Fighting Fire in the Operating Room

October is National Fire Prevention Month a time when perioperative professionals review policies on fire safety, educate staff, conduct mock fire drills and overall, ramp up awareness of prevention and management methods for surgical fires in the operating room. With the release of the Association for periOperative Registered Nurses' (AORN) updated Fire Safety Tool Kit, perioperative educators and other healthcare facility administrators will have a new fire safety resource to prepare perioperative staff members for fire in the OR.

Approximately 550 to 650 surgical fires occur each year in the United States, according to numbers released by ECRI Institute in "New Clinical Guide to Surgical Fire Prevention," published in the October 2009 issue of Health Devices. This guide also includes clinical guidance on controlling oxygen delivery, stating that, with certain exceptions, "the traditional practice of open delivery of 100% oxygen should be discontinued." Another key point in the guide is the importance of taking a team approach to surgical fire prevention.

This team approach has long been recommended by AORN. That's according to Byron Burlingame, RN, MS, CNOR, an AORN perioperative nursing specialist who managed the updates to AORN's revised Fire Safety Tool Kit. These updates were supported by Megadyne and the AORN Foundation.

Burlingame said the updated Fire Safety Tool Kit reflects new recommendations from ECRI Institute, as well as several AORN recommended practices, including: A fire risk assessment checklist, an updated sample fire safety policy and procedure, an updated fire safety competency evaluation tool, roles of the perioperative team in a fire, and links to new fire safety resources.

"Team involvement is critical because members of the surgical team have specific roles for monitoring different aspects of patient care and notifying others of their actions when there is a risk for fire," Burlingame stressed.

In AORN's updated Fire Safety Tool Kit, a detailed Fire Risk Assessment Checklist has been created in a format that enables individuals to tailor the checklist for use in their own facilities. The checklist includes the key questions that need to be part of a fire risk assessment, including the preoperative use of volatile chemicals. The tool kit also includes tools for tailoring detailed fire scenarios into mock drills as well as scenarios specific to different perioperative environments, such as hospitals and ambulatory surgery centers. Burlingame said other newly added tools in the updated Fire Safety Tool Kit provide resources that can be used by a facility to review and update policies and procedures, competency evaluations and to enhance in-services on fire safety. For example, the tool kit's updated sample policy and procedure for fire safety in the perioperative setting defines the purpose, policy, procedure interventions for prevention of fire on or in the patient, and procedure interventions for preventing fire, handling fire and evacuating an area in the event of a fire.

An updated competency evaluation tool for RN circulators includes key tasks the RN circulator must show competency in handling, such as managing fuel sources, ignition sources, oxidizers and following emergency procedures in the event of a fire on or near the patient.

"This updated tool kit will bring all members of the surgical team together in thinking about ways to enhance fire safety in OR and to be better prepared in the event a fire does take place," said Burlingame.

The AORN Fire Safety Tool Kit is sponsored by Megadyne and the AORN Foundation and is available free to the association's membership of 40,000 perioperative professionals and for $138.95 to non-members. The tool kit can be accessed by visiting