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Fires During Surgery Surprisingly
Common:
How to Avoid Getting Burned
by www.SixWise.com
Unlike other more sensational medical mishaps -- like items
left inside people after surgery -- fires in the operating
room are rarely talked about. However, new data reveals that
fires during surgery are more common than anyone realized.
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It's estimated that hundreds of surgery fires occur
in the United States every year.
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"Virtually all operating room fires ignite on or in
the patient. These fires typically result in little damage
to equipment, cause considerable injury to patients, and are
a complete surprise to the staff," according to non-profit
health agency ECRI.
Just how many people have been seriously burned or even killed
from a surgery fire? According to data from Pennsylvania,
the state has had 28 operating room fires each year for the
past three years, which amounts to about one in every 87,000
surgeries.
On a national level, this data suggests there may be hundreds
of surgery fires every year out of the estimated 50 million
annual surgeries performed.
"The numbers are higher than we expected," Mark
Bruley, vice president for accident and forensic investigation
at the ECRI Institute in Pennsylvania, told The Boston Globe.
"It's a small risk, according to the statistics, however,
having a fire on your face can be severely disfiguring and
a horrendous experience. And with throat procedures, where
these fires often occur, they can be fatal."
How do Surgery Fires Occur?
"There are three things necessary to create a fire,"
Dr. M. Christine Stock, head of the anesthesiology departments
at Northwestern University and Northwestern Memorial Hospital,
told ABC News.
"There has to be oxygen, extra oxygen. There has to
be a source of ignition. So in the operating room that would
be electrocartery. It could be a laser. And there has to be
some kind of fuel, paper drapes or cloth gowns things like
that. All of those things are used in almost every operating
environment," she said.
In fact, due to the extreme flammability of oxygen and the
common presence of heat-generating instruments, a static spark
may be all it takes to engulf a person in flames.
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Your greatest defense against surgery fires is to find
a health care team that is knowledgeable about the issue
-- and trained to prevent it.
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Because of the close proximity of electrical surgical tools
and oxygen for the patient, head, face, neck and chest surgeries
are particularly risky; they account for 44 percent of operating
room fires, according to ECRI.
Having Surgery? Here's What You Can Do
Surgery fires often result because of poor communication
between surgeons, nurses and anesthesiologists. In the case
of fire, this is critical, as each person on this team controls
a different aspect of what is called the "fire triangle"
-- heat, fuel, and oxidizer.
The surgeon, for instance, controls the heat source. The
nurse, the fuels, and the anesthesiologist the oxidizers.
As a patient, it is up to you to speak directly with your
health care providers about these concerns. Do not simply
assume that they are aware of this issue, as most doctors
have never encountered a surgical fire. Instead, ask your
doctor and surgical team if they have been trained in dealing
with surgical fires.
The American Society of Anesthesiologists issued a first-time
advisory on the topic in April 2008. Among their recommendations:
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Nurses should make sure flammable skin preps, like alcohol,
are dry before draping
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Surgeons should alert anesthesiologists before turning
on certain tools, like lasers
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Anesthesiologists should reduce the amount of oxygen
being administered, if possible
ECRI has also put together this bulletin advising clinicians
how to prevent surgical
fires, which is worth handing directly to your surgeon.
"This is a fairly unique hazard within health care because
in order to prevent it you have to have awareness and collaboration
of three different specialties," Bruley said. "Until
each is empowered to question the actions of the other two,
you can't have prevention."
Rather than waiting for this to happen, become an empowered
patient yourself. Speak up to your doctor about surgical fires
and inquire about what preventative measures are taken. And
while you're at it, inquire about these other 21
questions that every surgery patient should find out before
getting on the operating table as well.
Recommended Reading
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Do
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Surgery: What are the Risks vs. the Benefits?
Sources
The
Boston Globe November 7, 2007
ABC7Chicago.com
April 21, 2008
SurgicalFire.org
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