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Surgical fires and alcohol-based skin preparations
Rebecca Tooher1, Guy J Maddern, John Simpson
1Australian Safety and Efficacy Register of New Interventional Procedures-Surgical, Royal Australasian College of Surgeons, Adelaide, South Australia.
ANZ Journal of Surgery
|May 18, 2004
Summary
Alcohol-based skin preparations pose a significant fire risk, especially when used with electrocautery. This report details two such incidents and offers recommendations to prevent future fires during surgical procedures.
Area of Science:
- Medical Safety
- Surgical Fire Prevention
- Healthcare Risk Management
Background:
- Alcohol-based skin preparations are widely used for antisepsis before surgical procedures.
- These preparations are highly flammable, presenting an inherent safety risk in clinical settings.
- Despite known risks, the use of alcohol-based solutions persists due to their efficacy.
Observation:
- Two cases of surgical fires caused by the ignition of pooled alcohol-based skin preparations are presented.
- Both incidents occurred during procedures involving electrocautery used for hemostasis.
- The fires resulted in significant patient and staff harm.
Findings:
- Pooled alcohol-based solutions can easily ignite when exposed to an ignition source, such as electrocautery.
- Inadequate drying time or pooling of the antiseptic solution increases the risk of ignition.
- Electrocautery is a common ignition source in operating rooms, exacerbating the risk.
Implications:
- Healthcare facilities must implement stricter protocols for the use of alcohol-based skin preparations.
- Enhanced awareness and training for surgical staff on fire risks associated with these agents are crucial.
- Recommendations include ensuring complete drying of the antiseptic before using electrocautery and minimizing pooling.