ments on surgical drapes or other flamma-
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
tion of oxygen.
• Fuel. Virtually every material at the sur-
holsters when not in use, and ensure other
heat-generating devices are either safely
gical site can catch fire. Drapes, gowns
off the field and switched off, or with their
and caps; linens, towels and sponges;
ends covered by a guard or damp cloth.
gauze, dressings and tape; skin preps,
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
use, and avoid excessively prolonged use.
tissue, hair and intestinal gas. The key is to
With regard to electrosurgical instruments,
reduce the risks that fuel sources present
only the surgeon should control the hand-
and exercise extreme caution. Make sure
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
• Oxidizer. The surgical atmosphere is
alcohol-based preps entirely. Tape a
oxidizer-rich. The flow of high-quality oxy-
patient's hair or slick it back with a water-
gen, nitrous oxide, compressed medical air
based lubricant. And, as mentioned, never
and efficiently ventilated ambient air all
place heat-generating devices on drapes or
present risks. Surgical sites on the head,
the patient.
neck and upper chest are especially perilous, given the use of electrosurgery in
Patient warming
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-
reducing this risk by administering ambi-
operative pitfall that can leave patients
ent air instead of 100% oxygen for open
burned. In fact, the fire triangle isn't even
delivery, if sedated patients' oxygen satura-
necessary for injuries to occur. Non-fire
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
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