3-7. Patient fire

SJH Theatres and Anaesthetics
NHS Lothian

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.

 

Editorial Information

Last reviewed: 30/09/2018

Author(s): The Association of Anaesthetists of Great Britain & Ireland 2018.-19. www.aagbi.org/qrh Subject to Creative Commons license CC BY-NC-SA 4.0. You may distribute original version or adapt for yourself and distribute with acknowledgement of source. You may not use for commercial purposes. Visit website for details. The guidelines in this handbook are not intended to be standards of medical care. The ultimate judgement with regard to a particular clinical procedure or treatment plan must be made by the clinician in the light of the clinical data presented and the diagnostic and treatment options.

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