Module 11 Flashcards

1
Q

What agency publishes standards for fire prevention, detection, and suppression?

A

National Fire Protection Agency

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2
Q

Which code of the NFPA is specific to health care systems?

A

NFPA 99

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3
Q

Name the 3 limbs of the fire triad

A
  • ignition source (heat)
  • oxidizer
  • fuel
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4
Q

A chemical reaction of a fuel rapidly combining with an oxidizer to release energy in the form of heat and light

A

Fire

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5
Q

Name 3 examples of ignition sources in the OR

A
  • fiberoptic cables
  • ESUs (bovies)
  • lasers
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6
Q

Name 3 of the main oxidizers in the OR

A
  • air
  • O2
  • N2O
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7
Q

(T/F) Basically almost everything is a fuel source in the OR

A

True

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8
Q

Name the 3 major dangers from an OR fire

A
  • burns
  • toxicants released
  • smoke
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9
Q

Name 3 of the common toxicants from an OR fire that can damage to airways and cause lung parenchyma

A
  • carbon monoxide
  • hydrogen chloride
  • ammonia
  • cyanide
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10
Q

What are the four types of burn injuries?

A
  • thermal/heat
  • electrical
  • chemical
  • inhalation
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11
Q

What is the most common type of thermal/heat burn injury recorded?

A

Flame injury (43% of injuries reported)

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12
Q

What type of burn injury is most common to children up to age 4?

A

Scald injury

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13
Q

Which type of burn injury can be the most damaging?

A

Electrical

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14
Q

The extent of an electrical burn depends on the amount of ______ _______ conducted through the skin, which is based on the _______ and _______ of contact with the electrical source

A

thermal energy
voltage
duration

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15
Q

10 - 46% of those who have experienced an electrical injury experience some form of cardiac ________ and damage to the _________ can occur.

A

arrhythmias

myocardium

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16
Q

If the amount of muscle damaged from the conducted electric current is significant, _______ can be released into the circulation affecting nephron and renal tubular function, increasing risk of developing _____ _______.

A

myoglobin

renal failure

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17
Q

What is the initial treatment for chemical burns?

A

copious amounts of water or normal saline irrigation

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18
Q

This type of burn injury can often accompany a thermal burn and airway damage can vary

A

Inhalation injury

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19
Q

Inhalation burn injuries are classified based on _______ location

A

anatomical

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20
Q

What are the 3 types/classifications of inhalation burn injuries

A
  • upper airway
  • lower airway
  • metabolic asphyxiation
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21
Q

This classification of inhalation injury is caused primarily by thermal injury to the mouth, oropharynx, and larynx

A

upper-airway

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22
Q

This classification of inhalation injury includes injuries to the trachea, bronchioles, and alveoli caused by chemical and particulate constituents of smoke

A

lower-airway

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23
Q

This classification of inhalation injury in which certain smoke constituents such as carbon monoxide or hydrogen cyanide impair oxygen delivery or use by the tissues

A

metabolic asphyxiation

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24
Q

Most common classification of inhalation injury

A

Lower-airway

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25
Q

What are the 3 phases of burn treatment

A
  • resuscitation phase
  • burn management phase (skin grafting and debridement)
  • reconstruction phase
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26
Q

(T/F) The most common type of fire in the OR occurs on/in the patient

A

True

27
Q

What surgery areas on the patient increase the risk for fire dramatically, especially when the patient is receiving a high amount of supplemental O2?

A

Head
Neck
ENT
Upper Chest

28
Q

What factor dramatically increases risk of fire, and dangerously reduces ignition times?

A

An oxygen-enriched environment

29
Q

All materials burn in an ______-_______ environment

A

oxygen-enriched

30
Q

What are the 2 major ignition sources in the OR?

A
  • ESUs

- Lasers

31
Q

(T/F) You should not conduct open oxygen delivery in MAC cases involving the head and neck or upper body

A

True

32
Q

(T/F) A CO2 absorber fire is considered a type of remote fire

A

True

33
Q

This piece of equipment works via Light Amplification by Stimulated Emission of Radiation

A

Laser

34
Q

What is the laser acronym?

