Fires occur in the operating room but which are preventable medical errors. Many healthcare organizations have created tools, worked on strategies, and conducted education and outreach efforts to reduce the risk of fires.
To prevent surgical fires, FDA has regulated the drugs as. oxygen, skin preparation agents and devices like the ESUs, lasers and surgical drapes that are conducive to start a fire. However, despite FDA’s strong regulations, occurrence of fires has not been completely controlled.
FDA continually collaborated with relevant public and private partners to optimize the safe use of products the agency regulates as part of its Safe Use Initiative. FDA had convened a meeting with representatives from a variety of healthcare organizations to discuss ways to discuss ways to prevent surgical fires. This was the first step in identifying hindrances to safe habits with the ultimate goal of engaging all partners in developing specific, tangible interventions to prevent surgical fires.
Surgical fires are fires happening in, on or around a patient who undergoes medical or surgical procedure. It can happen anytime in the presence of the fire triangle: ignition source as
electrosurgical units (ESUs), lasers, and fiberoptic light sources); fuel source as surgical drapes, alcohol-based skin preparation agents, the patient and oxidizer oxygen, nitrous oxide and room air.
Each year, more than 650 surgical fires happened which do not include the fires that were immediately put out. Fires in the operating each year are potentially life-threatening. Three things have to be present for a fire to start the fire triangle must be present: the heat, a source of fuel or something that burns and oxygen. Surgical fires do not have to happen and can be avoided with proper precautions and communication by the surgical team.
Procedures followed in the head and neck area open a greater risk of fire due to the potential for an oxygen-rich environment around a patient’s face from a breathing mask. Skin cleaners like alcohol is highly flammable especially when it pools in the skin folds of overweight patients. Surgical drapes susceptible to fire can hide the pooling of liquid alcohol skin preps. Drapes may trap alcohol vapors from skin and starts igniting.
Tools used in operation such as electrocautery for tissue-cutting, units, lasers, fiber-optic lights and cables can generate heat or sparks and cause a fire. Even the hair on the face may need to be covered with water soluble jelly to prevent ignition. This is important for head and neck surgeries and for patients with beards, moustaches and thick eyebrows. The patient should be kept on room air and not highly concentrated oxygen. If extra oxygen is needed, it should be the lowest concentration that is safe for the patient. Lastly, the staff must be trained in preventing, recognizing and putting out surgical fires.
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