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Fire safety in the operating room

Author
Charles E Cowles, Jr., MD, MBA
Section Editor
Joyce A Wahr, MD, FAHA
Deputy Editor
Nancy A Nussmeier, MD, FAHA

INTRODUCTION

Fire in the operating room (OR) is a relatively rare event, but when it does occur the medical outcomes are often catastrophic for the injured patient, with severe legal and economic consequences for the surgical team and facility.

Most OR fires are preventable with communication, appropriate education, and management of risks. Since these preventive measures have little cost and are nearly 100 percent effective, they are prioritized in patient safety initiatives.

This topic will review causes, high-risk settings, and prevention of fires in the OR, as well as acute management of a surgical fire and the burned patient. An outline of resources is provided for further details regarding education of OR personnel in the causes and prevention of OR fires.

GENERAL CONSIDERATIONS

Incidence — Reports of occurrence of operating room (OR) fires range from 217 to 650 events each year in the United States [1]. Since half of the states do not have mandatory reporting, the actual number is probably higher. Most claims occur in an outpatient setting (76 percent), involve the upper body (85 percent), and are cases managed with monitored anesthetic care (MAC) (81 percent) [2].

Impact — Patient injuries after an OR fire are often severe (eg, painful and disfiguring burns to face and neck or severe airway injury with tracheostomy and permanent lung damage) [2]. Typically, a surviving patient must return to the OR many times to treat acute burn injuries and revise scar tissue, causing recurring anxiety, post-traumatic stress, and economic burden [2,3].

                                               

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Literature review current through: Nov 2016. | This topic last updated: Mon Mar 07 00:00:00 GMT+00:00 2016.
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