title: Operating room fires in otolaryngology: risk factors and prevention.
abstract: OBJECTIVE
  The aim of the study was to characterize the causes of operating room (OR) fires in otolaryngology.
  
  
  METHODS
  A questionnaire was designed to elicit the characteristics of OR fires experienced by otolaryngologists. The survey was advertised to 8523 members of the American Academy of Otolaryngology-Head and Neck Surgery.
  
  
  RESULTS
  Three hundred forty-nine questionnaires were completed. Eighty-eight surgeons (25.2%) witnessed at least one OR fire in their career, 10 experienced 2 fires each, and 2 reported 5 fires each. Of 106 reported fires, details were available for 100. The most common ignition sources were an electrosurgical unit (59%), a laser (32%), and a light cord (7%). Twenty-seven percent of fires occurred during endoscopic airway surgery, 24% during oropharyngeal surgery, 23% during cutaneous or transcutaneous surgery of the head and neck, and 18% during tracheostomy; 7% were related to a light cord, and 1% was related to an anesthesia machine. Eighty-one percent of fires occurred while supplemental oxygen was in use. Common fuels included an endotracheal tube (31%), OR drapes/towels (18%), and flash fire (where no substrate burned) (11%). Less common fuels included alcohol-based preparation solution, gauze sponges, patient's hair or skin, electrosurgical unit with retrofitted insulation over the tip, tracheostomy tube, tonsil sponge, suction tubing, a cottonoid pledget, and a red rubber catheter.
  
  
  CONCLUSIONS
  OR fire may occur in a wide variety of clinical settings; endoscopic airway surgery, oropharyngeal surgery, cutaneous surgery, and tracheostomy present the highest risk for otolaryngologists. Electrosurgical devices and lasers are the most likely to produce ignition.
authors.affiliation: Division of Pediatric Otolaryngology, Schneider Children's Hospital, North Shore Long Island Jewish Health System, New Hyde Park, NY, USA. lsmith8@nshs.edu
authors.forename: Lee P
authors.initials: LP
authors.lastname: Smith
authors.forename: Soham
authors.initials: S
authors.lastname: Roy
mesh_terms: D004598:Electrosurgery / Q000009:adverse effects; D005390:Fires / Q000517:prevention & control / Q000706:statistics & numerical data; D006801:Humans; D007834:Lasers / Q000009:adverse effects; D009873:Operating Rooms; D010036:Otolaryngology / Q000295:instrumentation; D012307:Risk Factors; D017751:Safety Management