Operating room fire prevention: creating an electrosurgical unit fire safety device

Area of Science:

• Surgical safety engineering
• Biomedical device development
• Fire prevention technologies

Background:

• Operating room fires pose a significant, life-threatening risk, often initiated by electrosurgical unit (ESU) pencils.
• Carbon dioxide, a known fire suppressant and medical gas, is routinely available in surgical settings.
• A hypothesis was formed that a carbon dioxide shroud around the ESU pencil tip could displace oxygen and prevent ignition.

Purpose of the Study:

• To develop and evaluate a novel device aimed at reducing the incidence of surgical fires.
• To test the efficacy of a carbon dioxide delivery system in preventing fire ignition from an ESU pencil.

Main Methods:

• A 3D-designed polymer sleeve was attached to an ESU pencil, connected to a carbon dioxide source.
• The sleeve directed carbon dioxide through angled ports, creating a fire-suppressive cone around the active tip.
• Flammability tests were conducted in chambers with 21%, 50%, and 100% oxygen, comparing device use with a control (no carbon dioxide).

Main Results:

• Surgical fires ignited in all control trials across all tested oxygen concentrations (15/15 fires).
• Ignition times in control trials were rapid, with medians of 3.0s (21% O2), 0.1s (50% O2), and 0.03s (100% O2).
• The carbon dioxide-shrouded device completely prevented fire ignition in all trials and oxygen concentrations (0/15 fires; P < 0.0001).

Conclusions:

• A carbon dioxide sleeve effectively enshrouding an ESU pencil prevents fire ignition in a high-flammability model.
• This fire safety device demonstrated a 76% to 100% absolute risk reduction for fire ignition.
• Clinical implementation of this device could significantly decrease the occurrence of surgical fires.