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SAFETY
odor, smoke or excessive heat.
Hold regular fire drills, which should include stopping procedures
and alerting the surgical team that a fire has started. Practice taking
appropriate action to put out the fire, and remove tracheal tubes and
all flammable materials such as drapes, even if the fire is not on the
patient. Immediately stop airway gases and pour saline into the
patient's airway to extinguish residual embers and cool tissues. Treat
the patient and evacuate the OR if necessary.
Add fire risk assessments to your surgical safety checklist. Before
each case ask: What's the fire risk for this procedure? The checklist
should verify that alcohol-based solutions are thoroughly dry. Also use
the checklist as a reminder to identify the location of the oxygen cutoff valve.
Surgeons set the tone in the OR. If they treat fire prevention with
the respect it deserves, the rest of the surgical team will do the same.
But if they're cavalier about the risks, the rest of the team won't see
the value of drills, preparation and constant vigilance. OSM
A former emergency room nurse, firefighter and paramedic, Dr. Cowles
(cowlesmd@gmail.com) serves on the American Society of Anesthesiologists
task force that created the practice advisory for prevention and management of
OR fires. He is an assistant professor in the department of anesthesiology and
perioperative medicine and chief safety officer of perioperative enterprise at the
University of Texas-MD Anderson Cancer Center in Houston.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | O C T O B E R 2013
