How Surgical Fires Start
Surgical fires are fires that occur in, on or around a patient who is undergoing a medical or surgical procedure. Surgical fires can occur any time all three elements of the fire triangle are present:
- Ignition source (for example, electrosurgical units (ESUs), lasers, and fiberoptic light sources)
- Fuel source (for example, surgical drapes, alcohol-based skin preparation agents, the patient)
- Oxidizer (for example, oxygen, nitrous oxide, room air)
Materials that may not burn in room air can ignite easily and burn fiercely in an oxygen-enriched environment (a situation when the concentration of oxygen is greater than in ordinary room air). In fact, most surgical fires occur in an oxygen-enriched environment.
Other factors also increase the risk of fire. For example, alcohol-based skin preparation agents are very flammable when still wet. The placement of surgical drapes (such as when they are placed in a way that allows oxygen to pool under them), and the handling of ignition sources (such as resting hot ignition sources on the drapes) may also increase the chance that a surgical fire will occur.
Fires burn hotter and faster in an oxygen enriched environment. The image above shows a nasal cannula set on fire in room air (left) and in an oxygen enriched environment (right). Courtesy of Anesthesia Patient Safety Foundation.