Operating room fires

Published on 07/02/2015 by admin

Filed under Anesthesiology

Last modified 07/02/2015

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Operating room fires

Daniel A. Diedrich, MD

With the movement away from the use of flammable anesthetic gases, the incidence of fires in the operating room (OR) has decreased. However, with the increased use of disposable drapes and alcohol-based prepping solutions, there is concern that the incidence may increase. Although the precise incidence of OR fires is difficult to determine because of a lack of a structured reporting system, it is estimated that 50 to 200 fires occur in the OR annually in the United States.

Fire triangle

For a fire to occur, three elements must come together: (1) an oxidizer, (2) fuel, and (3) an ignition source. These three elements are commonly called the “fire triad” and can be represented as a “fire triangle” (Figure 4-1). An OR fire can be prevented by removing any one element of the triangle.

image
Figure 4-1 The fire triangle.

The two oxidizing agents most prevalent in the OR are oxygen (O2) and nitrous oxide (N2O). In the OR, many potential fuel sources are present (Box 4-1). The most common ignition source is diathermy or electrocautery with other ignition sources listed in Box 4-1.

Box 4-1   Components of the Fire Triangle

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