Fuego en quirófano/OR fire

Operativo de seguridad contra incendios en quirófano


Operating room fire safety.
Hart SR, Yajnik A, Ashford J, Springer R, Harvey S.
Ochsner J. 2011 Spring;11(1):37-42.
Abstract
Operating room fires are a rare but preventable danger in modern healthcare operating rooms. Optimal outcomes depend on all operating room personnel being familiar with their roles in fire prevention and fire management. Despite the recommendations of major safety institutes, this familiarity is not the current practice in many healthcare facilities. Members of the anesthesiology and the surgery departments are commonly not actively involved in fire safety programs, fire drills, and fire simulations that could lead to potential delays in prevention and management of intraoperative fires.
KEYWORDS: Fire; intraoperative; program; safety; team
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096161/pdf/i1524-5012-11-1-37.pdf



Pensando en tres: cambios en las prácticas quirúrgicas de seguridad del paciente en la sala de operaciones moderna.


Thinking in three's: changing surgical patient safety practices in the complex modern operating room.
Gibbs VC.

World J Gastroenterol. 2012 Dec 14;18(46):6712-9. doi: 10.3748/wjg.v18.i46.6712.

Abstract

The three surgical patient safety events, wrong site surgery, retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to study. The likelihood of occurrence and the magnitude of risk for each of these surgical safety events are undefined. Many providers may never have a personal experience with one of these events and training and education on these topics are sparse. These circumstances lead to faulty thinking that a provider won't ever have an event or if one does occur the provider will intuitively know what to do. Surgeons are not preoccupied with failure and tend to usually consider good outcomes, which leads them to ignore or diminish the importance of implementing and following simple safety practices. These circumstances contribute to the persistent low level occurrence of these three events and to the difficulty in generating sufficient interest to resource solutions. Individual facilities rarely have the time or talent to understand these events and develop lasting solutions. More often than not, even the most well meaning internal review results in a new line to a policy and some rigorous enforcement mandate. This approach routinely fails and is another reason why these problems are so persistent. Vigilance actions alone have been unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stakeholders to optimize the OR environment. This article discusses standardized processes of care for mitigation of injury or outright prevention of wrong site surgery, RSI and surgical fires in an action-oriented framework illustrating the strategic elements important in each event and focusing on the responsibilities for each of the three major OR agents-anesthesiologists, surgeons and nurses. A Surgical Patient Safety Checklist is discussed that incorporates the necessary elements to bring these team members together and influence the emergence of a safer OR.

KEYWORDS: Complex adaptive systems; Retained foreign bodies; Retained foreign objects; Retained surgical items; Safety checklist; Surgical fires; Surgical patient safety; Wrong site surgery

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520159/pdf/WJG-18-6712.pdf

Factores que involucran fuego en la cirugía dental. Revisión de la literatura


Factors involved in dental surgery fires: a review of the literature.
VanCleave AM, Jones JE, McGlothlin JD, Saxen MA, Sanders BJ, Walker LA.

Anesth Prog. 2014 Spring;61(1):21-5. doi: 10.2344/0003-3006-61.1.21.

Abstract

Surgical fires are well-characterized, readily preventable, potentially devastating operating room catastrophes that continue to occur from 20 to 100 times per year or, by one estimate, up to 600 times per year in US operating rooms, sometimes with fatal results. The most significant risk factors for surgical fires involve (a) the use of an ignition source, such as laser or electrocautery equipment, in or around an oxygen-enriched environment in the head, neck, and upper torso area and (b) the concurrent delivery of supplemental oxygen, especially via nasal cannula. Nonetheless, while these 2 conditions occur very commonly in dental surgery, especially in pediatric dental surgery where sedation and anesthesia are regularly indicated, there is a general absence of documented dental surgical fires in the literature. Barring the possibility of underreporting for fear of litigation, this may suggest that there is another mechanism or mechanisms present in dental or pediatric dental surgery that mitigates this worst-case risk of surgical fires. Some possible explanations for this include: greater fire safety awareness by dental practitioners, incidental ventilation of oxygen-enriched environments in patient oral cavities due to breathing, or suction used by dental practitioners during procedures. This review of the literature provides a background to suggest that the practice of using intraoral suction in conjunction with the use of supplemental oxygen during dental procedures may alter the conditions needed for the initiation of intraoral fires. To date, there appear to be no published studies describing the ability of intraoral suctioning devices to alter the ambient oxygen concentration in an intraoral environment. In vivo models that would allow examination of intraoral suction on the ambient oxygen concentration in a simulated intraoral environment may then provide a valuable foundation for evaluating the safety of current clinical dental surgical practices, particularly in regard to the treatment of children.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3975610/pdf/i0003-3006-61-1-21.pdf




Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org