OSE_1310_part3_Layout 1 10/7/13 10:33 AM Page 106
SAFETY
dures performed around the face or above the xiphoid process.
Learn the risks
Teach your staff about the dangers of OR fires. Lessons should
cover what to do during high-risk surgeries, including explaining open
methods for surgical draping: Positioning drapes over the patient and
securing them to a pole prevents oxygen from accumulating to dangerous levels underneath the covers. A fire can occur if oxygen is
trapped under drapes and an ignition source such as an electrocautery pen is used. Materials that usually do not easily burn in room
air can ignite in this oxygen-enriched environment.
There is a greater risk of fire with open-oxygen delivery systems such
as nasal cannula or masks than there is with closed delivery systems
such as laryngeal masks or endotracheal tubes. If electrocautery or
other devices will be used with an open-oxygen delivery system, ensure
oxygen concentration is below 30%. (Sixty-five percent of surgical fires
reported occur in
MNEMONIC AIDS
cases of surgeries
When Every Second Counts
above the level of
R Remove everyone from fire area
the xiphoid. Most
A Alert others and use pull station
occur when the conC Confine fire by closing doors
centration of oxygen
E Extinguish or evacuate
eclipses the 30%
threshold).
P Pull pin on extinguisher
Remove just one
A Aim at base of fire
element of the fire
S Squeeze handle
triad and you
S Sweep from side to side
remove all risk of
— Charles Cowles, MD
fire. So do all
patients require oxy-
2
1 0 6
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