Fire Safety & Prevention
This three-part combination - an ignition source, fuel, and oxidizer-must be present for an OR fire to occur.
What is the Fire Triangle
When positioning a patient in lithotomy, both legs must be raised and lowered simultaneously to prevent injury to this anatomical region.
What is lumbar spine (or lower back/hip joints)?
The only specific pharmacological antidote used to treat a Malignant Hyperthermia crisis.
What is Dantrolene (Ryanodex).
On a sterile gown, the sterile area extends from the chest level down to this boundary.
What is the level of the sterile field (or waistline)?
Standard OR air exchange systems maintain this type of pressure relative to adjoining hallways to keep airborne contaminants out.
Positive Pressure?
Recommended drying time for alcohol-based skin antiseptics (like ChloraPrep) before draping to prevent vapor buildup.
What is 3 minutes (or until completely dry).
This upper extremity nerve is most commonly injured due to hyperabduction when an armboard is opened past 90 degrees.
What is the Brachial Plexus?
Typically the earliest and most sensitive clinical sign of an emerging MH crisis during general anesthesia
What is an unexplained rapid rise in End-Tidal CO2 (ETCO2)?
The mandatory practice performed by the surgical team immediately before incision to verify patient, procedure, site, and implants.
What is the Surgical Time-Out?
Recommended height alignment for laparoscopic monitors to prevent neck strain for surgeons and assistants.
What is at or slightly below eye level (15-25 degrees downward line of sight)?
The primary surgical tool responsible for the majority of ignition source incidents in the OR.
What is the Electrosurgical Unit (ESU/Bovie Pencil)?
Nerve injury manifesting as "foot drop" is caused by pressure or compression against the lateral aspect of the fibular head in lithotomy.
What is the Common Peroneal Nerve?
This class of volatile anesthetics, along with the depolarizing muscle relaxant succinlcholine, are the main triggers for MH.
What are halogenated inhalation agents ( sevoflurane, desflurane, isoflurane)?
The minimum distance non-sterile personnel must maintain from any sterile field boundary.
What is 12 inches?
The target humidity range recommended in the operating room to reduce static discharge while preventing microbial growth.
What is 20% - 60%?
The immediate first step when an airway fire is recognized during an intubated procedure.
What is removing the endotracheal tube (and disconnecting the breathing circuit)
The physiological phenomenon where blood pools in lower extremities during steep Reverse Trendelenburg, risking a sudden drop in cardiac output.
What is venous statis / hypotension ( or decreased venous return)?
The targeted core body temperature at which active cooling measures should be stopped during an MH crisis to avoid hypothermic overshoot,
What is 38C (100.4F)?
According to AORN standards, this is the maximum allowable time a sterile field may be left unmonitored before it is considered contaminated.
What is 0 minutes (it must never be left unmonitored).
To prevent back strain when prepping or positioning a patient, perioperative staff should adjust the operating room table to this anatomical height relative to the person performing the task.
What is waist height?
The acronym used to guide extinguisher use when managing an active fire: Pull, Aim, Squeeze, Sweep.
What is PASS
Position characterized by head-down tilt that increases intraocular and intracranial pressure while compromising respiratory compliance
What is Trendelenburg position?
The cellular mechanism driving MH an uncontrolled release of this specific ion from the sarcoplasmic reticulum into skeletal muscle cells.
What is Calcium?
The technique where a scrubbed team member uses a sterile instrument or barrier to hand off items off the field without directly reaching over non-sterile surfaces.
What is a neutral zone (or hands-free technique)?
Overhead booms and ceiling-mounted tracks are used in modern ORs to route cords and tubings away from the floor, primarily preventing this safety hazard
What is a Tripping Hazard?