Operating Room Fires: Communication is Key to Prevention

Of the many possibilities patients hope will not happen during surgery, an operating room (OR) fire may not even be on the list. Yet, 650 OR fires occur each year in the United States. CRNAs at the Annual Congress gathered to learn more about this preventable safety hazard during "Fire Safety in the Operating Room," yesterday afternoon.

All OR fires are preventable, and communication between surgical team members is key, according to presenter Maria van Pelt, CRNA.

"A constant vigilance to changing conditions by anesthesia professionals and communication with all team members is imperative in reducing the risk for OR fires," said van Pelt. She explained that open delivery of oxygen contributes to most OR fires, and should be avoided. Cauterization also is an ignition source in a majority of OR fires.

During the symposium, a three-value scale was presented that helps surgical personnel determine how much risk is present: 1) whether there is an ignition source, 2) if open delivery of oxygen exists, and 3) if surgery is occurring above the level of the xiphoid (lower part of the sternum). One point is given to an affirmative for each option. Not surprisingly, three points reveal high risk for the possibility of fire. Each risk level triggers a protocol for oxygen concentration, available equipment, and specific role assignment.

Each team member knowing his or her role in both the surgery and fire prevention measures, and effective communication among team members, are critical to preventing situations where a fire could erupt. 

"If a fire does occur, knowing proper procedures to follow for airway and non-airway fires is also important," said van Pelt. "Stopping the procedure and removing ignition sources, and extinguishing any fire with saline or water as quickly as possible, are critical to the patient’s health and well-being."

For more information about surgical fires, visit