Surgical fires happen rarely, but should be taken into consideration, for they can have serious consequences for the hospital’s patients, employees, and the institution as well. It’s necessary to learn the ways to prevent such fires and the ways to deal with inflaming if it happens. (“Surgical Fire Prevention”, 2012). The research on the matter shows that up to 650 surgical fires occur in the US operation rooms each year, with up to 5% causing death or serious harm (Rocos & Donaldson, 2012). According to Feldman, L., Fuchshuber, P. & Jones, D. B. (2012) nearly 44% of fires during surgery occur around the head, neck, face and chest and 21% happen in the airway, (p.75).
Feldman, L., Fuchshuber, P. & Jones, D. B. (2012) note that it takes three elements to start a surgical fire: an oxidizer (e.g. oxygen), fuel (e.g. surgical prep solution) and a heat source (e.g. laser) (p.75). During the surgery heated laser with the connection with the alcohol remains on a patient and oxygen have developed a surgical fire in the patient’s neck.
After the fire has started alarm has been declared immediately. Small flames in the area of the surgical field were covered and extinguished. The laser could have burnt through a pinhole in the outer layer of the surgical linen and ignite the interior. Intensifying flames in the inner layers of surgical linen were checked thoroughly. The power of all electrical equipment has been turned off. The doctors and surgical team were able to put out the fire with minimum consequences to the patient’s health.
After a proper investigation of what had happened the hospital administration came to the conclusion that nurse’s negligence and lack of education on the topic of surgical fire prevention= has become the cause of the fire in the operation room. During preoperational procedure she used too much alcohol, which formatted pool of liquid, endangered and eventually caused a fire.
Surgical Fire Prevention
Alcohol is extremely flammable and can be found in each operation room. No matter how dangerous and flammable it is almost all surgical fires can be prevented if the surgical team has been educated and knows what can lead to a fire. Surgeons, nurses and anesthesiologists should follow practices to minimize fire risks (Gregg, M., Martinez, L. & Samaritan, G., 2015). So it is very important to be extremely careful while using alcohol-based prep. In fact, nonflammable, water-based preps, such as Soloprep, Betadine, Pharmaseal and others should be used when possible (“Surgical Fire Prevention”, 2012).
The finished prep must be completely dry before draping; this should take several minutes, depending on the manufacturer of the medicine and application techniques. Only after complete unwatering an endoscopic laser can be applied without fear of inflaming the alcohol. (Steelman, V. M. & Graling, P. R., 2013).
Rocos & Donaldson (2012) suggested that the course on preventing and dealing with surgical fires must be added to World Health Organization trainings for all the members of the surgical team. All employees of the hospital must have the knowledge of possible dangers regarding an alcohol-based surgery preparation and must take precautions in order to minimize the possibility of causing a surgical fire (p. 87).
References
Rocos, B. & Donaldson, L. (2012, March). Alcohol Skin Preparation Causes Surgical Fires. Annals of the Royal College of Surgeons of England. 94(2): 87–89. doi: 10.1308/003588412X13171221501221
Surgical Fire Prevention. (2012). ECRI Institute. Retrieved from https://www.ecri.org/Accident_Investigation/Pages/Surgical-Fire-Prevention.aspx
Gregg, M., Martinez, L. & Samaritan, G. (2015, December). Surgical Fires and How to Prevent Them. MagMutual. Retrieved from http://www.magmutual.com/surgical-fires-and-how-prevent-them
Steelman, V. M. & Graling, P. R. (2013, June). Top 10 Patient Safety Issues: What More Can We Do? AORN Journal. Retrieved from http://dx.doi.org/10.1016/j.aorn.2013.04.012
Feldman, L., Fuchshuber, P. & Jones, D. B. (2012). The SAGES Manual on the Fundamental Use of Surgical Energy (FUSE). Boston: Springer.
