Oxygen Enriched Environment and Surgical Environments

Fire Triangle
The fire triangle illustrates the three elements a fire needs to ignite: heat, fuel, and an oxidizing agent (usually oxygen). A fire naturally occurs when the elements are present and combined in the right mixture, and a fire can be prevented or extinguished by removing any one of the elements in the fire triangle. For example, covering a fire with a fire blanket removes the "oxygen" part of the triangle and can extinguish a fire.

  1. Ignition Source – laser, electrosurgical unit, Bovie
  2. Fuel – tracheal tube, pledget, drapes, catheter
  3. Oxidizer – oxygen, nitrous oxide

Operating Room Hazards
Surgery has the ability to save lives, but a number of hazards lurking in operating rooms. Surgeons, nurses, anesthesiologists, assistants and other professionals working in surgical environments put themselves at risk every day in their careers. If you work as part of a surgical team, it's essential that you familiarize yourself with potential hazards so you can avoid getting injured or exposing yourself to other dangers while on the job.

These hazards include but are not limited to:

  1. Electricity
  2. Oxygen
  3. Heat Sources
  4. Lasers
  5. Flammable materials / liquids
  6. Trip hazards
  7. Drills – burs, sparks
  8. Static Electricity

Activating the Alarm, Detection, and Suppression System
in case of an emergency or fire related incident, there are multiple was to have a detection system activated. The following are alarms, detection devices and suppression systems we need to be aware of.

  1. Pull boxes
  2. Smoke detectors
  3. Sprinklers
  4. Fire Extinguishers
  5. Oxygen Shut-off Valves
  6. Compartmentalization – corridors, doors, penetrations


  1. Ensure Clinical Engineering inspection sticker is present and current on all medical equipment, prior to use.
  2. Control heat sources by following laser and ESU Safety Practices, allowing sources to cool between uses, put in holster or other appropriate resting place.
  3. Manage fuels, by allowing sufficient time for patient prep allows vapors to dissipate; prevent pooling under patient.
  4. Minimize oxygen concentrations through judicious use of O2 and tenting drapes, proper ventilation.  Question need for 100% O2 use.
  5. Ensure ESU (e.g. Bovi) grounding pad is properly positioned under the patient (ESU must remain in holster or sheath when not in use – never allow ESU to rest on sterile drapes or patient)

Response: R.A.C.E.
Maintain your environment and keep minor fires from getting out of control. In addition know where your nearest fire alarm, detection, communication and suppression systems/equipment are located. If there is an CODE RED activation, please do the following:

Close (the door)
Evacuate and/or Extinguish