4 Tips for Improved Fire Safety in Operating Rooms

ASC operating rooms can be dangerous breeding grounds for fire outbreaks, especially during head and neck surgeries when three components — an ignition source such as a cautery, fuel such as alcohol-based solutions and oxygen — are combined, says Jo Ellen Braden, RN, administrator of Marysville (Ohio) Surgical Center. Here are four tips for improving fire safety in ASC operating rooms.

1. Consult recommendations and best practices from health organizations. Ms. Braden often visits websites of various organizations, including the Association of periOperative Registered Nurses and ECRI Institute. ECRI published clinical guidance on surgical fire prevention and management in late 2009 that outlines what ASC surgical teams should do to prevent the incidence of surgical fires before the start of surgery, during various types of surgery and when using equipment such as electrocautery or lasers.

"The ECRI clinical guide to surgical fire prevention is free and comes from a file that you can download," she says. "I downloaded that guide and actually had posters made, which were laminated and posted in every operating room and procedure room so that the physicians can see it. AORN, [which] is like the gold standard in our industry, also has a whole program on prevention of surgical fire."

2. Educate physicians and staff on fire safety awareness. Marysville Surgical Center has a fire safety day that incorporates the local fire department in raising fire safety awareness within the facility. The fire department assisted in training physicians and staff members on how to use OR extinguishers, which are filled with CO2 and don't contain the propellants found in a conventional fire extinguisher, and ABC fire extinguishers. Ms. Braden says she is in the process of working with the ASC's quality assessment/performance improvement committee and governing board to require that all physicians complete continuing medical education the Anesthesia Safety Foundation will likely roll out sometime in the near future.

"Another resource we use for education is a video that the Anesthesia Patient Safety Foundation came out with that the entire ASC watched together over breakfast," Ms. Braden says. "The video proves just how easy it is for a surgical fire to happen in an ASC setting."

3. Equip the facility with fail-safe materials. Ms. Braden says the ASC has invested extra money to purchase fail-safe cables for use with their endovideo system to prevent potential fire outbreaks.

"What the fail-safe cables essentially do is automatically shut down the fiber optic cables that are not connected to a scope," she says. "Otherwise, those cables could burn through drapes, injuring a patient or and catch something on fire. That light gets so hot, so it's something we implemented a few years ago to beef up our fire prevention program in the OR."

4. Watch oxygen levels. During actual procedures, Marysville Surgical anesthesiologists are reminded to, when possible, run the lowest concentration of oxygen during head and neck surgeries, a best practice Ms. Braden gleaned from an ECRI recommendation. Anesthesiologists can use a mix of oxygen and room air to lower the risk of fire outbreaks.

"We try to keep the oxygen concentration at about 30 percent or less to prevent surgical fires," she says. "Normal healthy patients can certainly tolerate that, but it takes sound medical judgment to discern how far down you can go with patients."

Learn more about Marysville Surgical Center.

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