Prevention and Preparation for an OR Fire

 

 

Education

• Anesthesiologists should have fire safety education specific to OR fires and participate in OR fire drills with the entire OR team.

Preparation

• Before each surgical case, the entire OR team must determine if a case is at high risk for surgical fires.
• If a high-risk situation exists, the team must decide on a plan and roles for preventing and managing a fire.
• In every OR where a fire triad can exist, a protocol for the prevention and management of fires should be displayed.

Prevention

• Avoid using ignition sources in proximity to an oxidizer-enriched atmosphere.
• Configure surgical drapes to minimize the accumulation of oxidizers.
• Allow sufficient drying time for flammable skin prepping solutions.
• Moisten sponges and gauze when used in proximity to ignition sources.
• The anesthesiologist should collaborate with all surgical team members throughout the procedure to minimize the presence of an oxidizer-enriched atmosphere in proximity to an ignition source.
• During high risk procedures in which an ignition source is to be used in an oxidizer-enriched atmosphere, before the ignition source is activated:
  • Announce the intent to use the source
  • Reduce the delivered oxygen concentration to the minimum required to avoid hypoxia
  • Stop the use of nitrous oxide

Management

• Recognize early signs of fire.
• If fire is present, halt the procedure and initiate fire management tasks.
• For airway fires, remove tracheal tube, stop flow of all airway gases, remove all other flammable materials from airway, and pour saline into airway.
• For non-airway fires, stop the flow of all airway gases, remove burning or flammable materials and extinguish fire.
• After fire is extinguished, reestablish ventilation, assess the patient’s status and devise a plan for ongoing care.