3 Steps to Refresh Fire Safety in Your OR

Review Fire Safety Knowledge

With October being Fire Safety Month, Miner encourages all perioperative professionals to review their fire safety knowledge with learning resources in the open access AORN Fire Safety Tool Kit, including tools for assessing fire risk, creating a fire drill, assigning fire team responsibilities, and extinguishing a fire.

Fire-specific safety practices are also discussed in three AORN guidelines and accompanying Guideline Essentials: Electrosurgical Safety, Laser Safety, and Perioperative Environment of Care.

Recognize the Surgical Fire Triad

Miner reminds that surgical fire is a risk perioperative teams take with every surgical case that includes aspects of the surgical fire triad:

• Fuel – surgical skin antisepsis
• Oxidizer – oxygen provided to patients undergoing anesthesia
• Ignition – any type of spark-producers such as the electrosurgical device or drill

While perioperative teams may not always be able to mitigate all fire hazards, Miner says well-informed and well-prepared surgical team members do have the ability to reduce fire risk and act quickly if fire erupts.

Assess for Fire Risk Before Every Procedure

Assessing for fire risk is a critically important step to prevent fire and AORN recommends using a Fire Prevention Assessment Protocol (PDF) to increase awareness of surgical fires during every procedure, Miner explains. Important assessment questions look at fire risks related to the surgical fire triad and procedure, such as:

• Is an alcohol-based skin antiseptic or other flammable solution being used preoperatively?
• Is the operative or other invasive procedure being performed above the xiphoid process or in the oropharynx?
• Is open oxygen or nitrous oxide being administered?
• Is an ESU, laser, or fiber-optic light being used?
• Are there other possible contributors?

The assessment is completed by the RN circulator prior to the procedure and then fire assessment results are shared with the surgical team during preoperative team communication, such as the Time Out. Many teams incorporate fire risk assessment into the surgical safety checklist, Miner notes.

Prepare for Surgical Fire as a Team

Refreshing fire safety education as a team is an important way to make sure all team members know their role and what do if a fire occurs. Miner suggests these three important steps that should be included in fire safety education:

1. Step 1: Confirm roles and responsibilities to mitigate fire risk, extinguish a surgical fire and respond quickly to reduce injury if a fire occurs.
2. Step 2: Assess competencies with using fire safety supplies, including knowing where supplies are located and making sure they are not expired.
3. Step 3: Review evidence-based practices to reduce surgical fire risk and look for what Miner calls “switches” to reduce fire risk, such as switching to bipolar electrosurgery. “Team members can always be looking for ways to reduce triad fire risk factors so that the level of risk for a surgical fire remains as low as possible.”

Non-members can access the AORN Fire Safety Tool kit, including the Fire Safety Poster by providing an email address.