Crisis management of fire in the OR

Fire in the OR is a life-threatening emergency that demands prompt, coordinated, and effective interventions. Specific applications of fire protocols and guidelines for perioperative nurses and their interprofessional colleagues may take several approaches. The perioperative nurse’s role is one that can frequently prevent or ameliorate the damaging thermal effects of a fire. For example, to some degree, the nurse can control all three components of the fire triangle: the ignition sources used during surgery (eg, fiberoptic lights, ESU devices), the oxidizers (eg, room air, supplemental oxygen administered during procedures under straight local anesthesia), and the fuel sources (eg, alcohol-based prep solutions). Although all members of the surgical team play an important role, the ability of and the opportunity for the nurse to minimize the risks of fire are important patient safety attributes of the nurse. Team training, rehearsing appropriate actions, and reacting effectively are essential to preparing health care providers to respond in emergent situations and be able to deliver optimal care. In most jurisdictions, any fired--regardless of size--must be reported to the local fire department. Personnel, managers, and administrators should be prepared also for the possibility of participating in postcrisis evaluations by the fire marshal, The Joint Commission, the Occupational Safety and Health Administration, Centers for Medicare & Medicaid Services, and possibly other fire safety-related organizations. Additionally, supplemental information related to investigating a fire is available through the ECRI Institute.28 The ECRI Institute serves as a third-party investigator and can facilitate root-cause analyses, identify whether the crisis ought to be reported and to whom, and assist in restoring clinical operations.