手术火灾和听起来一样糟糕. Imagine waking up in a post-anesthesia care unit (PACU) after you just went under for a normal, routine surgery only to be told that a fire occurred while you were under anesthesia. 虽然皇家88账户注册听起来像是电影里的情节，但危险是真实存在的. 据估计，美国每年发生90到100起手术火灾, 平均每周发生两次手术火灾.
尽管手术火灾是很严重的事件, 它们是可以预防的，如果发生，手术团队需要做好准备. 事实上, the NFPA 99 卫生保健 Facilities Code includes guidelines for training all operating room (OR) personnel in the prevention of surgical fires. Additionally, CMS and other health care accreditation organizations reference NFPA 99 2012 Edition.
例如，联合委员会环境护理(EC)标准02.03.01, 绩效要素(EP) 11要求“定期评估”, 由[组织]决定, are made of potential fire hazards that could be encountered during surgical procedures. 书面防火和应对程序, including safety precautions related to the use of flammable germicides or antiseptics, 建立了.“自2023年1月1日起，联合委员会EC.02.03.03, EP 7 requires annual fire exit drills for operating rooms/surgical suites to “involve applicable staff and licensed practitioners and focuses on prevention as well as simulated extinguishment and evacuation.”
外科手术火灾风险评估
在手术开始之前和单个切口之前, 外科小组应进行外科火灾风险评估(FRA). 森林资源评估有助于确定关键的风险因素(例如.e., heat oxygen and fuel) and can easily be incorporated into routine processes already in place for identifying other perioperative assessments and concerns. 例如, 在一个团队确认了正确的手术部位之后, 患者识别和过敏, the surgical FRA will assess the specific risk factors and include a scoring mechanism to identify the surgery’s fire risk as high, 中或低. The scoring is an important tool to initiate open communication between the team and ensure that proper surgical fire prevention procedures and risk mitigation strategies are in place.
评估三个关键要素:热、氧和燃料
热. 手术能量是病人体内或身上大多数手术火灾的点火源. The most common form of surgical energy is monopolar radiofrequency energy, also known as the “Bovie.Bovie将电磁能转化为热能, and it is the heating of tissue or the energy device itself that serves as the ignition source for the fire. 像光纤光源皇家88账户注册样的设备, lasers and high-speed burrs are other heat factors that could help ignite an operating room fire. Hospitals need to provide proper education to all staff on when to use such devices and the hazards associated with each device.
氧气. 氧气和手术火灾有什么关系? 氧气 can help enhance a fire, making it burn faster, stronger, bigger and brighter. During almost all surgeries, the anesthesia provider administers oxygen to the patient. 它们如何输送氧气非常重要. Open delivery of oxygen poses a bigger threat to the patient than a closed system (e.g.(病人插管). Certain risk reduction strategies can be used to limit the potential for oxygen-enriched atmospheres as well as pooling or “tenting” of oxygen in and around the patient.
燃料. Controlling the heat source and monitoring how oxygen is admitted are easier steps to control. 但燃料就在皇家88娱乐身边. 任何东西都可以成为燃料来源, from the surgical drapes and prep solution applied on the patient’s skin to gauze pads and surgical towels. Ensuring that the prep solution is fully dried per manufacturer guidelines and being aware of fuel source proximity can dramatically help reduce the threat of fire occurrences and enhance operating room fire safety.
外科防火培训和教育
Hospitals and surgery centers need to invest time in education and training to help ensure that staff, 外科医生和麻醉提供者准备好处理手术火灾. 设施应该有一个适当的过程来处理气道火灾的扑灭, 褶皱的火灾, prep solution fires and even equipment fires that can occur inside the operating room. 所有设施都应该在其组织内部培训和实践皇家88账户注册些技术.
Different members of the surgical team should also know how to suppress various types of surgical fires. 例如, an airway fire is almost always handled by the anesthesia provider in the room. The anesthesia provider must stop the flow of oxygen prior to extubating the patient. Failure to do so can cause the fire to burn all the way up the patient’s airway and to continue to burn inside the operating room.
此外, emergency procedures should clearly define surgical team members’ roles and responsibilities to identify how they will assist with evacuation in the event of an operating room fire. Proper evacuation sites should be identified and comparable to the operating room environment. 例如, 如果病人断了氧, 抽吸或监测, 他们需要一个能容纳氧气的疏散地点, 抽吸和监测.
采取措施防止手术火灾
Surgical fires are a life-changing event, not only for patients but for the staff involved. 在皇家88账户注册种类型的火灾紧急情况下，外科团队是真正的第一道防线. 他们需要知道和理解手术过程中他们周围的危险. 皇家88娱乐的专家可以帮助您开发合适的, hands-on operating room fire safety training and drills to reduce the potential for loss of life and injury in a surgical fire. 了解更多关于皇家88账户注册的信息 消防训练服务.