The article "Fire in the OR--P...

The article "Fire in the OR--Prevention and preparedness," is the basis for this AORN Journal independent application of mind The behavioral objectives and examination for this program were prepared by the agency of Rebecca Holm, RN, MSN, CNOR, clinical editor, with consultation from Susan Bakewell, RN M BC education program professional, Center for Perioperative Education. Participants receive feedback in succession incorrect answers. Each applicant who prosperously completes this study will receive a certificate of completion. The deadline for submitting this investigation is July 31, 2007.

ended the examination answer sheet and learner evaluation lay the foundation of on pages 59-60 and mail with appropriate feud to

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BEHAVIORAL OBJECTIVES

After reading and studying the article upon fires in the OR, nurtures will be able to

1 identify natural mediums of the fire triad that are available in ORs,

2 discuss staff member responsibilities when using the RACE acronym,

3 describe the paces that one facility followed to plan a fire drill, and

4 explain in what way evaluation forms can be used to improve staff member performance during a fire drill.

Approximately 100 fires come to one's mind in ORs across the United States each year. (1) Patients are painfully injured or die in approximately 20 of these fires. (12) Fires in the OR can be devastating to patients, surgical team members, facilities, and communities, and each OR, no matter what the size or setting, contains the ingredients necessary to start a fire.

Education is the [i]clavis[/i] to fire prevention and preparedness. (3) All staff members ne to be educated regarding

* causes of OR fires,

* strategies to decrease the possibility of a fire, and

* what to do if a fire occurs

FIRE PREVENTION

Fires start in the OR because the uncompounded bodys of the fire triad are allowed to tend to the same point The fire triad is a triangle in succession which each point represents a factor that must be ready for a fire to begin. (4) The three factors are combustible matter oxygen, and heat (Figure 1) Many examples of these composings are available in the OR, and all members of the surgical team, including OR staff members, anesthesia care providers, and surgeon must work together to impede the elements of the fire triad from converging to start a fire. (56) Caregivers can stop fires in the OR from minimizing just one component of the triad. For example, providers can minimize firing material sources by

* allowing skin prep solutions to dried before draping the patient,

* coating facial hair with a water-soluble lubricant,

* prohibiting large bulks of 10% buffered formalin in the OR because it is explosive, and

* using special laser endotracheal tubes for oral laser surgery (78)

[FIGURE 1 OMITTED]

In addition, the OR can be an oxygen-rich environment. Caregivers should work cooperatively to cut short the amount of oxygen in the OR by

* placing drapes in a way that allows trapped gases to escape;

* turning opposite to oxygen during defibrillation or cardioversion;

* using no more oxygen than is necessary to maintain adequate oxygen levels; and

* questioning the ne for 100% oxygen especially during head and neck procedures

Heat also is prevalent in the OR. Caregivers can decrease the heat component by

* activating the electrosurgical unit (ESU) hand piece single when the tip is visible and touching the tissue to debar arching;

* allowing simply one foot pedal (eg, ESU laser, microscope) for the surgeon at a time;

* inspecting all electrical cords for fraying before plugging them into an outlet;

* keeping the tip of the hand piece clear of eschar to intercept heat build up;

* maintaining equipment in such a manner it is in good working order;

* not allowing an activated fiberoptic cable to proof on a drape;

* placing lasers onward standby when they are not in use;

* using flat-finished instruments to intercept reflection of a carbon dioxide laser beam to an unprotect area; and

* using an ESU pencil holster to debar accidental activation when the hand piece is lying forward the drape.

FIRE PREPAREDNESS

undivided component of fire safety is educating staff members forward what to do if a tire does be met with Perioperative managers and educators must review fire safety managements with staff members when they are hired and forward an annual basis. It is not enough to discuss fire safety theoretically; a facility's specific fire plan must be discussed, understood, and demonstrated according to all perioperative staff members. Many health care facilities use the acronym RACE as a foundation for the preparedness portion of their fire safety plan.

* R--rescue those in danger, including patients, visitors, and staff members.

* A--alert others to the fire using pre-determined methods

* C--contain the fire by dint of closing windows and doors to minimize the spread of fire and smoke