Fire

Fire in the operating room is a rare event that requires the presence of an ignition source, fuel, and an oxidizing agent.

1. Lasers and electrocautery devices are the most common ignition sources.
2. Fuels include alcohol, solvents, sheets, drapes, and plastic or rubber materials (including endotracheal tubes). Modern potent inhalation anesthetics are not fuels. During an electrical fire, it is important to unplug the electrical source.
3. Oxygen is by far the most common oxidizing agent, although nitrous oxide also supports combustion. Materials that are only marginally combustible in air can produce a massive flame in the presence of a high oxygen concentration. Supplemental oxygen can accumulate under surgical drapes and should be administered only when medically indicated.
4. Fire extinguishers should be readily available in all anesthetizing locations. Carbon dioxide and halon fire extinguishers offer the advantage of efficacy against a variety of fires without producing the particulate contamination associated with dry chemical extinguishers.