Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942012000300015
Brazilian Journal of Anesthesiology
Clinical Information

Incêndio no centro cirúrgico

Fire in the surgical center

Carlos Eduardo David de Almeida; Erick Freitas Curi; Renato Brezinscki; Rafaela Claudino de Freitas

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Resumo

JUSTIFICATIVA E OBJETIVOS: A existência de um ambiente rico em oxigênio, material combustível em abundância e a utilização de aparelhos capazes de fornecerem ignição transformam a sala cirúrgica em um ambiente de risco para a ocorrência de incêndios. Apesar de rara, trata-se de uma complicação potencialmente grave e na maioria das vezes evitável. Relatamos um caso de incêndio no campo cirúrgico durante uma cirurgia de blefaroplastia em que foi suplementado oxigênio por meio de cateter nasal. RELATO DO CASO: Paciente de 52 anos, sexo feminino, sem comorbidades, admitida para realização de blefaroplastia bilateral. Após monitorização e venóclise, procedeu-se à sedação endovenosa com oferta de oxigênio suplementar por meio de cateter tipo óculos, com fluxo de 4 L.min-1, seguida de anestesia local das pálpebras. Durante o ato cirúrgico, a utilização do bisturi elétrico ocasionou combustão dos campos cirúrgicos e queimaduras na face da paciente. CONCLUSÕES: O anestesiologista desempenha papel fundamental na prevenção de incêndio na sala cirúrgica, reconhecendo possíveis fontes de ignição e administrando de forma racional o oxigênio, principalmente com sistemas abertos. O primeiro passo para a prevenção deve ser a lembrança constante da possibilidade de incêndio.

Palavras-chave

anestesiologia, segurança, triângulo do fogo

Abstract

BACKGROUND AND OBJECTIVES: There are several factors in operating rooms that increase the risk of fire. Besides being an oxygen-enriched environment, it contains combustible materials and equipment with available ignition sources. Although fires in operating rooms are a relatively rare event, the consequences are potentially serious and mostly avoidable. We present a case report of a fire occurring in the surgical drape during a blepharoplasty in which oxygen was supplemented by nasal catheter. CASE REPORT: Female patient, 52-years old, without comorbidities, admitted to hospital for a bilateral blepharoplasty. After monitoring and venoclysis, the patient underwent intravenous sedation and additional oxygen given via spectacle-type catheter at a flow rate of 4 L.min-1, followed by local anesthesia in the eyelids. During surgery, the use of electric scalpel provoked combustion in the surgical drapes and burns on the patient's face. CONCLUSIONS: Anesthesiologists play an important role preventing fire in operating rooms, as they can recognize possible ignition sources and rationally administer the oxygen, especially in open systems. The first step toward prevention is to be constantly aware of potential fire.

Keywords

anesthesia, electrosurgery, fire prevention and protection, operating rooms, safety management

References

Ehrenwerth J, Seifert HA. Fire safety in the operating room. ASA Refresher Courses in Anesthesiology. 2003;31:25-33.

Bhananker SM, Posner KL, Cheney FW. Injury and liability associated with monitored anesthesia care: a closed claims analysis. Anesthesiology. 2006;104:228-234.

Trindade MRM, Grazziotin RU. Eletrocirurgia: sistemas mono e bipolar em cirurgia videolaparoscópica. Acta Cir Bras. 1998;13:194-203.

Torres M, Mathias RS. Complicações com o uso da monitorização - segurança no uso de equipamento eletromédico. Rev Bras Anestesiol. 1992;42:91-101.

Wolf GL, Simpson JI. Flammability of endotracheal tubes in oxygen and nitrous oxide enriched atmosphere. Anesthesiology. 1987;67:236-241.

Williams DM, Littwin S, Patterson AJ. Fiberoptic light source induced surgical fires: the contribution of forced air warming blankets. Acta Anesthesiol Scand. 2006;50:505-508.

Prasad R, Quezado Z, Andre AS. Fires in the operating room and intensive care unit: Awareness is the key to prevention. Anesth Analg. 2006;102:172-174.

Briscoe CE, Hill DW, Payne JP. Inflammable antiseptics and theatre fires. Br J Surg. 1976;63:981-983.

Batra S, Gupta R. Alcohol based surgical prep solution and the risk of fire in the operating room: a case report. Patient Saf Surg. 2008;2:10.

Barker SJ, Polson JS. Fire in the operating room: a case report and laboratory study. Anesth Analg. 2001;93:960-965.

Goldberg J. Brief laboratory report: surgical drape flammability. AANA J. 2006;74:352-354.

Orhan-Sungur M, Komatsu A, Sherman A. Effect of nasal cannula oxygen administration on oxygen concentration at facial and landmarks. Anaesthesia. 2009;64:521-526.

Yardley IE, Donaldson LJ. Surgical fires, a clear and present danger. Surgeon. 2010;8:87-92.

Meneghetti SC, Morgan MM, Fritz J. Operating room fires: optimizing safety. Plast Reconstr Surg. 2007;120:1701-1708.

Lampotang S, Gravenstein N, Paulus DA. Reducing the incidence of surgical fires: supplying nasal cannulae with sub-100% O2 gas mixtures from anesthesia machine. Anesth Analg. 2005;101:1407-1412.

Rego MMS, Mehernoor FW, White PF. The changing role of monitored anesthesia care in the unit ambulatory setting. Anesth Analg. 1997;85:1020-1036.

Morell RC. Why should I learn about fire extinguishers?. APSF Newsletter. 2011;25:59-60.

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