Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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S U R G I C A L S A F E T Y source, an oxidizer and ments on surgical drapes or other flamma- fuel — are often present and abundant in the close confines of the surgical endotracheal tube or laryngeal mask air- ble materials, even for just a few seconds. way to prevent the escape and accumula- Place electrosurgical handpieces in their FRONTLINE FOCUS Every member of your surgical team must be aware of burn risks, including not-so-obvious dangers. tion of oxygen. • Fuel. Virtually every material at the sur- holsters when not in use, and ensure other suite. Minimizing the risk heat-generating devices are either safely gical site can catch fire. Drapes, gowns means strictly controlling off the field and switched off, or with their and caps; linens, towels and sponges; each component of this ends covered by a guard or damp cloth. gauze, dressings and tape; skin preps, potentially dangerous com- Activate electrical devices only when their degreasers and tinctures; anesthesia cables are connected and they're ready to masks, cannulas and tubing; or a patient's Plan Your Prevention use, and avoid excessively prolonged use. tissue, hair and intestinal gas. The key is to T he Centers for Medicare and Medicaid Services and the With regard to electrosurgical instruments, reduce the risks that fuel sources present leading accreditation agencies, not to mention local, only the surgeon should control the hand- and exercise extreme caution. Make sure state and federal authorities, require surgical facilities or foot-switch, and only when the active skin prep solutions are completely dry tip is directly in his view. before surgery begins, or avoid flammable bination. STAFF EDUCATION • Heat or ignition source. The energies generated by electrosurgery and electrocautery units are put to use in nearly every case. to implement fire safety policies. But protecting your patients Minimally invasive proce- against burn injuries involves a wider focus than quarterly surgi- dures demand bright endo- cal fire drills. scopic and arthroscopic • Oxidizer. The surgical atmosphere is alcohol-based preps entirely. Tape a oxidizer-rich. The flow of high-quality oxy- Your thorough risk assessment and prevention policy should patient's hair or slick it back with a water- gen, nitrous oxide, compressed medical air based lubricant. And, as mentioned, never light sources. Some spe- include the likelihood of burn injuries resulting from the thermal and efficiently ventilated ambient air all place heat-generating devices on drapes or cialties employ power extreme of flash-sterilized instruments, a chemical reaction from present risks. Surgical sites on the head, the patient. tools or lasers to achieve prep solution pooled on the skin or the improper use of electrical neck and upper chest are especially per- their aims. There's no nerve stimulators. Add a notification of potential burn injury risks ilous, given the use of electrosurgery in Patient warming shortage of electrical to pre-op time outs. close proximity to the delivery of oxygen. Anything that can cause a fire can harm a Fire safety experts at ECRI recommend patient, but an OR blaze isn't the only peri- equipment in the OR that Training builds awareness of the risks that staff might not have can produce heat or spark, seen. AORN, the ECRI Institute, the Anes-thesia Patient Safety reducing this risk by administering ambi- operative pitfall that can leave patients and consequently increase Foundation and other sources offer a wealth of useful education- ent air instead of 100% oxygen for open burned. In fact, the fire triangle isn't even the potential risks of OR al materials and recommendations. Use them to inform your delivery, if sedated patients' oxygen satura- necessary for injuries to occur. Non-fire fires and patient burns. frontline staff during regularly scheduled in-services. tion levels remain stable without extra related burns are an often-overlooked issue oxygen, or by securing the airway with an in patient safety and burn prevention Never set hot instru- 1 8 SUPPLEMENT — Marilyn Burns, RN, BS, CNOR TO O U T PAT I E N T S U R G E R Y M A G A Z I N E | J A N U A R Y 2013 J A N U A R Y 2013 | S U P P L E M E N T TO O U T PAT I E N T S U R G E R Y M A G A Z I N E 1 9