Prevention of and response to surgical fires (1 August 2019)

Summary

Operating theatre fires remain an uncommon but real safety risk for patients undergoing nearly all types of procedures, and despite ongoing safety initiatives, occur more commonly than wrong-site surgeries. One of the most compelling cases for safety improvement in the surgical setting is within this area. Combining the simple steps of operating theatre team education; improving lines of communication between surgeons, anaesthetists, and operating theatre nurses or practitioners; and the deliberate separation of the elements of the fire triangle can almost completely eliminate the incidence of surgical fires.

In this brief review, Cowles Jr and Culp Jr hope that readers will be able to reduce the risk of surgical fires effectively by the application of the safety principles described.

Content

Key points

• Communication between members of the surgical team is an integral component of the prevention of surgical fires.
• Open delivery of 100% oxygen should be avoided if at all possible for surgery above the xiphoid process.
• Surgeons usually control the ignition sources, such as electrosurgical units and lasers.
• Operating theatre nurses or practitioners usually control the fuel sources, such as alcohol-based preparations and surgical drapes.
• The use of an ignition source in close proximity of an oxidiser-enriched environment creates a high risk for surgical fires.