Patient Safety: Scoring patients for fire risk adds to safety
Denise A. Dennison BSN, RN, CNOR

February 2011 
Volume 41  Number 2
Pages 67 - 68
  PDF Version Available!

IN RECENT YEARS, healthcare professionals have turned their attention to reducing the risk of fires in the OR. From 2005 to 2009, a Joint Commission National Patient Safety Goal (11) was to reduce the risk of surgical fires.1 Although fire safety usually focuses on surgical patients, the risk is similar for patients undergoing procedures outside the OR.At Christiana Care Health System in Wilmington, Del., we've made reducing the risk of fire both within the OR and during bedside procedures a top priority. This article describes our innovative approach to scoring fire risk before procedures and explains how to lessen the possibility of fire based on the level of risk involved. First, let's take a look at the factors that contribute to fire risk.Fires occur when the three components of the fire triangle-fuel, an ignition source, and oxygen-come together. (See The fire triangle.) In the OR, each of these components is typically controlled by a different member of the OR team. Mainly the surgeons control the heat sources, such as electrosurgical units, lasers, and fiberoptic light cables. The anesthesia providers are responsible for the anesthetic gases and supplemental oxygen that contribute to an oxygen-enriched atmosphere in the OR. Nurses are involved with potential fuel sources, including gowns, drapes, sponges, lap pads, prep solutions, and even the patient's clothing, hair, and skin.2Each component of the fire triangle may be present at the bedside as well. A patient who receives supplemental oxygen during a bedside procedure is just as much at risk from fire as a surgical patient, if an ignition source is also present.3Many bedside procedures, such as electrical cardioversion, percutaneous tracheostomy, and wound debridement, involve equipment that can provide an ignition source. These procedures are often performed in the postanesthesia care unit, surgical ICU, ED, and medical-surgical units.We began our fire safety initiative by assembling a multidisciplinary

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