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Post by katevaughn on Aug 27, 2016 15:37:44 GMT -5
This month's journal club is presented by Mary Scott-Herring. She has shared a great article with us concerning a practice advisory for the risk assessment and management of operating room fires. Operating room fires are often something we learn about in school but only think about during high-risk procedures. However, assessing the risk should be a crucial part of every anesthetic we deliver because unfortunately they are a harsh reality. This is a wonderful article and hope you all find it helpful and can reference the algorithm as needed. The questions Mary added are as follows... 1. Do you know how we calculate a fire score? What are the components and/or ratings? Do you do this for every case? 2. What are your thoughts regarding the use of an ETT or LMA when moderate or deep sedation is required? Please click on the link to read the article. link
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Post by AugustineEmmanuel on Sept 23, 2016 12:00:21 GMT -5
This article posted is very information and the algorithm is something handy to keep in the back of our minds if such a scenario occurs in our clinical practice. I remember having a talk about fire scores during a simulation learning session during grad school. From my understanding the fire score is calculated based on the the presence of 3 elements: fuel, oxygen and heat. Rated 1-3 for low risk to high risk. I've heard some of the circulating staff mention the fire risk score but almost everyone I've asked does not know what exactly that means or what measures we need to take if there is a high risk of a potential fire. In regards to the use of a ETT/LMA for moderate or deep sedation the advisory board suggests a sealed gas delivery system however realistically we all know that doesn't happen as often as it should. We do sometimes change our practice based on convenience, prior exercise and appeasing our surgical and anesthesia colleagues
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Post by belinda on Oct 18, 2016 15:19:00 GMT -5
Great review for management of and evaluating high risk procedures for OR/ airway fires.
1. Most recently our nursing colleagues note the "Fire Risk" value during the surgical "Time Out" prior to incision with each case in the OR which is determined by these 3 factors: -Oxidizer (O2/N2O) -Ignition source(Bovie/cautery) -Fuel (drapes/patient/airway)
All airway cases are given a fire risk of "1" and most other cases a value of "2" per nursing. There is a posted fire risk assessment in ZBOR for reference. This is important to discuss prior to every case so that all team members know risk of fire for that particular case as well as any special plan in case of fire and each persons role in case of fire.
2. In most cases we seem to do most of our anesthetics with closed breathing systems here except smaller facial/plastics cases done in JHOC which seems to be provider/surgeon preference.
Taking part in an annual OR specific Fire Drill would probably be a great review for all OR personnel.
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Post by Shannon on Oct 27, 2016 14:30:26 GMT -5
I like the idea of the fire drill Belinda. I do not think us going to fire extinguish a cup every year is likely enough. With that being said; how do you suggest we perform a fire drill. I envision a skills day of sorts. Remember those? I am not sure we could perform such a drill when our patients are anesthetized. Thoughts?
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Post by belinda on Oct 28, 2016 13:02:01 GMT -5
Maybe a skills/safety review day inclusive of a few important and different items than we all review at every conference. Could we make this part of our next meeting for credit? Or would this be a good Thursday morning meeting item done in the OR? Is there anything else we would all like to "play with" or practice in the OR without a patient on the table?
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