Fires occasionally occur in the operating room and they can have cause significant injury and damage. They can be prevented by eliminating risk factors.


Elements needed for a fire ("fire triangle"):

(1) ignition source

(2) flammable material

(3) oxygen, nitrous oxide or other oxidizer that supports combustion


Ignition sources may include:

(1) laser

(2) electrocautery unit

(3) electric spark from faulty equipment or poor grounding

(4) fiberoptic light source

(5) defibrillator


Flammable material:

(1) alcohol or other flammable skin preparation solution

(2) tincture (any preparation suspended in alcohol)

(3) petrolatum or other petroleum-based product

(4) dry surgical drapes or dressings

(5) dry clothing or gowns

(6) hair

(7) intestinal gases (!)

(8) ether

(9) solvents


Oxygen or other combustible gas are a hazard if:

(1) present at a high concentration

(2) accumulate under drapes near the operative field


Surgery around the head and neck has the highest frequency of fires because of the proximity of an oxygen or gas rich atmosphere to an ignition source.


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