The Wall Street Journal has an article about situations that cause fires in the surgical theater and what is being done to minimize the events. Considering that around 650 fires occur annually in ORs around the country, more care should be taken not to mix oxygen with fire.
Operating rooms are a special concern because high-tech electrosurgical tools and an oxygen-rich atmosphere can create a combustible mix. ECRI, a nonprofit group that conducts patient-safety research, says that in addition to surgical fires, other potential sources of burns include the magnets, coils and sensors used in MRI machines, IV solution bags that are overheated, fiber-optic lighting, and even blankets warmed in heating cabinets, whose internal folds may reach high temperatures that a nurse may not feel as the blanket is spread over an anesthetized patient. One analysis of closed malpractice claims by the American Society of Anesthesiologists shows that of 145 claims for burn injuries, more than half were from devices intended to warm the patient, while 31% were from electrical tools used for cauterization.
Concern about surgical fires waned in hospitals after the use of flammable anesthetics, such as ether, was discontinued more than 25 years ago, according to Mark Bruley, vide president of accident investigation and forensics for ECRI. But new risks have emerged with the use of lasers and electrosurgical tools used to cut, cauterize or vaporize tissue in minimally invasive surgical procedures, and the practice of enriching oxygen delivered to patients under anesthesia. Heat sources and oxygen can then combine with potential fuel sources — alcohol prep solutions, tonsil sponges and even the hair on a patient’s eyebrows.