I’ve had the chance to be involved in the development or implementation of life and fire safety systems in various stages across several hospitals in Latin America. These projects have shown that firefighters have recognized the necessity of securing the operating room from electrical and fire risks. The danger increases when you consider the expense of the medical equipment in the room. However, only some people know the magnitude of risk during surgical procedures. This article will provide you with the basic information of fire hazards in operating rooms.
Risk elevates when considering the price of medical equipment
The fires in these areas are particularly deadly as they can occur through the body or the air methods of patients in oxygen-rich environments. A hospital’s planners and designers should first prevent fires, then work with medical professionals to reduce the chances of a fire to a minimum and ensure doctors and nurses have access to methods to control flames and prevent patients from getting hurt.
Fire Watch Guards construction sites are indispensable, considering the vulnerability of such sites to fire hazards. Their integrated presence within the construction team is essential, focusing on preemptive measures and active fire risk management.
Common Fire Sources
As a result of this type of situation, medical personal protective equipment such as gowns, masks, sponges, and towels, which are placed on the patient’s skin, and also plastic tubes and other accessories connected directly to the patient, which might enter the airways, are the most common sources of fire. Various kinds of explosive chemical and alcohol-based solutions are used to prepare or cleanse the patient, as well as the presence of gasses from medical treatment. Organizations believe that the hair and skin be considered fire hazards if specific conditions exist, for example, high levels of oxygen in the air.
About 68% of the fires occurring in operating rooms were caused by electrosurgery and other electro-hematological devices. In these settings that are subject to oxygen-rich environments sparks, any spark could be an ignition source. In the medical equipment that could generate sparks, you will discover high-speed operating drills for surgical use, defibrillators, electrocautery units, and lasers. Damaged wires and cables are the most common ignition sources inside ORs.
The NFPA 99 (Standard for Fire Protection in Healthcare Facilities) states that medical gas and air distribution systems are at risk of danger of explosions and fires caused by them, as these gases are oxidizers and cause perfect conditions for ignition. Most materials can ignite with oxygen levels over 30% (the average oxygen concentration in the air is 211%). It’s important to remember that nitrous oxide in anesthesia can aid combustion in a similar to oxygen (Hart MD. And others. 2011).
Types of Fires and How to Reduce Their Risk
There are two types of fires in the operating room, according to the different organizations: fires that happen inside the OR, like the ones that ignite medical equipment or other materials that are on the table during surgery, and fires that start directly on the patient’s airways and skin. Numerous studies suggest that 40% of the fires that occur on the skin of a patient are located on the neck, face, and upper chest, and 21% of them are in the airways.
“The fundamental components of fire will always be present when undergoing surgery, “Slow reaction or the improper use of techniques or tools for fighting fires can result in the destruction, damage or even death.” It is essential to involve all medical personnel, such as surgeons and anesthesiologists, in preparation for surgery and fire prevention plans.
Pre-surgery Fire Prevention Plan
Many organizations strongly suggest that nurses and surgeons incorporate fire prevention and risk identification in their surgical preparation. “Each one should be able to control a certain part that is a part of the fire tetrahedron, and through proper management of their procedure and the associated factors, surgical fires are prevented,” according to Bruley.
Medical personnel should determine the locations of oxygen and gas shutoff valves and assess the necessity of oxygen concentrations over 25 percent. Organizations such as the OMS suggest avoiding using oxygen-rich open sources in faces during surgical procedures. Utilize laryngeal tubes or tracheal masks instead. Additionally, it’s a great option to utilize floor-to-ceiling drapes to create a barrier between an oxygen-rich environment around the operating table and the surrounding area.
Employees should take part in training and drills on using firefighting equipment. Additionally, some organizations recommend that all employees take part in training and exercises regarding the use of equipment for fighting fires and evacuation and rescue methods. When a fire occurs, control all sources of medical gases and oxygen, and move or remove all medical equipment (if feasible) when a fire directly impacts them or has been extinguished.
It’s important to know that organizations like the World World Health Organization recommend using fire extinguishers after removing someone from danger. If there is a fire that has spread that is affixed to the skin of the patient, a CO2 extinguisher is preferred as it limits damage to the skin and tissue.
Fire Protection Equipment in the Operating Room
The IFC (International Fire Code), as well as the NFPA 99 and 101 (Life Safety Code), give several guidelines to ensure the safety of healthcare facilities in case of fire.
“fire protection” is active or passive, but one does not exclude the other. Passive fire protection has the goal of reducing the spread of fire through electrical wiring ventilation, as openings are made through windows and walls. They must be constructed to prevent smoke and flames emanating from nearby fires far from the operating area, as well as to prevent the smoke and fire that may happen within one operating room from spreading to surrounding areas.
The information of these protections can include, however, they are not only limited to:
- Walls, floors, and ceilings can’t be certified for 120 minutes, and doors must be as miniature as possible 3/4 of the time and sealed to stop flames and smoke from spreading.
- Fire-stopping devices are used throughout all electrical, ventilation, and other conduits that run through flooring, walls, or ceilings.
- For all non-structural and structural elements, intumescent covers are used.
- Fire-resistant furniture is essential, but it is also important to note that virtually no product is considered to be fire-proof in environments in which the oxygen concentration is more than 30%.
- Smoke control systems and dampers.
- All electrical and medical gas, medical air, or oxygen systems must be designed by the guidelines in the NFPA 70 (National Electrical Code) as well as the NFPA 99.