Fire Triangle
Components that make up the fire triangle.
What is fuel, ignition and oxidizer?
The body area where surgical fires occur most frequently.
What is head, face, and airway?
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 sign(s) of a surgical fire.
What is flame/flash, unusual sounds, odors, smoke and heat?
Common FUEL sources in the OR.
What is alcohol-based skin preps, drapes, sponges, ET tubes, petroleum-based ointments, patient hair, GI tract gases, suction catheter...?
Location(s) of manual fire pull station(s) and fire exits.
What is:
Fire Exit: outside OR 3 in Hall 1.
Fire Pull:
Hall 1 (outside OR 3); Hall 2 (outside OR 8); break down area x2.
Primarily controls the IGNITION sources in the OR.
Who is the surgeon?
Type of fire extinguisher in our OR.
What is Class ABC?
Class A: ordinary combustibles - wood, paper, fabric, rubber, trash fires
Class B: flammable liquid & gas fires
Class C: electrical equipment
Ignition source interventions for fire prevention.
What is:
- the use of moistened towels/sponges close to active electrode;
- use of holster;
- keep bovie tip clean;
- place light source/laser on standby when not in use;
- do not place light cord/laser tip directly on drapes.
Common IGNITION sources in the OR.
What is electrosurgical/electrocautery device, laser, light source, drill, heated probe, defibrillator pads/paddles, sparks/tissue embers...?
The proper response to a Code Red.
What is R.A.C.E.:
RESCUE anyone in immediate danger;
ALARM - pull the closest fire alarm;
CONFINE the fire by closing the doors behind you;
EXTINGUISH the fire if it is safe to do so?
Primarily controls the OXIDIZER sources in the OR.
Who is anesthesia?
Steps to smother a fire.
What is:
- hold towel between the fire and the patient's airway.
- drop the end of the towel closest to the patient's head.
- drop the other end of the towel over the fire.
- when extinguished, raise towel to decrease heat.
DO NOT PAT the towel... will fan the flames.
Used to assess fire safety concerns intra-operatively during the Surgical Time Out.
What is the Fire Risk Assessment?
Common OXIDIZER sources in the OR.
What is oxygen and nitrous oxide?
Types of evacuation.
What is horizontal and vertical?
Horizontal: move from one fire zone to another ON THE SAME FLOOR. No special permission is required.
Vertical: movement from one floor to another only after being instructed to do so by administration, house supervisor or fire dept.
Responsible for knowing the location and operation of fire extinguisher(s).
Who are ALL employees?
Steps to extinguish a fire with a solution.
What is:
- aim the nonflammable liquid at the base of the fire.
- cover the fire completely.
Steps to extinguish a small fire on the patient.
What is:
- stop the flow of gases and alert the team.
- smother/extinguish the fire with water/NS.
- remove burning materials.
- assess patient for injuries.
- assess surgical field for secondary fire.
- notify charge nurse.
- save all involved materials.
Recommended minimum dry time for alcohol based surgical skin prep.
What is a minimum of 3 minutes on hairless skin and up to 1 hour in hair.
Item(s) 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 P.A.S.S.?
- 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:
- alert the team
- disconnect/remove breathing circuit
-turn off the flow of breathing gases to the patient
- remove the ET tube
- pour saline into the airway
- re-establish the patient airway
- ventilate with air until certain there is no burning/smoldering, then switch to 100% oxygen
- examine the patient's airway