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Fires During Surgery Surprisingly Common:
How to Avoid Getting Burned


Unlike other more sensational medical mishaps -- like items left inside people after surgery -- fires in the operating room are rarely talked about. However, new data reveals that fires during surgery are more common than anyone realized.

surgery fires

It's estimated that hundreds of surgery fires occur in the United States every year.

"Virtually all operating room fires ignite on or in the patient. These fires typically result in little damage to equipment, cause considerable injury to patients, and are a complete surprise to the staff," according to non-profit health agency ECRI.

Just how many people have been seriously burned or even killed from a surgery fire? According to data from Pennsylvania, the state has had 28 operating room fires each year for the past three years, which amounts to about one in every 87,000 surgeries.

On a national level, this data suggests there may be hundreds of surgery fires every year out of the estimated 50 million annual surgeries performed.

"The numbers are higher than we expected," Mark Bruley, vice president for accident and forensic investigation at the ECRI Institute in Pennsylvania, told The Boston Globe. "It's a small risk, according to the statistics, however, having a fire on your face can be severely disfiguring and a horrendous experience. And with throat procedures, where these fires often occur, they can be fatal."

How do Surgery Fires Occur?

"There are three things necessary to create a fire," Dr. M. Christine Stock, head of the anesthesiology departments at Northwestern University and Northwestern Memorial Hospital, told ABC News.

"There has to be oxygen, extra oxygen. There has to be a source of ignition. So in the operating room that would be electrocartery. It could be a laser. And there has to be some kind of fuel, paper drapes or cloth gowns things like that. All of those things are used in almost every operating environment," she said.

In fact, due to the extreme flammability of oxygen and the common presence of heat-generating instruments, a static spark may be all it takes to engulf a person in flames.

surgery fires

Your greatest defense against surgery fires is to find a health care team that is knowledgeable about the issue -- and trained to prevent it.

Because of the close proximity of electrical surgical tools and oxygen for the patient, head, face, neck and chest surgeries are particularly risky; they account for 44 percent of operating room fires, according to ECRI.

Having Surgery? Here's What You Can Do

Surgery fires often result because of poor communication between surgeons, nurses and anesthesiologists. In the case of fire, this is critical, as each person on this team controls a different aspect of what is called the "fire triangle" -- heat, fuel, and oxidizer.

The surgeon, for instance, controls the heat source. The nurse, the fuels, and the anesthesiologist the oxidizers.

As a patient, it is up to you to speak directly with your health care providers about these concerns. Do not simply assume that they are aware of this issue, as most doctors have never encountered a surgical fire. Instead, ask your doctor and surgical team if they have been trained in dealing with surgical fires.

The American Society of Anesthesiologists issued a first-time advisory on the topic in April 2008. Among their recommendations:

  • Nurses should make sure flammable skin preps, like alcohol, are dry before draping

  • Surgeons should alert anesthesiologists before turning on certain tools, like lasers

  • Anesthesiologists should reduce the amount of oxygen being administered, if possible

ECRI has also put together this bulletin advising clinicians how to prevent surgical fires, which is worth handing directly to your surgeon.

"This is a fairly unique hazard within health care because in order to prevent it you have to have awareness and collaboration of three different specialties," Bruley said. "Until each is empowered to question the actions of the other two, you can't have prevention."

Rather than waiting for this to happen, become an empowered patient yourself. Speak up to your doctor about surgical fires and inquire about what preventative measures are taken. And while you're at it, inquire about these other 21 questions that every surgery patient should find out before getting on the operating table as well.

Recommended Reading

27 Never Events: They're Not Supposed to Happen, but They Often Do

LASIK Surgery: What are the Risks vs. the Benefits?


The Boston Globe November 7, 2007 April 21, 2008

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