Fire Flashcards
Why are fires a risk during monopolar surgeries?
Active electrode is the most common ignition source in OR fires
Fire triangle?
Ignition source
- usually controlled by surgeon
- laser, active electrode
Oxidizer
- usually controlled by anesthesia
- O2, nitrous oxide
Fuel source
- usually controlled by nurses
- skin prep, sponges/gauze
What are some fire safety precautions in the OR?
Allows follow manufacturers instructions
Fire risk assessments
Allow alcohol skin prep to dry before draping
Ensure alarms are on loud
Place ESU pencil/lasers in holster when not using
Have sterile water or NS immediately available
Where on the body is there an increased risk of fires?
Above xiphoid process
Head, neck, face
Fire triad is all in close proximity
3 steps of fire safety in OR
Prevent
- P&P’s
- drills
- education
- safety assessment
Extinguish
- smother * do not pat or pull of drapes*
- sterile water/NS
- do not use fire blanket or extinguisher on pt
Evacuate
Fire risk assessment?
Time out before surgery Identifying elements of fire triangle Preventative/safety measures - allowing prep to dry - lowest amount of O2, no leaks in circuit
Alcohol based prep considerations for fire?
Allow time to dry
Do not allow solutions to pool or saturate drapes
- place towels under patient and then remove
Management of ignition sources for fire safety?
Follow manufacturers recommendations Use lowest setting Keep clean - path of least resistance Keep on holster when not in use Only controlled by surgeon Frequent inspection of equipment
Types of fires that may occur in OR?
On - affects skin, hair, drapes
In - inside Cody cavity ex. Airway, stomach
Off - does not involve patient ex. Piece of equipment
Response to fire in OR?
Alert team Stop O2 / shut off electrical panel Extinguish Move away from sterile field Remove burning material from patient Assess for injuries Keep materials to assess Complete incident report and notify appropriate personnel
What is surgical smoke?
A by product of surgical energy devices
- ESU, lasers
Or
High speed power instruments that may procedure serious that contain blood/bloody fluids
- drills/saws
Health hazards from surgical smoke?
Contains: Toxic chemicals Viruses Bacteria Blood Cancer cells Lung damaging particles
Smoke evacuation?
Wall suction
Used less than 2 inches from source of smoke
Evacuation system
PPE
Hierarchy of controls for smoke elimination?
TOP Elimination -remove hazard Substitution - replace the hazard Engineering controls - air control Administrative controls - education PPE - N95 BOTTOM
most effective at the top to least effective at the bottom
Who came up with the hierarchy of controls for surgical smoke?
National institute for Occupational safety and health
