Management of a fire in the operating room

Abstract

Operating room (OR) fires remain a significant source of liability for anesthesia providers and injury for patients, despite existing practice guidelines and other improvements in operating room safety. Factors contributing to OR fires are well understood and these occurrences are generally preventable. OR personnel must be familiar with the fire triad which consists of a fuel supply, an oxidizing agent, and an ignition source. Existing evidence shows that OR-related fires can result in significant patient complications and malpractice claims. Steps to reduce fires include taking appropriate safety measures before a patient is brought to the OR, taking proper preventive measures during surgery, and effectively managing fire and patient complications when they occur. Decreasing the incidence of fires should be a team effort involving the entire OR personnel, including surgeons, anesthesia providers, nurses, scrub technologists, and administrators. Communication and coordination among members of the OR team is essential to creating a culture of safety.

Centro cirúrgico e cirurgia segura

“…Este sistema deve proporcionar segurança aos pacientes e profissionais do CC em casos de incêndio, minimizar a propagação do fogo e facilitar ações de socorro público. Devem possuir detectadores de fumaça que são acionados a qualquer sinal de fumaça no ambiente e emite um sinal Os sistemas aplicados em CC são os extintores e hidrantes, posicionados em locais adequados e de uso facilitado a todos os usuários 6 .…”

Benzine as fire source in operation room

“…Estimates in the US indicate that around 550 to 650 sparks or begins of ire situation occurs each year, resulting in around 20 to 30 patients being severely injured [1,2,4]. Associations such as the American Society of Anesthesiologists (ASA), the Anesthesia Patient Safety Foundation (APSF) and the Food and Drug Administration (FDA) have released over the last three years recommendations and guidelines for preventing accidents with ire, always focusing on removing situations where fuel sources (surgical drapes, towels, skin antiseptics, masks, hair), oxidizers (oxygen, nitrous oxide) could interact with ignition sources (electrocautery, lasers, iber-optic light sources and cable) [5][6][7][8]. Special attention must be given to the anesthesiologist's role when providing supplementary gas, which could lead to an increased oxygen concentration in the environment.…”

Are you and your patients safe from a surgical fire?

“…Surgical fires are rare occurrences, but they are probably under‐reported . Studies describe between 100 and 650 surgical fires in the United States per year . A substantial number of anaesthesia malpractice claims relate to surgical fires, particularly around the head, neck and airway .…”

“…Studies describe between 100 and 650 surgical fires in the United States per year . A substantial number of anaesthesia malpractice claims relate to surgical fires, particularly around the head, neck and airway . Local New Zealand data is not published, although at least two adverse events involving surgical fires have been reported to the New Zealand Accident Compensation Corporation (ACC) .…”

“…Laparoscopic light sources, lasers and diathermy provide new ignition sources in the modern surgical era . Ignition results from a concentrated source of heat, or a spark . The source is most commonly diathermy; however, lasers carry a relatively greater risk .…”