The combination of a fuel, an oxidizer, and a heat source is required for a fire to start (Fig. 1). Strategies for preventing surgical fires have included recommendations directed toward 1 or more limbs of this triangle. Heat sources such as lasers are to be placed in standby; cautery devices holstered. Fuels (prep solutions) that contain alcohol need to dry before starting a procedure: gauze and pads moistened. Most importantly, the concentration of oxygen in the surgical field needs to be controlled because commonly used surgical textiles become fuels in the presence of enriched oxygen and will burn hotter and faster than they would in room air. This last recommendation can be problematic, for example, when a patient with a high oxygen requirement presents for tracheostomy. In that case, prevention focuses on eliminating the use of electro-cautery when entering the trachea and the use of suction, wet packs, and bipolar cautery if necessary.
展开▼
