Surgical Fires. The basics of preventing and responding to fires in the operating room. Presented for:. Presented by: OmniSure Consulting Group Kathleen Fitzgerald, RN, BSN Risk Management Consultant. Identify the 3 elements necessary to create fire
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The basics of
preventing and responding to
fires in the operating room
OmniSure Consulting Group
Kathleen Fitzgerald, RN, BSN
Risk Management Consultant
550-600 surgical fires in the United States annually (comparable to wrong site surgeries)
Surgical fires cause 2 to 3 patient deaths and approximately 20 serious injuries annually
About 75% of surgical fires occur under local and are caused by oxygen trapped under the drapesThe Stats
TO CAUSE FIRE
O2, N2O, medical compressed air, and ambient air
Surgeons: Ignition Sources
defibrillators, lasers, electrocautery units, and fiber-optic light sources, electronic scalpels
drapes and preps, gowns, towels and sponges (other fuels: hair, intestinal gases and body tissue)THE CHEMISTRY OF FIRE IN THE OR
CARBON DIOXIDE PREFERRED IN THE SURGICAL SETTING
Practice fire prevention techniques and precautions
Educate and re-educate staff to the OR-specific fire plan, the roles of personnel, the locations and operation of alarms, extinguishers, exits, etc.Elements of an Effective Fire Plan Continued
Do not apply drapes until all flammable preps have completely dried.Elements of an Effective Fire Plan Continued
Smother the fire and/or remove the burning material.
Stop the flow of gases.
Remove the burning materials.
Extinguish the fire.
Ventilate the patient.
Call for help.
Evacuate, if necessary.
Examine and treat the patient.
Don’t forget to save equipment, materials and devices for risk management/patient safety investigationManagement of Fire on the Patient General Principles
Containers of volatile solutions (alcohol, acetone, etc.) should be closed soon as possible.
Avoid petroleum-based ointments.
During local or conscious sedation, turn off oxygen 60 seconds prior to activation of ESU or Laser if used on the head or neckControlling Fuels
FIRE SPREADS QUICKLY, SO YOU MUST RESPOND QUICKLY
1. Immediately remove burning materials from patient
2. Shut off medical gases; manually ventilate, if necessary
3. Anesthesia disconnects patient from oxygen source
4. Smother fire. Use fire blanket, if necessary.
5. Move patient to safe area where oxygen may be administered
IN RAPID SEQUENCE:
1. Disconnect breathing circuit from endotracheal tube and stop the flow of airway gases
2. Remove tube & extinguish burning material
3. Examine airway and remove any debris
& if necessary, pour saline down the airway
4. Re-establish airway. Ventilate with air
5. Examine airway and treat injuries
Assists in moving patient out of the ORScrub Nurse
honors from Indiana University Southeast in 1986. She was named
Nursing Student of the Year in 1986.
Her professional experience includes 24 years of nursing practice in clinical,
leadership and management roles. This experience encompasses Healthcare
Risk Management, Medical Liability Claims, Patient Safety, Legal Nurse
Consulting, In-house Defense Medical Malpractice, Operating Room Nursing,
Dialysis, Labor and Delivery, Hospice and Psychiatry.
Ms. Fitzgerald also designs and presents risk management training programs for
healthcare providers. She has worked for hospitals, long term care providers
insurance companies, law firms, individual attorneys, and claims managers.
Her work has allowed her to attend and assist in the preparation for trials, mediations
and depositions. Proactively, she has assisted healthcare providers to promote
Patient Safety, and to successfully identify, address and manage risks.Kathy’s Bio