Only You Can Prevent Surgical Fires

Poster (PDF)

  • 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 delivery.
  • 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 nonflammable.

During oropharyngeal surgery:

  • Scavenge the oropharynx with separate suction.
  • 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 2 at least one minute before and during use of the unit, if possible. (Surgical team communication is essential.)
  • 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 surgical site.
  • 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 use.
  • Do not place red rubber catheter sleeves over electrosurgical electrodes.

Fiberoptic light sources CAN start fires. Complete all cable connections before activating the source. Place source in standby when disconnecting cables.

Note: The applicability of these recommendations must be considered separately for each patient, consistent with their needs.

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