On November 1st The Today Show did a story on OR Fires.
The story was titled "Inside the Operating Room - The Danger of Fires During Surgery". It was a fair representation of what can happen in even the most simple of procedures when things go VERY wrong. While one can certainly argue that with 650 fires a year of the many millions of procedures performed, the percentage is indeed very small. Small it may be, but explain that to the patient that has been burned in a fire. Dr. David Cowels calls the problem of Oxygen, Alcohol Prep and an Ignition Source (electrocautery, lasers and the like). As a side note, electrocautery was their term.
In reality, the correct term should be electrosurgery, but we can save that for another blog. But getting back to Dr. Cowels "trifecta", a fire should virtually NEVER happen in the operating room. His suggestion is that in removing one of the three eliminates the problem. It certainly improves your chances, but you can't remove the ignition source in most cases and oxygen certainly can't either. You have the added problem in the operating room of a large number of paper products like drapes that easily burn if a fire begins. I think the best suggestion came from Ms. Snyderman who suggests that patients getting ready to undergo surgery discuss the risk of fire in the operating room with the surgeon prior to having the procedure. Since fires happen so seldom statistically, a discussion with your doctor should improve your already favorable odds by drawing their attention to safety.
Let me repeat, fires should never happen in the operating room! Make sure if a flammable alcohol prep is used that it is completely and totally dry before you get anywhere near it. When using oxygen, make sure that oxygen does not tent under some drapes leaving a highly oxygenated area. When using electrosurgery or laser, make sure you know exactly what you are doing with it before you activate the device. When properly used, electrosurgery and lasers are absolutely safe, just like driving a car is safe. In both cases, when not carefully used, very bad things can happen.
J. Robert Saron
President, Bovie Medical Corporation
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