Only You Can Prevent Surgical Fires
- Both O2 and N2O support combustion. Be
aware of possible enriched O2 and N2O atmospheres near the surgical site under
the drapes, especially during head and neck surgery.
- Question the need for 100% O2 for open delivery on the face.
- Use air or FiO2 30% for open
- Minimize O2 and N2O buildup beneath surgical drapes;
tent drapes to dissipate gases.
- Use an incise drape to isolate head and neck incisions from
O2 and alcohol vapors.
- Do not drape patient until all flammable preps
have fully dried.
- Coat facial hair near the surgical site with
water-soluble surgical lubricating jelly to make it
During oropharyngeal surgery:
- Scavenge the oropharynx with separate
- Wet gauze or sponges used with uncuffed tracheal tubes to
minimize leakage of O2
into the oropharynx; keep them wet.
- Moisten sponges, gauze, and pledgets (and their
strings) to render them ignition resistant.
When using electrosurgery, electrocautery, or lasers:
- Stop supplemental O
at least one minute before
and during use of the unit, if possible. (Surgical team communication is
- Activate the unit ONLY when the active tip is
in view (especially if looking through a microscope).
- Deactivate the unit BEFORE the tip leaves the
- Place electrosurgical electrodes in a holster
or off of the patient when not in active use (i.e., when not needed
within the next few moments).
- Place lasers in standby when not in active
- Do not place red rubber catheter sleeves over
light sources CAN start fires. Complete all cable connections before activating
the source. Place source in standby when disconnecting
Note: The applicability of
these recommendations must be considered separately for each patient, consistent
with their needs.