Monday, June 1, 2009

Fire Extinguishers in Operating Rooms

...was recently surveyed by the Joint Commission. It was recommended, by the survey team, that we add CO2 fire extinguishers in the OR rooms. It was explained to us that CO2 extinguishers were safe to use in the OR rooms during surgery. Is this is a code requirement or just a recommendation? Also, what do the other facilities use in the OR suites and rooms?


Maine Healthcare Engineers said...

I am changing to Halotron which is ABC rated.

Maine Healthcare Engineers said...

If you haven't already check with the state to see what they think. If it is not a requirement I would do a Risk Assessment behind the pros and cons of doing this and document your findings at your EOC/Safety Committee. I was surveyed last Wednesday and Thursday thus I missed our meeting on Wednesday. I have a great form from the Life Safety Surveyor that I can share sometime with all.

Maine Healthcare Engineers said...

In April 2008 a surgical team in Houston faced fire during surgery due to an electrical light on a drape. Staff removed the burning drape, extinguished the fire with a water mist extinguisher and surgery continued. ASA (American Society of Anesthesiologist) published an advisory to increase awareness of surgical fires. Approximately 50-100 fires occur in OR per year due to electrocautery pens, drapes and alcohol pens and oxidizers. Key to mitigation is education, preparations, prevention and management.

The Life Safety Code NFPA 101 recommends portable fire extinguishers in accordance with section which directs to NFPA 10 portable fire extinguisher guidelines. This guideline indicates portable fire extinguishers sized and designed to protect hazards that are present. They do not specify exact type to be used in an Operating room.

Advisory teams recommend the use of Co2 extinguishers but there is debate about using water mist instead. Co2 discharged (at high pressure) directly into a wound compromises sterility and are not recommended for Class A fires (ordinary combustibles such as wood, paper, textiles etc.). Water mists (distilled water) reduces electrocution risk and is rated for Class A fire hazards but are not as effective for Class B and C fires. Water mists were designed to reduce electrocution hazards but if the water pools it presents an electrocution risk.

One extinguisher used in Operation Room Suites is Ansul Model FE-13 Cleanguard. It is a clean agent and designed to suppress Class A, B, or C fires (interrupts chemical reactions due to fire). I’m researching technical studies and debates concerning this agent being used inside operating rooms during surgery. DuPont FE36 chemical formula is C3H2F6 and goes under the name Hexaflouropropane which is a nonflammable gas.

Maine Healthcare Engineers said...

Hello everyone. As far as the Fire Marshal Office in concerned - Inspector Mark Stevens has done some research on this. Nothing in NFPA 99, NFPA 1, or NFPA 10 mandates the installation of CO2 extinguishers in an operating room setting. We have sent an email for CMS to make sure there is something we are not aware of. I will let you know as soon as we here from them.

Have a great afternoon!


Gregory Day, CFI II
Public Safety Inspector II
Maine Fire Marshal Office
1 Darcie Drive, Suite 205
Houlton, Maine 04730
207-532-5407 (Houlton Office)

Maine Healthcare Engineers said...

________ Hospital has switched to Halotron in areas that contain sensitive equipment, and we plan on doing the same in our new operating rooms.

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