Operating Room Fire Safety

1. Operating Room Fire Safety VPNG State Conference 2009 Sandra de Rome - Deakin Dave McCurdy - MFB

2. An Operating Room Fire Begins: • You are circulating for a patient undergoing a laparoscopic cholecystectomy • Disposable drapes are in use • The light lead is disconnected from the telescope and accidently placed on the drapes • The intense light ignites the drapes • Smoke begins to quickly fill the room • How will you respond?

3. Considerations • Switch off the electricity at the wall • Extinguish the fire if safe to do so • Press the emergency button • Call the emergency number, state your name, location and code red • Advise the Floor Manager of the situation • Prepare an additional operating room • Transfer the patient on the operating table, while being manually ventilated, to another room to complete surgery • Keep the doors closed as much as possible to contain smoke

4. The Fire Escalates…. • How would you evacuate your Operating Suite? • How can you account for all staff, patients, visitors, students, medical representatives, etc in the Operating Suite? • Which exits would you use? • What is the best process to use when checking all rooms have been evacuated?

5. Other Considerations… • Is the hospital co-located with another hospital? • Ambulances may be required to transport patients to nearby hospitals • Transferring a patient: • With an open surgical wound • An anaesthetised patient • Process for recording where patients are evacuated to & informing concerned relatives

6. What are Your Responsibilities? • Who is the ‘Fire Warden’ in your Operating Suite • What is their role? • What is the internal phone number to notify the hospital of an emergency? • In every area of the Operating Suite, how would you evacuate to safety? • Do you know the location of all Emergency Alarms in every operating room and recovery?

7. What Happens ‘Out of Hours?’ • How does a ‘Fire Door’ operate to protect staff / patients • If you rely on ‘swipe cards’ to access the Operating Suite, are these deactivated in a fire situation? Why? • Do you know the location of: • All gas isolation valves – what are these? • All switchboards in the operating suite • All break glass alarms • All Warden Intercom Phones (WIP) • All exits

8. Fire: Code Red • What burning substances can you extinguish with a CO2 fire extinguisher? • Can you efficiently use a fire extinguisher? • Operating Suites are usually divided into ‘compartments’ – how are these utilised in a fire emergency?

9. Evacuation Stages: Code Orange • Immediate: from an operating room to a corridor • Lateral: from an area of threat to a safe area i.e. behind a smoke door • Partial: from the Operating Suite to another part of the hospital (provided it is not under threat) • Total: controlled evacuation from the Operating Suite to an Evacuation Point outside the hospital

10. References • ACORN Standards for Perioperative Nursing (2008): Australian College of Operating Room Nurses Ltd., Adelaide, South Australia • J. Rothrock, (Ed) (2007), Alexanders Care of the Patient in Surgery, (13thed). St Louis, MO: Mosby. • Hogan, C. (2002). Responding to a Fire at a Paediatric Hospital: AORN, Vol. 75(4)