Operating rooms, where lives are saved, and health is restored, should be places where precision and safety reign supreme. Unfortunately, within this haven of medicine is a peril that’s both alarming and preventable: surgical fires. Although surgical fires are relatively rare, their potential to cause harm is significant – making prevention and preparedness essential.
In this article, we explore the dangers associated with surgical fires by exploring their causes, fuel sources, and the importance of prevention and preparedness measures in healthcare facilities. By understanding risks, identifying contributing factors, and taking effective measures, healthcare professionals can strengthen patient safety in operating rooms.
The operation room: preventing surgical fires
Surgical fires can be as hazardous as they appear. Imagine you wake up in a post-anesthesia care facility (PACU) following the time you underwent a normal routine procedure but then were informed that a fire broke out during anesthesia. Although it sounds like something straight from an animated film, the dangers are real. Around 90 to 100 surgical fires are reported across the United States per year, with an average of two surgical fires happening each week.
While surgical fires can be dangerous, they’re easily prevented, and should they occur, surgical teams have prepared. The NFPA 99 Code for Health Facilities contains guidelines for the training of every surgical room (OR) personnel to avoid surgical fires. In addition, CMS and other health accreditation agencies for health care refer to NFPA 99: 2012 Edition.
Surgical Fire Risk Assessments
Before starting a procedure and before making a single cut, the team performing the surgery must conduct a Fire risk analysis (FRA). FRAs aid in identifying the most significant risk elements (i.e., oxygen, heat, and fuel) and can be easily integrated into routine procedures to identify other perioperative assessments and issues.
For instance, after the team has verified the right surgical site, identification of the patient, and any allergies, The surgical FRA will evaluate the particular risks and will include an assessment tool that scores the risk of fire for the surgical procedure as high, medium, or low. It is a crucial tool for establishing an open dialogue between the group and ensuring that the proper procedures for preventing fires during surgery, as well as risk reduction strategies, are implemented. For more details, go to the website!
Assessing three Critical Elements:
Heat
The surgical energy is ignited to cause the majority of surgical fires that occur around the patients. The most commonly used type of energy used in surgery is monopolar radiofrequency energy, often referred to as “the “Bovie.” The Bovie transforms the energy of electromagnetic waves into thermal energy, and it’s the process of heating tissues or the device that acts as the source of ignition of the fire.
Equipment like fiberoptic light sources, lasers, and high-speed burrs are additional heat sources that can aid in the ignition of the fire in an operating room. Hospitals need to educate their personnel on the appropriate use of these devices and on the dangers that come with each device.
Oxygen.
What does oxygen have to do with surgical fires? Oxygen is a great way to develop fires by making them burn more quickly and stronger, larger and more intense. In nearly all procedures, anesthesia providers administer oxygen directly to patients. How they distribute that oxygen is crucial. Open oxygen delivery can pose a greater risk for the patient than closed systems (e.g., intubated patients). Certain strategies can be employed to minimize the risk of oxygen-rich environments and oxygen pooling in and surrounding patients.
Fuel.
Controlling the source of heat and monitoring the rate at which oxygen is introduced is much easier to manage. Fuel is everywhere around us. Everything can be a source of fuel, from surgical drapes and the prep solution applied to the skin of the patient as well as gauze pads and surgical towels. Making sure your prep solution has been dried according to the manufacturer’s guidelines and being aware of the fuel sources’ proximity can significantly decrease the risk of fire-related incidents and improve the safety of operating rooms.
Surgical Fire Prevention: Training and Education
Hospitals and surgical centers should invest in education and training to ensure that the surgeons, staff, and anesthesia specialists are well-prepared to deal with surgical fire. The facility should have a plan to stop airway fires, drape fires, fires in prep solutions, and equipment fires that could occur in the surgical room. Every facility should be trained and apply these methods within their organizations.
The various members of the medical team need to be aware of how to stop various kinds of fires during surgery. For instance, the airway fire is usually controlled by the surgeon within the room. The anesthesia provider has to shut off oxygen flow before having the patient extubated. Without this, it could result in the flame igniting the patient’s airway and burning inside the surgical room.
Additionally, emergency procedures must clearly define members of the surgical team as well as their roles and responsibilities. This will help them be able to determine their roles and responsibilities with evacuation in the case in the event of an operational room fire. The proper evacuation locations must be identified and linked to the operational room. For instance, when a patient needs to be removed from oxygen suctioning or monitoring the patient, they require an evacuation location that can accommodate suctioning, oxygen, and monitoring.
Final thoughts
As is clear from healthcare facilities, safeguarding against surgical fires is not optional but essential. Due to the risks they entail, surgical teams must remain alert and ready at all times. As this article has emphasized, a comprehensive approach involves conducting fire risk assessments to classify potential dangers, paying attention to heat, oxygen, and fuel sources and strategies to combat each.
Training and education programs can assist healthcare professionals in responding effectively during a surgical fire. Preparatory measures go beyond regulatory compliance: they serve as the cornerstone of patient safety and demonstrate healthcare facilities’ dedication to providing superior care. By remaining informed, trained, and ready, surgical teams can ensure every post-anesthesia care unit patient experiences a smooth recovery without fear of fires.