Reference Articles and Advisories 

• American Society of Anesthesiologists (ASA) Task Force on Operating Room Fires – Practice Advisory for the Prevention and Management of Operating Room Fires    
  This updated version of the practice advisory was published in: Anesthesiology. 2013 Feb;118(2):271-290.

• Association of periOperative Registered Nurses (AORN) – OR Fire Extinguisher Placement (2013) 

• Center for Medicare & Medicaid Services (CMS) - Use of Alcohol-based Skin Preparations in Anesthetizing Locations (PDF - 79KB) (2007) 

• "FDA Seeks to Prevent Surgical Fires" 
  ENT Today. April 2012 Issue.   Official publication of the Triological Society (The American Laryngological, Rhinological, and Otological Society, Inc.)
  This article provides recommendations for otolaryngologists on how to minimize the risk of surgical fires. It also mentions the Preventing Surgical Fires Initiative.

• The Joint Commission Sentinel Event Alert - Preventing Surgical Fires  (2003)

• “Operating Room Fires: A Closed Claims Analysis"  
  Anesthesiology. 2013 May;118(5):1133-9.
  Mehta SP, Bhananker SM, Posner KL, Domino KB.

• "Surgical Fire Injuries Continue to Occur: Prevention May Require More Cautious Use of Oxygen"  
  Anesthesia Patient Safety Foundation's APSF Newsletter
  Winter 2012 Issue (volume 26, No. 3, pg 41 and 43)
  This article lists conditions that put patients at risk for surgical fires and steps anesthesia professionals can take to decrease the likelihood of a surgical fire, including reassessment of the administration of supplemental oxygen using the included algorithm.
  
  APSF Fire Prevention Algorithm (updated March 2013)  
  Poster in three sizes to download and print  (Anesthesia Patient Safety Foundation)

• "Surgical Fires: Trends Associated with Prevention Efforts" 
  Pa Patient Saf Advis 2012 Dec;9(4):130-5 
  
  John R. Clarke, MD
  Editor, Pennsylvania Patient Safety Advisory
  Clinical Director, Pennsylvania Patient Safety Authority
  Professor of Surgery, Drexel University
  
  Mark E. Bruley, CCE
  Vice President, Accident and Forensic Investigation, ECRI Institute
  Editorial Advisory Board, Pennsylvania Patient Safety Advisory
  
  From the Abstract: "Surgical fires remain a significant enough risk to justify use of a Fire Risk Assessment Score and adherence to the recommendations of the American Society of Anesthesiologists Task Force on Operating Room Fires and those of the Anesthesia Patient Safety Foundation."
   

• "Surgical Fires in Laser Laryngeal Surgery-Are We Safe Enough?"
  Soham Roy, MD and Lee P. Smith, MD
  Otolaryngol Head Neck Surg. 2015 Jan;152(1):67-72

Education Programs for Healthcare Providers

• Fundamental Use of Surgical Energy (FUSE) Educational Program for OR Safety – Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) ^NEW
  SAGES’ FUSE program was developed in collaboration with gynecologic (AAGL), urologic (AUA), anesthesia (ASA), and nursing colleagues (AORN). FUSE covers a wide variety of topics in the use of surgical energy and has a specific focus in the prevention and management of fires in the operating room. This interactive, web-based program is a multimedia-enhanced didactic curriculum . Free access, CME and CEU certificates, and a high-stakes, multiple choice cognitive certifying exam are available options. The program was designed to certify that a successful candidate has demonstrated the knowledge fundamental to the safe use of surgical energy-based devices in the operating room, endoscopic suite and other procedural areas.
  
   

Fire Codes Relevant to Healthcare Facilities

   From the National Fire Protection (NFPA):

• NFPA 101 Life Safety Code 
• NFPA 99 Health Care Facilities Code
• NFPA 70E Electrical Safety in the Workplace 
• NFPA 1 Fire Code 

Fire Risk Assessment Tools

• Surgical Fire Risk Assessment Tools   
  Christiana Care Health System (Wilmington, DE) has developed and integrated a fire risk assessment in their universal protocol. Examples of this protocol, as well as an accompanying presentation are available on their website.

• Fire Safety Tool Kit  
  The Association of periOperative Registered Nurses (AORN) has created a fire safety tool kit. The Tool Kit contains slide shows to teach OR fire safety, fire risk assessment tool,
  fire safety competency tool, description of the perioperative team member roles in a fire, fire drill scenarios for the hospital & ambulatory settings, instructions on how to create an OR fire drill, fire drill evaluation tool, a Fire Safety Poster and references. The toolkit also includes two testimonial videos. 
   

• Fires in the OR  (Dartmouth-Hitchcock Medical Center) 
  This video shows a modified time out procedure that includes a discussion of the steps each operating room team member would take to prevent a fire and the steps they would take if a fire occurred.

Fire Extinguisher Recommendations for Operating Rooms

Please see the current recommendations from these initiative partners:  

• ECRI Institute 
• Anesthesia Patient Safety Foundation (APSF) 
• American Society of Anesthesiologists (ASA) 
• (PDF-386KB)Association of periOperative Registered Nurses (AORN) 

Educational Posters

• Airway Fires During Surgery (PDF - 820KB) 
  This poster from the Pennsylvania Patient Safety Authority discusses ways to minimize and fight airway fires.

• APSF Fire Prevention Algorithm (updated March 2013)  
  Poster in three sizes to download and print  (Anesthesia Patient Safety Foundation)

• Emergency Procedure - Extinguishing A Surgical Fire (PDF - 406KB) 
  ECRI Institute’s poster describes emergency procedures for extinguishing fires and caring for patients if a surgical fire should occur.

• Know Your Role in Preventing Surgical Fires (PDF - 1.02MB)  
  This poster from AORN links the three sides of the fire triangle with the personnel usually in control of each portion of the triangle.  

• Only You Can Prevent Surgical Fires (PDF - 3MB) 
  ECRI Institute‘s poster details recommendations to prevent surgical fires.

Educational Videos

• FDA Videos hosted by Medscape (Non-CME and CME)
   
  • Surgical Fires: How They Start and How to Prevent Them  – FDA Expert Interview  
    No registration required. No CME credits are available for this version.
    
    
     
  • Prevention of Surgical Fires
    Continuing Medical Education (CME) credits are available to physicians for this video.
    Please see the Medscape.org site for CME details. (Registration required.)
  • FDA Patient Safety News: Preventing Fires in the Operating Room 
    This 3 minute FDA video clip for health care professionals, summarizes the main points of APSF’s video, “Prevention and Management of Operating Room Fires."
     

• Fires in the OR  (Dartmouth-Hitchcock Medical Center) 
  This video shows a modified time out procedure that includes a discussion of the steps each operating room team member would take to prevent a fire and the steps they would take if a fire occurred.
   

• Prevention and Management of Operating Room Fires 
  With the assistance of ECRI Institute, The Anesthesia Patient Safety Foundation (APSF) has produced this 18-minute long video describes best practices to prevent the potentially devastating complication of a fire in the operating room. The intended audience is everyone who works in the OR during surgery. Watch the video online or request a complimentary DVD. The APSF Fire Safety Video may also be downloaded for subsequent off-line presentation and review.