VPNG State Conference 2009Sandra de Rome - Deakin

Dave McCurdy - MFB

You are circulating for a patient undergoing a laparoscopic cholecystectomy

Disposable drapes are in use

The light lead is disconnected from the telescope and accidently placed on the drapes

The intense light ignites the drapes

Smoke begins to quickly fill the room

How will you respond?

Switch off the electricity at the wall

Extinguish the fire if safe to do so

Press the emergency button

Call the emergency number, state your name, location and code red

Advise the Floor Manager of the situation

Prepare an additional operating room

Transfer the patient on the operating table, while being manually ventilated, to another room to complete surgery

Keep the doors closed as much as possible to contain smoke

How would you evacuate your Operating Suite?

How can you account for all staff, patients, visitors, students, medical representatives, etc in the Operating Suite?

Which exits would you use?

What is the best process to use when checking all rooms have been evacuated?

Is the hospital co-located with another hospital?

Ambulances may be required to transport patients to nearby hospitals

Transferring a patient: ◦ With an open surgical wound◦ An anaesthetised patient

Process for recording where patients are evacuated to & informing concerned relatives

Who is the ‘Fire Warden’ in your Operating Suite

What is their role?

What is the internal phone number to notify the hospital of an emergency?

In every area of the Operating Suite, how would you evacuate to safety?

Do you know the location of all Emergency Alarms in every operating room and recovery?

How does a ‘Fire Door’ operate to protect staff / patients

If you rely on ‘swipe cards’ to access the Operating Suite, are these deactivated in a fire situation? Why?

Do you know the location of:◦ All gas isolation valves – what are these?◦ All switchboards in the operating suite◦ All break glass alarms◦ All Warden Intercom Phones (WIP)◦ All exits

What burning substances can you extinguish with a CO2 fire extinguisher?

Can you efficiently use a fire extinguisher?

Operating Suites are usually divided into ‘compartments’ – how are these utilised in a fire emergency?

Immediate: from an operating room to a corridor

Lateral: from an area of threat to a safe area i.e. behind a smoke door

Partial: from the Operating Suite to another part of the hospital (provided it is not under threat)

Total: controlled evacuation from the Operating Suite to an Evacuation Point outside the hospital

ACORN Standards for Perioperative Nursing (2008): Australian College of Operating Room Nurses Ltd., Adelaide, South Australia

J. Rothrock, (Ed) (2007), Alexanders Care of the Patient in Surgery, (13thed). St Louis, MO: Mosby.

Hogan, C. (2002). Responding to a Fire at a Paediatric Hospital: AORN, Vol. 75(4)