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D E C E M B E R 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
drapes, and in and around the head and neck area.
Another big misconception is the notion that there are fire-retardant
surgical drapes. The technology simply doesn't exist. The reason? It's
all about the oxygen. The world of oxygen-enriched ignition and flame
spread is unlike anything people experience with candles, campfires
or gas stoves. It's a totally different world and a frightening world. In
fact, the chemicals used to make fabrics fire-retardant in room air lit-
erally add fuel to the fire in an OR, because in an oxygen-enriched
environment, they burn.
Q
Is time pressure a factor that might lead to inadequate drying time
being allotted to alcohol-based preps?
MB:
Only about 5% of surgical fires involve alcohol-based skin preps
that were still wet when the patient was draped. Alcohol gets much
more attention because everyone knows it's flammable. It's easy to
understand. But the more important issue is oxygen and how easily it
allows things to catch fire and burn faster and hotter. Alcohol's role is
overrated. Oxygen's is underrated.
Q
Has there always been limited recognition of the role oxygen plays,
and is recognition growing?
MB:
Historically, because oxygen was so freely available, if
providers wanted to give patients fresh gas under the drapes for an
ostensibly "minor" procedure, they would just put an oxygen mask on
and turn it to 3 or 4 liters per minute. It was being given at 100% with-
out any consideration as to what the patient actually needed. We
would never do that with any other drug or medication. Well, the real
hazards happen when you get up above about a 40% or 50% concen-
tration. And it was that type of minor surgery that often resulted in
O R F I R E S
