wants to start the case before the prep dries, let your nurses know that
they have the authority to tell him that the alcohol prepping solution is
not dry, and that you must wait until there is no tackiness.
3. Respect electrosurgery's dangers. Don't assume that your
OR team knows the risks of surgical fires. Take electrosurgery, for exam-
ple, which is used in 85% of all surgical procedures and has many associ-
ated fire hazards. Many fires start when the surgeon activates the elec-
trosurgical device in the presence of an oxygen-enriched environment or
in the presence of an alcohol-based prepping solution that has not been
allowed to dry. Another common fire risk: failing to use a holster. If elec-
trocautery and surgery electrodes will be present, they should be placed
in a holster when not in use and not laid on a patient when not in active
use (i.e., going to be used in the next few seconds). Encourage your sur-
geons and staff to read the fire hazard warnings in the user manual for
your electrosurgical equipment. I've talked to many surgeons and tactful-
ly observed to them: "You're an expert user of electrosurgery, but you're
not an expert in understanding all of the hazards." Unless you under-
stand the equipment, you won't understand your risk of fire.
Education key to fire prevention
The more you educate OR team members on fire safety, the more
you'll lower the risks. Free educational posters on fire prevention and
extinguishment, along with other resources, are available at
ecri.org/surgical_fires.
OSM
N O V E M B E R 2 0 1 7 • O U T PA T I E N T S U R G E R Y. N E T • 1 0 5
Mr. Bruley (mbruley@ecri.org), vice president of accident and forensic investiga-
tion at ECRI Institute in Plymouth Meeting, Pa., has been researching, publishing
and lecturing on the causes and prevention of surgical fires for more than 40 years.
