Fire Triangle
Components that make up the fire triangle.
What is fuel, ignition and oxidizer?
The most common surgical fire location (anatomy).
What is airway, head, neck or face?
*Collaborate with anesthesia on the need to lower the Fi02 for airway cases using bovie/laser. (<30%)
Primarily controls the fuel sources in the OR.
Who is the circulating nurse?
Three fire classifications.
What is Class A, Class B, and Class C fires?
Class A - burning wood, paper, cloth, and other ordinary combustibles.
Class B - burning liquid (ETOH, gasoline, solvents, grease, paint, or other liquids that gasifies when heated).
Class C - Electrical equipment, devices, or wiring.
Early signs of a surgical fire.
What is flame/flash, unusual sounds, odors, smoke, and heat?
Common fuel sources in the OR.
What are alcohol skin preps, drapes, sponges, ET tubes, petroleum-based ointments, patient's hair, GI tract gases, suction catheters, gases in surgical smoke ...?
Location of fire pull and fire stairway.
What is outside of OR 7?
Primarily controls the ignition sources in the OR?
Who is the surgeon?
4 Types of fire extinguishers.
What is water, Class ABC, Halon, and Class C?
Water - Use on Class A fires only.
Class ABC - Use on Class A, B and C fires.
Halon - Use on Class B or C fires.
Class C - Use on Class B or C fires.
Ignition source interventions to help prevent fires.
What is use of moistened towels/sponges close to active electrode; place electrodes in holster off patient when not in use; keep bovie tip clean; place light source on standby when not in use; place laser in standby when not in use; do not place light cord/laser tip directly on drapes... etc.
Common ignition sources in the OR.
What is a electrosurgical/electrocautery devices, laser, light source, drills, heated probe, defibrillator pads/paddles, sparks/tissue embers ...?
Code Red procedure.
What is RACE?
Rescue patients immediately.
Activate the fire alarm & call the emergency number (*85999)
Close the door(s) to the room the fire is located.
Extinguish the fire when safe to do so.
Primarily controls the oxidizer sources in the OR?
Who is anesthesia?
Four steps to smother a fire.
What is:
1. Hold a towel between the fire and the patient's airway.
2. Drop the end of the towel closest to the patient's head.
3. Drop the other end of the towel over the fire.
4. When extinguished, raise towel to decrease heat.
DO NOT PAT the towel... will fan the flames.
Time to address fire safety concerns in relation to the scheduled surgical procedure.
What is the Fire Risk Assessment.
Common oxidizer sources in the OR.
What is oxygen and nitrous oxide?
Two types of evacuation.
What is horizontal and vertical?
Horizontal - move from one fire zone to another zone on the same floor. No special permission is needed.
Vertical - movement from one floor to another floor. Done only after being instructed to do so by administration, nursing supervisor or the fire dept.
Who are all employees?
Two steps to extinguish a fire with a solution.
What is:
1. Aim the nonflammable liquid (NS or H20) at the base of the fire.
2. Cover the fire completely.
Steps to extinguish a small fire on the patient.
What is:
-Stop the flow of gases and alert the team to the presence of a fire.
-Smother or extinguish the fire with water/NS.
-Remove the burning materials.
-Assess the patient for injuries.
-Assess the surgical field for secondary fire.
-Notify charge nurse.
-Save all involved materials.
What is a minimum of 3 minutes on hairless skin; up to 1 hour in hair.
Items that are to be kept after a surgical fire.
What is save all items involved in a surgical fire?
Responsible for alerting the team of the presence of a fire.
Who is anyone in the OR suite that sees a fire/early signs of a fire?
Steps to use a fire extinguisher.
What is PASS?
Pull the pin and break the seal.
Aim the nozzle at the base of the fire.
Squeeze the handles.
Sweep the base of the fire.
Steps to extinguish an airway fire.
What is:
1. Alert the team. 2. Disconnect and remove the breathing circuit. 3. Turn off the flow of breathing gases to the patient.
4. Remove the ET tube, including segments of burned tube that remain in the airway. 5. Pour saline into the airway. 6. Re-establish airway. 7. Ventilate with air until certain there is no burning/smoldering, then switch to 100% oxygen. 8. Examine the patient's airway.