Danger: Operating room flash
December 19, 2003
Imagine going into a hospital for routine
surgery and waking up so severely burned that you are unrecognizable.
It may sound hard to believe, but it's happening often enough that
a national health care commission recently took the unusual step
of issuing an alert to hospitals.
The Joint Commission on Accreditation
of Healthcare Organizations, which accredits 17,000 hospitals nationwide,
estimates that between 100 and 200 operating room fires break out
Hospital systems across the country
are putting into place an aggressive training program for their
operating staff. Operating room workers get classroom and hands-on
training. The program warns of a fire triangle: oxygen, available
fuel and an ignition source. Each element must be present for a
fire to start, and many times all three elements come together in
a hospital's surgical unit.
It's difficult to tell how many operating
room fires break out because hospitals are not required to report
them to any federal agency. But some sources estimate that there
are close to 100 surgical fires each year which could possibly result
in serious injuries to patients and in some cases even death.
Many flammable materials are found
in the surgical suite, from the wide range of alcohol-based prepping
agents and linens such as drapes, towels, gowns, hoods and masks;
to the multiple types of dressings, ointments and equipment and
supplies used during surgery. Common ignition sources found in the
operating room are electrosurgical or electrocautery units fiberoptic
light sources and cables; and lasers. In addition, lasers and high-speed
drills can produce incandescent sparks that can fly off the target
tissue and ignite some fuels, especially in oxygen-enriched atmospheres.
"The basic elements of a fire
are always present during surgery and a misstep in procedure or
a momentary lapse of caution can quickly result in a catastrophe,"
says Mark Bruley, vice president, Accident and Forensic Investigation,
ECRI (Emergency Care Research Institute). "Slow reaction or
the use of improper fire-fighting techniques and tools can lead
to damage, destruction or death." Bruley also notes that virtually
all surgical fires are preventable and that their impact can be
lessened through an understanding of fire and how to fight it. "Each
member of the surgical teamóthe surgeon, the anesthesiologist, and
the nursesócontrols a specific side of the triangle and by properly
managing their technique and part of the equation, surgical fires
can be avoided," says Bruley.
Patients should always ask about safeguards
the hospital has in place to prevent fires.
Remember, ask questions, It's your life!