Outpatient Surgery Magazine

Is Your Data Secure? Subscribe to Outpatient Surgery Magazine - November 2017

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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Page 102 of 122

So where'd the oxygen come from? The cuff on the patient's anesthe- sia endotracheal tube was inflated. The heat from the disconnected light cable melted the inflation tube. Once the tube melted, the cuff deflated, which caused oxygen to leak past the cuff and build up under the drapes around the patient's head. Right then I knew that some- where on the floor, there had to be a Luer connector that had come loose from the inflation tube when it melted. I started looking around for the luer like a contact lens, and sure enough, found it. Case closed. Could this fire have been prevented? Yes, had the OR team placed the light source in standby when the surgeon disconnected the light cable. For most outpatient surgeries, these 3 preventative measures will help minimize the risk of a surgical fire. 1. Question the need for 100% oxygen delivered on the face. A surprisingly high number of OR staff members think alcohol- based skin preps are the biggest cause of surgical fires, but that's not the case. Skin preps make up only 4% of all surgical fires in ECRI Institute's experience. You'd also be wrong if you guessed draping technique or ignition source power were the leading causes. No, the most significant factor leading to most surgical fires is using 100% supplemental oxygen delivered openly on the face by mask or nasal cannula. Historically that has been common during surgery performed under monitored anesthesia care (MAC). Fortunately, that mindset is changing. More than 70% of fires involve oxygen enrichment. Most patients undergoing MAC procedures don't need 100% oxygen on the face, so always question how much the patient requires before you enter the OR and during initial patient prepping. You can safely sedate most patients without any open oxygen supplementation, using air instead via the face mask or nasal cannula. However, the use of air versus supplemental oxy- N O V E M B E R 2 0 1 7 • O U T PA T I E N T S U R G E R Y. N E T • 1 0 3

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