A

Light Amplification by Stimulated Emission of Radiation

35
Q

A laser consists of an energy source and material that the energy _____ to emit light

A

excites

36
Q

In a laser, the material that the energy excites is called the_____ ______ and provides the name of the particular type of laser

A

lasing medium

37
Q

Name and describe the 3 properties of lasers

A
  • coherent radiation (meaning all the waves have the same frequency and phase)
  • monochromatic (of a single color or wavelength)
  • collimated (the beam does not disperse as the distance from the source increases)
38
Q

(T/F) There are several types of lasers used for different procedures and areas of the body

A

True

39
Q

Filling the ETT cuff with ______ can help with early detection of rupture and help alleviate the addition of O2 to an airway fire during high risk procedures

A

Saline

40
Q

(T/F) The ETT is basically a blow torch when it catches fire

A

True

41
Q

The ____ was found to be the ignition source of 90% of airway fires.

A

ESU

42
Q

Which type of ESU is safer?

A

Bipolar

43
Q

What are 3 ways to prevent airway fire in high risk procedures?

A
  • dont use free flow of O2 unless truly required
  • use minimum O2 needs (<30%)
  • ensure no leaks in ETT/LMA
  • dont cover face unless truly required
  • make sure drapes are secure at surgical site
  • use moist gauze/sponges near ignition sources
  • allow alcohol prep to dry completely
44
Q

What “nonflammable” halogenated inhalation agent specifically has been linked to airway fires under certain conditions?

A

Sevoflurane

45
Q

Sevoflurane is nonflammable in air, but serves as a fuel in combinations of ___ and ____

A

O2 & N2O

46
Q

Sevoflurane in _________ CO2 absorbent can undergo exothermic chemical reactions implicated in OR fires

A

desiccated

47
Q

What CO2 absorber is the safest to use with sevoflurane regarding risks of airway fires?

A

Amsorb

48
Q

What are the 10 detailed steps to take during an airway fire?

A
  • Extinguish ASAP, Call for Help, and Interrupt the Fire Triad!!!
  • Stop ignition source: laser, ESU
  • Stop oxidizer (O2 flow)
  • Stop ventilation to limit lung exposure to flame & heat
  • Remove burning ETT: place in water bucket or away from flammable material
  • Extinguish fire with NS, remove drapes
  • Mask ventilate with air until fire extinguished, then FiO2 1.0 (100%)
  • If stable, assess airway for damage with bronchoscopy
  • Reintubate if needed or significant damage noted
  • Arrange for ICU and supportive therapy
49
Q

What are the 5 simplified steps to take during an airway fire? (BE ABLE TO ANSWER IN <10 SECONDS)

A
  • Disconnect ETT circuit
  • removed ETT
  • exstinguish fire with NS
  • re-intubate or mask ventilate
  • assess damage and consult appropriate resources
50
Q

(T/F) N2O is flammable and acts as oxidizer fuel.

A

True

51
Q

______ _______ are impervious to water; thus, throwing water or saline on them will do little to extinguish the fire.

A

Paper drapes

52
Q

Most effective way to extinguish fire on patient (unless the paper drape is on fire)

A

Saline

53
Q

If paper drape is on fire what do you do first to extinguish?

A

Remove it!

54
Q

If you are working a procedure with a high risk of fire, you better have a bottle of what on your cart, readily available?

A

NS

55
Q

If a fire is on the patient and you dont have saline, do not fan it, _______ it.

A

Smother

56
Q

Name the 4 risk factors associated with high fire risk procedures

A
  • open O2 delivery or O2-rich environment
  • Ignition source use (ESU/laser)
  • surgical location head/neck/ENT/upper chest
  • alcohol based prep solutions
57
Q

If > or = ____ fire risk factors exist, then the procedure is at high risks for fires, requiring preventative steps.

A

> or = 3

58
Q

What can class A fire extinguishers be used on?

A

Paper, cloth, plastics

59
Q

What can class B fire extinguishers be used on?

A

Flammable liquids or grease

60
Q

What can class C fire extinguishers be used on?

A

Electrical

61
Q

What type of fire extinguisher is best for the OR?

A

CO2

62
Q

What 2 classes can CO2 extinguishers be mainly used on?

A

B & C (some A)

63
Q

This type of fire extinguisher removes oxygen & heat with cold discharge

A

CO2