. They found several significant risk factors for the accumulation of oxidizers, one of the elements of the fire triangle, in this scenario, "including higher oxygen flow rate, the presence and application of the head drape and not using the warming blanket blower," according to the findings published in the June issue of AORN Journal.
"A slow endotracheal tube leak can cause the unsafe accumulation of oxygen in an enclosed environment in as little as 5 to 10 minutes," write the authors. "To interrupt the oxidizer element of the fire triangle, it is imperative that when a head drape is used, steps be taken to minimize the fire risk."
They recommend venting the drape, for instance by cutting an opening in the drape around the endotracheal tube, using the warming blanket blower, "and having the anesthesia care provider frequently lift the head drape, thus minimizing the accumulation of trapped gases."
Irene Tsikitas
