Reducing surgical fire risk

Healthcare Purchasing News, March, 2005 by Cynthia T. Crosby

* Ensure that alcohol vapors have dissipated before allowing a heat source in proximity

* Be aware of the flammability of prepping agents and dressings during surgery

Based on these guidelines, some assumptions can be made: the type of applicator for antiseptic skin preparations is an important criterion for product selection, and water-based ointments are safer choices than petrolatum.

The need to control the application of flammable solutions during electrocautery procedures cannot be overstated. The Food and Drug Administration requires that solutions with alcohol must have an applicator that controls solution flow, allows alcohol vapors to dissipate and minimizes excess solution from collecting-single-use bottles with no applicators should not be used.

In addition to carefully evaluating flammable solutions, purchasers may wish to reevaluate the use of disposable drapes. These materials are less expensive than cloth drapes but are much more flammable, even when treated with flame retardants. (2)

Conclusion

Preventing surgical fires requires attention from everyone in the operating room as well as hospital staff members who are responsible for researching and making purchasing decisions. The potential for surgical fire risk is another consideration in the process of selecting products. There may be more choice in evaluating infection control products, such as antiseptic skin preparations and draping materials, than there is in other components of the fire triangle. Understanding how a product should be used to minimize fire risk--such as the need to control the flow of a flammable solutions--is part of the product selection process.

References

(1.) Macdonald AG. A brief historical review of non-anaesthetic causes of fires and explosions in the operating room. Br J Anaesth. 1994;73(6):847-856.

(2.) Podnos YD, Williams RA. Fires in the operating room. Bulletin of the American College of Surgeons. 1997;82(8):14-17. Available at: http://www.facs.org/about/committees/cpc/ oper0897.html. Accessed January 25, 2005.

(3.) ECRI. A clinician's guide to surgical fires: how they occur, how to prevent them, how to put them out. Health Devices. 2003;32(1):5-24

(4.) ECRI. Medical Device Safety Reports. The Patient is on Fire! A Surgical Fires Primer. 1992;21(1):19-34. Available at: http:// www.mdsr.ecri.org/summary/detail.aspx?doc_id-8197. Accessed January 25, 2005

(5.) Sentinel Event Alert. June 24, 2003, Issue 9. Available at: http:/ /www.jcaho.org/about us/news letters/ sentinel event alert/sea_29.htm. Accessed January 9, 2005.

Heat Sources (4)

These heat sources can produce temperatures from a few hundred to a few thousand degrees:

Fahrenheit

Overhead surgical lights

Defibrillators

Electrosurgical and electrocautery units

Heated probes

Drills and burs

Argon beam coagulators

Fiberoptic light sources

Lasers