Adults

Fire

Diagnosis

Evidence of fire (smoke, odor, flash) on patient or drapes, or in patient’s airway, or in OR equipment

Diagnosis

Evidence of fire (smoke, odor, flash) on patient or drapes, or in patient’s airway, or in OR equipment

  1. Call for help

    • Ask: "Who will be the crisis manager?"
    • Crisis manager designates checklist reader

  2. Halt surgery, if possible

  3. If AIRWAY FIRE

    Attempt to extinguish fire

    • Shut off medical gases
    • Remove endotracheal tube
    • Remove flammable material from airway
    • Pour saline in airway

  4. After fire extinguished

    • Re-establish ventilation using self-inflating bag with room air
    • Confirm no secondary fire
      • Check surgical field, drapes and towels
    • Assess airway for injury or foreign body
      • Assess ETT integrity (fragments may be left in airway)
      • Consider bronchoscopy

  5. Assess patient status and devise ongoing management plan

  6. Save involved materials/devices for examination

  7. If NON-AIRWAY patient fire

    Obtain a fire extinguisher

  8. Attempt to extinguish fire

    • FIRST ATTEMPT
    • Discontinue N2O and minimize FiO2
    • Remove drapes / all flammable materials from patient
    • If patient or drapes are on fire: extinguish burning materials with saline or saline-soaked gauze
    • If Fire PERSISTS
    • Use fire extinguisher (Class A and BC are safe in wounds)
    • Activate fire alarm

  9. After fire extinguished

    • Assess patient for injury at site of fire, and for inhalational injury if not intubated
    • Confirm no secondary fire
      • Check surgical field, drapes and towels

  10. Devise ongoing management plan

  11. Save involved materials/devices for examination

  12. If OR EQUIPMENT fire

    Obtain a fire extinguisher

  13. Attempt to extinguish fire

    • Use CO2 (Class BC) fire extinguisher (avoid liquids)
    • If Fire PERSISTS
    • Evacuate patient
    • Close OR door
    • Turn OFF gas supply to room
    • Activate fire alarm

  14. After fire extinguished or patient evacuated

    • Assess patient for injury at site of fire, and for inhalational injury if not intubated
    • Confirm no secondary fire
      • Check surgical field, drapes, and towels

  15. Devise ongoing patient management plan

  16. Save involved materials/devices for examination

Patient weight

Between 30 kg and 250 kg

Reset the checklist?

Checked steps, the timer and this crisis log are cleared. The patient’s weight is kept.

Finish the crisis?

The timer pauses, and you can review the case and the event log.