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Surgical fires: What are they and why they happen?

A surgical fire -- which is one that occurs inside the operating room while the patient is on the operating table and usually under anesthesia -- is a "never" event.

That means that it should never happen. If proper controls are in place, it wouldn't. Yet, it's estimated that there are as many as 600 surgical fires every year. In a notable case that happened in 2016, a patient who accidentally passed gas during laser surgery was left severely burned over most of her body when the surgical drapes caught fire.

What leads to surgical fires?

In order for a surgical fire to happen, there has to be a source of heat, a source of fuel and oxygen.

Most of the time, the problem comes from a source of heat getting to the surgical drapes and alcohol soaked gauze around a patient. The air in the room can provide the final ingredient to start a fire, but the real danger is the oxygen being used on the patient -- it can accelerate the fire quickly.

What should an anesthesiologist do?

The anesthesiologist has the most responsibility for preventing surgical fires. An anesthesiologist should always take certain steps:

  • Make certain to communicate clearly to the individual prepping the skin for surgery before beginning the oxygen.
  • Make sure that the physician is aware of the oxygen being used and keeps the heat source carefully under control.
  • Examine the surgical drapes to make certain they are not too close to the area under operation and won't trap excess oxygen if an open oxygen delivery system is used.
  • Use a closed oxygen system whenever possible to reduce the chances of a fire.
  • Use the minimum amount of oxygen necessary to keep the patient properly oxygenated.

Fire risk assessment should be part of every surgical procedure.

If you've been the victim of a surgical fire, an attorney can help you understand your rights. Make sure that you don't agree to any settlement offer presented by the hospital until you have sound legal advice and understand all the implications of the agreement.

Source: www.aana.com, "Surgical Fires," accessed Oct. 20, 2017

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