Fire safety in the operating room

Current Opinion in Anaesthesiology

Volumn 21, Issue 6, 2008, Pages 790-795

  Rinder, Christine Stowe ^a  

^a YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Fire triad; Monitored anesthesia care liability; Operating room fires; Oxygen enriched atmospheres

Indexed keywords

FUEL; OXYGEN;

ANESTHESIA; ANESTHESIST; ANESTHETIC EQUIPMENT; ENDOTRACHEAL TUBE; FIRE PROTECTION; HEAD AND NECK SURGERY; HUMAN; LASER; MALPRACTICE; MEDICAL INSTRUMENTATION; OPERATING ROOM; PRIORITY JOURNAL; REVIEW;

ANESTHESIA; BURNS; ELECTROCOAGULATION; FIRES; HUMANS; MONITORING, INTRAOPERATIVE; OPERATING ROOMS; OXYGEN; SURGICAL PROCEDURES, OPERATIVE;

EID: 56849091813     PISSN: 09527907     EISSN: None     Source Type: Journal    
DOI: 10.1097/ACO.0b013e328318693a     Document Type: Review

References (20)

1. JCAHO. National patient safety goals. http://www.jointcommission.org/ PatientSafety/NationalPatientSafetyGoals/07_amb_obs_npsgs.htm
2. ECRI Inst. Devastation of patient fires. Health Devices 1992; 21:3-39.
3. Williams DM, Littwin S, Patterson AJ, Brock-Utne JG. Fiberoptic light source-induced surgical fires: the contribution of forced-air warming blankets. Acta Anesthesiol Scand 2006; 50:505-508.
4. Bhananker SM, Posner KL, Cheney FW, et al. Injury and liability associated with monitored anesthesia care: a closed claims analysis. Anesthesiology 2006; 104:228-234.
5. Goldberg J. Brief laboratory report: surgical drape flammability. AANA 2006; 74:352-354.
6. 2 laser? A comparative study. J Clin Anesth 1992; 4:217-219.
7. Weber SM, Hargunani CA, Wax MK. Duraprep and the risk of fire during tracheostomy. Head Neck 2005; 28:649-652.
8. Sommers JR. Flammability standards for surgical drapes and gowns: past, present, and future. SSM 1998; 2:41-44.
9. Ehrenwerth JE. Electrical and fire safety. In: Barash PG, Cullen BF, Stoelting RK, editors. Clinical Anesthesia, 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. pp. 169-173.
10. Neuman GG, Sidebotham G, Negolanu E, et al. Laparoscopy explosion hazards with nitrous oxide. Anesthesiology 1993; 78:875-879.
11. Niskanen M, Purhonen S, Koljonen V, et al. Fatal inhalation injury caused by airway fire during tracheostomy. Acta Anesthesiol Scand 2007; 51:509-513.
12. Wolf GL, Simpson JI. Flammability of endotracheal tubes in oxygen and nitrous oxide enriched atmosphere. Anesthesiology 1987; 67:236-241.
13. GL W. Danger from OR fires still a serious problem: ASA panel reports risks. J Clin Monitor and Comput 2000; 16:237-238.
14. Barker SJ, Polson JS. Fire in the operating room: a case report and laboratory study. Anesth Analg 2001; 93:960-965. This landmark study describes an actual operating-room fire, and then creates a model of that event to systematically and scientifically determine which specific risk factors contributed to the fire. Their approach is ingenious and their findings give insight pertinent to virtually all fires that develop during MAC anesthesia.
15. Sa Rego MM, Watcha FJ, Whilte PF. The changing role of monitored anesthesia care in the ambulatory setting. Anesth Analg 1997; 85:1020-1036.
16. Meneghetti SC, Morgan MM, Fritz J, et al. Operating room fires: optimizing safety. Rast Reconstr Surg 2007; 120:1701-1708. A significant proportion of today's operating-room fires occur during MAC anesthesia for plastic surgery of the head and neck. Accordingly, the plastic surgery literature contains a number of excellent reviews and investigations, such as this one, which maps the area of the face most at risk in the presence of nasal cannula oxygen. They also propose and test delivery of supplemental oxygen through a nasal trumpet during MAC as a means of reducing that risk.
17. Rinder CS, Dabu-Bondoc S, Salgar V. A Device to Reduce O2 Accumulation and Reduce Fire Hazard during MAC Anesthesia. Anesthesiology 2005; 105(Suppl):46C.
18. 2 gas mixtures from anesthesia machines. Anesth Analg 2005; 101:1407-1412.
19. Barnes AM, Frantz RA. Do oxygen-enriched atmospheres exist beneath surgical drapes and contribute to fire hazard potential in the operating room? AANA 2000; 68:153-161.
20. Smyth ET, Humphreys H, Stacey A, et al. Survey of operating theatre ventilation facilities for minimally invasive surgery in Great Britain and Northern Ireland: current practice and considerations for the future. J Hosp Infection 2005; 61:112-122.