Safety: Only You Can Prevent Surgical Fires
3 basic precautions will keep the flames from flying in your ORs.
Charles Cowles, MD
Consider this true-life case: An 18-year-old underwent minor surgery to have a mole removed from his cheek. Although he was in good health and had no comorbidities, the anesthesia provider opted to give supplemental oxygen with a nasal cannula. As soon as the surgeon activated an electrocautery device to stop bleeding at the operative site, a fire ignited that severely burned the patient. The young man arrived for a minor procedure and exited disfigured, requiring extensive reconstructive surgery. The tragedy of it all: This OR fire could have been prevented if the surgical team had adhered to these basic protocols.
A review of OR fire claims shows most are caused by a lack of communication among the OR team. Surgeons are unaware of how oxidizers are being administered by anesthesia providers, while anesthesia providers don't anticipate when surgeons are going to use ignition sources. All members of the surgical team must remain in constant communication when surgical energies are employed. Clear communication is also especially important during seemingly minor procedures performed around the face or above the xiphoid process.
Learn the risks
Teach your staff about the dangers of OR fires. Lessons should cover what to do during high-risk surgeries, including explaining open methods for surgical draping: Positioning drapes over the patient and securing them to a pole prevents oxygen from accumulating to dangerous levels underneath the covers. A fire can occur if oxygen is trapped under drapes and an ignition source such as an electrocautery pen is used. Materials that usually do not easily burn in room air can ignite in this oxygen-enriched environment.
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