3-7. Patient fire
SJH Theatres and Anaesthetics
Objectives
Evidence of fire (smoke, heat, odour, flash, flame) on patient or drapes, or in patient's airway.
START.
❶ Call for help and inform theatre team:
• Activate fire alarm
• Dial hospital fire emergency number and report location and nature of fire
• Bring CO2 fire extinguisher into theatre
| If AIRWAY fire: | If NON-AIRWAY fire: |
|
❷Extinguish fire: • Stop laser or diathermy • Discontinue ventilation AND fresh gas flow • Remove tracheal tube if on fire • Remove flammable material from airway • Flood airway with 0.9% saline ❸ After fire extinguished: • Re-establish ventilation • Minimise O2, avoid N2O • Check airway for damage and debris • Consider bronchoscopy • Re-intubate |
❷Extinguish fire: • Stop laser or diathermy • Remove all drapes and burning material • Flood fire with 0.9% saline or saline soaked gauze • Use CO2 extinguisher ❸After fire extinguished: • Re-establish ventilation • Minimise O2, avoid N2O • Assess damage • Consider inhalational injury if not intubated • Consider intubation depending on degree of injury |
❹ Assess patient and devise ongoing management plan
• Confirm no secondary fire, assess smoke risk to patient, consider intensive care.
❺ Keep involved materials or devices for inspection and report to the MHRA.
❻ If secondary non-patient fire occurs, or concerned about smoke/fire risk to staff, follow local fire procedures.