ABSTRACT * APPROXIMATELY 100 OPER...

ABSTRACT

* APPROXIMATELY 100 OPERATING field fire occur each year in the United States. Although rare, fire in a perioperative setting can be disastrous for the couple patients and staff members.

* IT IS CRUCIAL that all perioperative departments have a well musing out and previously rehearsed fire plan in place. Multidisciplinary planning and implementation of regularly scheduled and scripted fire drills are essential to preclude adverse outcomes.

* FIRE DRILLS render certain that all staff members are familiar with the use and location of fire twitch stations, fire extinguishers, and fire blankets. Fire drills also prepare staff members to evacuate the OR area if necessary.

* THIS ARTICLE provides the information and framework necessary to make known and implement comprehensive OR fire safety plans that could make the difference between life and death in a fire pass AORN J 79 (March 2004) 588-600

**********

Approximately 100 OR fires appear every year in the United States. (1) Although OR fires are infrequent, they can be deadly for the two patients and staff members. Unique safety matters in the OR (eg, lasers, electrosurgery oxygen-enriched atmosphere, flammable solutions, anesthetized patients) require specific signs of solutions and preparedness. (2) The decision to review and augment the fire safety plan for Faulkner Hospital, Boston, was made after latter facility renovations and the addition of just discovered OR staff members and a large anesthesia form into groups that rotates to 12 separate facilities. The plan of this article is to provide a framework for developing a comprehensive, facility specific, fire safety plan for the perioperative area that culminates in treat with contempt fire drills. (2)

PURPOSE

Five years ago, Faulkner Hospital merg with a a great deal of larger metropolitan hospital. The other hospital was in ne of more OR space, and Faulkner Hospital's ORs were being underused. Since that time, many surgeon from the other facility have obtained privileges at Faulkner Hospital, which necessitated adding more OR space. sum of two units more OR suites were built within the existing OR space on altering its configuration. As a follow a small 150-bed community hospital with seven OR suites has now expanded to contain nine OR suites with a novel architectural configuration. The merger increased the number of medical personnel in the OR and added medical students' OR rotations and surgical residents to an already transient population of anesthesia care providers, nursing scholars and student technologists.

Although there was a fire safety plan in place, the OR director, suckle practitioner, and clinical educator/systems coordinator cogitation that the plan as it existed was far too generic and did not adequately address the many composite issues that could develop during a fire in a multifaceted environment like as the OR. The question of to what extent to evacuate an intubated patient with an lay open incision, for example, had in no degree been addressed adequately. It was real important that a simple, safe, and straightforward plan clearly defining the parts and expectations of all staff members be developed

PLANNING

After identifying the ne for a plan, the nurture practitioner and clinical educator/systems coordinator began organizing support for the devise Meetings were held with the OR nursing director, chief of anesthesia, director of security, and, eventually, the hospital urgency management committee (EMC). The EMC consists of security personnel hospital department directors, and local fire and police representatives. Dialogue with the EMC was advantageous. It was discovered that pair departments within the hospital had assigned the same evacuation road and triage areas. Discussion interrupted a potential logistical problem.

Cooperation among the aforementioned collections proceeded without problems. The not many barriers encountered were logistical in nature rather than ideological. For example, the anesthesia dispose that covers the hospital give employment tos more than 100 professional personnel When could the entire staff meet? in what manner would the mock drills be implemented and when?

AUTHORITY HAVING JURISDICTION. The goal was to write the plan to include specific tasks and priorities for each team member. An "authority having jurisdiction" (AHJ) was central to the plan (Table 1) Authority having jurisdiction is a nationally recognized fire safety terminus that denotes the person designated to have overall authority in a particular situation. It was important that the lead authority be clearly defined at all times and that this living body would make all key decisions with clinical input from the departments of nursing and anesthesia. each team member, including surgeons, had to understand and be able to identify the chain of command. The AHJ was central to ensuring fortunate implementation and ongoing operation of The plan. (2)

do job-work DESCRIPTIONS. A plan was written to describe responsibilities for each staff member's part (eg, circulating nurse, scrub [i]role[/i] anesthesia care provider, surgeon) in the OR (Table 2) The basics of the fire triangle, which consists of three leg or sources--oxygen, firing and ignition--were introduced. (3) Fire alarms, extinguishers, and fire blankets were located, and evacuation paths were delineated. Architectural schematics detailing these features were placed in each OR suite, corridor, and loll All primary and secondary evacuation passages were color coded to assist team members in the incident that evacuation becomes necessary. (3)