When electrosurgery is used during operations there is always a risk of fire, and with over 80% of all surgical procedures today involving electrosurgery, the risk is frequently present in the operating theater. This article addresses some common concerns and questions regarding OR fires and offers some strategies for reducing their occurrence.
What is the most common cause of operating room fires? Three factors must be present for a fire to happen:
-
A source of fuel (prepping agents containing alcohol, surgical drapes, etc. Even the patient's hair, blankets, fiberoptic cable coverings can be a source of fuel.)
-
A source of oxygen (supplemental oxygen)
-
A source of ignition (electrosurgery accessories, lasers, drills, etc).
Fuel source can be minimized by letting prepping agents dry thoroughly before surgery begins; even a small amount of alcohol can be very dangerous. Careful preparation of the OR, eliminating unnecessary materials and ensuring that all equipment is in perfect working order is essential for a safe working environment.
Supplemental oxygen delivered through a nasal cannula can be extremely dangerous: oxygen delivery via this method is fairly routine during a surgical procedure. Problems arise when oxygen builds up in the cannula or accumulates under surgical drapes positioned to establish the sterile field. Use of compressed air or intermittent use of supplemental oxygen decreases the amount of oxygen in the operating room, and reduces the potential for build-up.
Today electrosurgery is used in most surgical procedures, making ignition sources ubiquitous to most operating rooms. Electrosurgery is considered extremely safe if performed by a trained medical professional and carries many benefits to traditional surgical methods.
Electrosurgery accessories minimize the invasive nature of surgery by increasing the surgeon's precision and reducing bleeding. Procedures are shorter, resulting in improved outcomes.The risk of fire comes from the electrosurgery accessories being in proximity to : for example, a blade, ball, needle or loop, which may spark and therefore must be carefully monitored.
Electrosurgery, when properly used, nearly alwas give the doctor and the patient the results they desire. Unfortunately, since there is so rarely a problem, complacency can set in. Always be vigilant and pay particular attention to your ignition source when combined with a source of fuel and/or increased oxygen levels.
Feel free to contact us or leave a comment below.
Photo courtesy of CMRF_Crumlin
