Fire safety in the operating room.
OBJECTIVE
Elimination of flammable anesthetic gases has had little effect on operating-room fires except to change their etiology. Electrocautery and lasers, in an oxygen-enriched environment, can ignite even the most fire-resistant materials, including the patient, and the fire triad possibilities in the operating room are nearly limitless. This review will: identify operating room contents capable of acting as ignition/oxidizer/fuel sources, highlight operating room items that are uniquely potent fire triad contributors, and operating room identify settings where fire risk is enhanced by proximity of triad components in time or space.


RESULTS
Anesthesiologists are cognizant of the risk of airway surgery fires due to laser ignition of the endotracheal tube and/or its contents. Recently, however, head/neck surgery under monitored anesthesia care has emerged as a high-risk setting for operating room fires; burn injuries represent 20% of monitored anesthesia care-related malpractice claims, 95% of which involved head/neck surgery.


CONCLUSIONS
Operating room fires are infrequent but catastrophic. Operating room fire prevention depends on: (a)understanding how fire triad elements interact to create a fire, (b) recognizing how standard operating-room equipment, materials, and supplemental oxygen can become one of those elements, and (c) vigilance for circumstances that bring fire triad elements into close proximity.
Rinder
Christine Stowe
CS
Department Anesthesiology, Yale University School of Medicine, New Haven, Connecticut 06520, USA. christine.rinder@yale.edu
D000758:Anesthesia / Q000009:adverse effects / Q000592:standards*; D002056:Burns / Q000209:etiology / Q000517:prevention & control*; D004564:Electrocoagulation / Q000009:adverse effects; D005390:Fires / Q000517:prevention & control*; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods; D009873:Operating Rooms / Q000592:standards*; D010100:Oxygen / Q000009:adverse effects; D013514:Surgical Procedures, Operative / Q000592:standards
D010100:Oxygen