Only YOU Can Prevent Surgical Fires

Suzan Miller-Hoover DNP, RN, CCNS, CCRN-

In an article discussing surgical fires, MacDonald reported that the first of surgical fire dates back to 1850; when a fire erupted during a facial procedure using both ether and hot cautery (MacDonald, 1994). Another devastating fire occurred in 2009 during the procurement of organs from a 19-year-old motor vehicle accident victim. At the beginning the surgeon, seeing discharge from around the tracheostomy site, wrapped the tracheostomy with an alcohol-soaked sponge. This sponge burst into flames during the procedure! (Herman, Krzysztof, & Berger, 2009) These tragic fires could have been prevented if the surgical teams had followed a few simple rules.

Surgical Fire

As this image suggests, it take all three of these components for a fire to erupt. It is the responsibility of the entire surgical team to ensure that fire prevention is a high priority. Each team member has control of each side of this triangle:
  •   Anesthesiologists: Oxidizers: Medical gases such as oxygen
  •   Surgeons: Ignition: Heat sources such as lasers, overhead lights, and drills
  •   Nurses: Fuel: Flammable items such as alcohol-based hand sanitizers, bone cement, dressings

Prevention is the most important step in the process! It can happen to you if you and your team become complacent regarding fire safety (AORN, 2018)

What do you do if a fire should erupt? Follow the R.A.C.E acronym:
  •   Rescue the individual that is involved in the fire.
  •   Alarm should be sounded as soon as possible.
  •   Confine the fire.
  •   Extinguish the fire and evacuate if required.

If the fire is small you can use a CO2 extinguisher, be sure you know how:
  •   Pull the pin
  •   Aim the nozzle at the base of the fire
  •   Squeeze the handle
  •   Sweep the stream over the base of the fire

Fire safety is a priority and nurses must act as leaders to ensure proactive fire safety programs are established and practiced by the entire surgical team. With proper training and staff vigilance, virtually all surgical fires can be avoided. For more detailed information on surgical fire prevention go to RN.com and review the Fire Safety and Prevention for Surgical Nurses.

AORN. (2018). Fire Safety Tool Kit. Retrieved from: https://www.aorn.org/guidelines/clinical-resources/tool-kits/non-member-tool-kits/fire-safety-tool-kit-nonmembers

Herman, M., Krzysztof, L. & Berger, J. (2009). Surgical fire during organ procurement. Retrieved from: http://www.ispub.com/ostia/index/php?xm1FilePath=journals/ija/vol19n1/fire.xml

MacDonald, A.G. (1994). A short history of fires and explosions caused by anaesthetic agents. Retrieved from: https://bjanaesthesia.org/article/S0007-0912(17)44447-3/pdf

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