Operating Room Fires: Preparation and Prevention

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Table of Contents

Introduction
Literature Review
Patient Safety/Risk Management
Patient Safety/Risk Management Objectives in the Event/Issue
Surgical Fires
Risk Management Strategies
Nursing Implications
References

Introduction

In the few years that have passed, there has been a prevalence of surgical fires across the hospitals in the U.S.A. Approximately; there are 240 cases of operating room fires occurring annually. Research supports the view that operating room fires can be prevented, managed, and controlled. Effective knowledge about the preparation for incidences of fire breakout is crucial.

Literature Review

American Association of Nurse Anesthetists (ANNA) has collaborated with Food and Drug Administration (FDA) to increase the awareness of the factors leading to surgical fire, provide fire preclusion tools, and encourage implementation of safer practices in the hospital fraternity. American Association of Surgical Physicians Assistants (AASPA) emphasizes patient safety through communication and collaboration among the operating team members. ASA (American Society of Anesthesiologists) made proposals regarding prevention and preparation for operating room fire occurrence and has advanced efforts in the dissemination of its policies in hospitals. Many other organizations are assiduously working to ensure the administration of the best fire safety standards in health care.

Patient Safety/Risk Management

Risk management issue is the process of exercising precautionary measures against a peril that aims at reducing the incidences of harm to the patient and reduction of the losses that could occur in the event of the hazard. Patient Safety/Risk Management can be defined as the measures that are laid down to help in safeguarding patients against the occurrence of a given undesired threat. In the context of operating room burn events, one can say that it is the formal measures that elucidate how the patients should be safeguarded against the undesired event whose occurrence can’t be predicted. Patients in the operating room need to be evacuated immediately in the event of fire (Dankanich, 2013). Proper procedures regarding the prevention of the death of the patient should also be exercised. After safeguarding the patient, treatment should commence immediately. It is important to exercise maximum control over the undesired peril since its occurrence can lead to financial losses or death.

Patient Safety/Risk Management Objectives in the Event/Issue

Surgical fires can have distressing outcomes on the patients, personnel, and the health facility in general. It is vital to know how the preventive measures can be exercised. Knowledge of the exit strategy is also crucial. It helps in laying the possible precautionary measure to be adhered to in case of an undesired event. The health facility employees who handle patients in an operating room should exercise meticulous control and management measures to prevent fire-related losses (Amaral, 2012). Patients are usually unconscious and cannot as such manage to evacuate themselves during a surgical room fire. There should be clearly laid down procedures that safeguard patients in the cases of fire break out.

Surgical Fires

Patients are taken to the hospital for treatment in advance before their conditions worsen and probably lead to death. A surgical room provides an area where the patients are operated on. There are different products used that have a high probability of causing a fire. Operating room fires are avertable. If they are in their extremes, proper precautions and management measures can be applied to prevent loss. Patient safety/risk management in the event of a fire is usually carried out to safeguard the life of a patient (Dankanich, 2013). It is also exercised to ensure that the patient continues with treatment without being disrupted by fire. There should be appropriate measures regarding prevention and management of fire. The hospital’s workforce needs to protect itself during such incidences.

Hospital personnel needs to familiarize themselves with their fire prevention and management roles. Research shows that there has been ignorance on part of the staff in adhering to different fire safety programs such as; attendance to fire drills and fire models that turn out to be the reason for the potential hindrance in the prevention and management of operating room fires (Bane, 2014). Fire prevention skills need to be continuously updated for effective management in the occurrence of a fire. Operating room fires are controllable, only that, the adoption of the preventive measures across the hospitals is gradual. Fires in the operating room can be caused by the presence of a number of elements found in a fire triangle.

The first one is the oxidizer. When enough vapors are supplied with adequate oxygen, it can lead to fire a breakout; given that oxygen supports combustion. The source of oxygen can be the decomposition of nitrous oxide due to extreme heat (Dankanich, 2013). The room air also has oxygen. An oxygen-enriched room can ignite and burn causing a fire in a room. The second element is the Ignition source. Heat can be produced from the electrosurgical or electrocautery units (ESUs, ECUs), lasers used in the free beam way, or by contact tips or fibers. These produce the necessary heat that burns due to oxygen presence producing both heat and light (fire). The third element is fuel. This includes all the products that can smolder. All the products that are used for patients in an operating room can burn in the presence of oxygen. They include surgical drapes, alcohol-based skin preparation agents, and the patient (Dankanich, 2013).

Risk Management Strategies

Fire in a surgical room can be categorized into two types: the fire occurring on the patient and the one occurring in the surgical room’s internal environment. If the fire occurs and affects a patient, it should first be extinguished. One can achieve this through the use of CO₂ on the burning material. The alarm should be raised without hesitating. The gasses sources for both oxygen and nitrous oxide need to be put off to prevent the flow of these gasses into the operating room (Bane, 2014). Once the fire is brought down, treatment and care for the patient should resume instantly. The other management procedures should follow suit. If the room has a lot of smoke evacuation should be done as quickly as possible. Notification to the relevant bodies of the peril occasion should be done without dithering.

The risk of fire management strategy revolves around controlling all the elements of the triangle. Preventing fire breakouts is paramount. Proper measures with regard to preparation for fire hazards in an operating room are essential. If the two are observed, the management of surgical fire becomes easy (Dankanich, 2013). Heat sources in an operating room need to be prevented from getting into contact with fuels for the minimization of the chances of a fire break-out. Surgical room safety can also be achieved through the excellent management of fuels. The levels of oxygen in a surgical area should be reduced. Hospital personnel should conduct a fire risk evaluation at all times before undertaking any course of action. Surgical equipment needs to be used safely and kept away from patients’ reach. The health facility personnel need to be adequately prepared with the right safety procedures to follow in the event of a fire. It can be through conducting fire drills in the operating room. The staff should be equipped with the necessary knowledge concerning the usage of fire extinguishers (Anesthesia Patient Safety Foundation – Resources – Fire, 2010). Communication is also critical in the management of fire. The surgical room personnel should not blame each other in the event of a fire. Rather, they should unite in curbing the fire. The operating room personnel should also be aware of the legal requirements in relation to reporting such a fire. They need to report the fire occurrence to the relevant body (Dankanich, 2013). Failing to report a case of fire constitutes a crime.

Nursing Implications

The nursing fraternity should be aware of all the possible measures to follow with regard to an operating room fire (Bane, 2014). Implementation of all relevant measures will save the lives of the patients and will also save their lives. The losses that could otherwise occur as a result of fire breakouts will also be prevented. It is the work of the health facility’s nursing personnel to prevent, prepare for and manage operating room fires.

References

Amaral, J. F. (2012). Surgical energy sources (p. 34-72). Philadelphia: Lippincott Williams & Wilkins.

Anesthesia Patient Safety Foundation – Resources – Fire. (2010) Prevention and management of operating room fires. Web.

Bane, C. (2014). OR surgical fire training: How to prevent and respond to surgical fires (p. 7-19). Marblehead, MA: HCPro.

Dankanich, N. (2013). Operating room skills (p. 22-33): Fundamentals for the surgical technologist. Boston: Pearson.

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