O C T O B E R 2 0 1 6 O U T P A T I E N TS U R G E R Y. N E T 5 7
Whether it rises from an open surgical site or is vented unfiltered from a deflat-
ing pneumoperitoneum after laparoscopic surgery, some of the airborne particu-
late matter likely makes its way through staff and surgeons' standard surgical
masks and into their respiratory tracts.
According to AORN, chronic exposure to surgical smoke takes a toll on
employee health that's similar to the effects of cigarette smoking. Be sure to
outfit every OR with smoke evacuation technology, and make its use mandatory
in every case in which surgical energies are used. Or, better yet, choose electro-
surgical devices that include automatic smoke evacuation features.
4. Is the fire triangle neutralized?
Staff members who lack an understanding of basic fire prevention protocols
could unknowingly contribute to sparking a flash fire in the sterile field.
Fire safety in the OR should begin with an acknowledgement that the fire risk
triangle — an ignition source, plus oxygen, plus fuel — exists in any case that
involves energy-based devices. The surgical team should take every precaution
whenever surgical energies are activated, especially during (but not limited to)
procedures taking place around the airway. Your fire prevention policies should
also include a strict protocol for including a fire risk announcement during the
pre-op time out to alert staff to take cautions, routinely cleaning the char off the
electrosurgery tip to remove fuel from an igniter and vigilantly placing the hand-
piece in a bedside holster between uses to avoid inadvertent activation of the
device or burns from a still-warm tip.
OSM
Dr. Robinson (thomas.robinson@ucdenver.edu) is a
professor of surgery at the University of Colorado School
of Medicine in Aurora, Colo., and co-chair of the Society
of American Gastrointestinal and Endoscopic Surgeons'
FUSE (Fundamental Use of Surgical Energy) program.