IŞIL IŞIK ANDSOY

Cerrahi ekibin bilmesi gereken bir konu:Ameliyathanelerde yangın riskleri nelerdir? yangın güvenliği nasıl sağlanmalıdır?

Ameliyathaneler, yeni ve gelişmiş bilgilerin ışığında çeşitli cerrahi teknik ve yöntemlerin uygulandığı, ileri teknolojik araç ve gerecin kullanıldığı, hasta ve çalışan sağlığını etkileyen birçok riskin bir arada bulunduğu yerlerdir. Cerrahi girişime bağlı olarak meydana çıkma olasılığı olan yangınlar, yaralanma ya da ölüm vakalarına yol açabilmekte; hukuksal sorunlara, ameliyathane çalışanları, hasta ve hasta yakınları üzerinde psikolojik travma gibi istenmeyen sonuçlara neden olmaktadır. Ameliyathane çalışanları ve hasta güvenliğini sağlamak icin yangını önleme ve yangın esnasında yapılması gerekenler konusunda protokollerin hazırlanması ve tahliye planlarının oluşturulması son derece önemlidir. Her kurum, ameliyathanelerde yangının önlemesi ve yangın sırasında hasta ve yaralıların tahliyesinin sağlanması için tüm çalışanlarına, kapsamlı ve uygulamalı eğitim vermeli ve verilen eğitimi senede bir kez mutlaka tekrarlamalıdır. Bu makalede ameliyathanede yangına neden olabilecek risk faktörleri, yangına karşı alınması ve bilinmesi gereken önlemler literatürler eşliğinde ele alınmıştır.

A topic that must be known by surgical team: What are the risks of fire in operating rooms? how to establish fire security?

Operating rooms are places where different techniques, methods, and technological tools are used in the light of new and advanced information and where there exist a lot of risks that affect patients’ and staff’s health. Fires that occur as a result of surgical operations may cause injuries and deaths in addition to some other issues like legal problems, psychological trauma on patients, their relatives and operating room staff. It is important to have protocols and evacuation plans for prevention of fires and things to do during fires to form safety of patients and operating room staff. All institutions must give an extensive education to its entire staff to prevent fires and to evacuate patients and other injured people during fire and this education must be repeated once in a year. In this article the risk factors that may cause fire in the operation room and precautionary actions against fire was evaluated together with literature.

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1. AORN guidance statement: Fire prevention in the operating room. AORN J. 2005 May;81(5):1067- 75.
2. Berquer R. Surgery and Ergonomics. Arch Surg. 1999; 134: 1011-1016.
3. Çobanoğlu A. [Risks arising from the operating room environment and health worker safety]. Yavuz M, Özbayır T, Korkmaz FD, Kaymakçı Ş. Eds. 6. Türk Cerrahi ve Ameliyathane Hemşireliği Kongre Kitabı. Đzmir: Meta Basım, 2009.p.258.
4. Eti Aslan F, Kan Öntürk Z. [Safety Operating Environment: Biological, Chemical, Physical and Psychosocial Risks, Effects and Precautions]. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi. 2011; 4 (11): 133-140.
5. Sönmez M, Yavuz M. [Staff safety in operating room]. Yavuz M, Özbayır T, Korkmaz FD, Kaymakçı Ş. Eds. 6.Türk Cerrahi ve Ameliyathane Hemşireliği Kongre Kitabı. Đzmir: Meta Basım, 2009.p.255-257.
6. Moyer P. Operating room fires: how to prevent and minimize spread. Todays Sur Nurse1998; 20(6):13-17.
7. Salmon L. Fire in the OR-Prevention and preparedness, AORN Journal. 2004; 80(1):41-60.
8. Smith C. Surgical fires- Learn not to burn, AORN Journal. 2004; 80(1):23-38.
9. Rinder CS. Fire safety in the operating room. Curr Opin Anaesthesiol. 2008;21(6):790-795.
10. Guidance article: Surgical fire safety, “ Health Devices”Vol 35, No.2 ( ECRI, February 2006)
11. Hall MJ.Owinas MF. 2000 national Hosipital Discharge Survey. Advance data from vital and health statistic, Hyattsville, Maryland: National Center for Health Statistic, No.329, 2002.
12. McCarthy PM, Gaucher KA. Fire in the OR: Developing a fire safety plan. AORN Journal. 2004; 79: 588-600.
13. Bruley ME. Surgical fires: perioperative communication is essential to prevent this rare but devastating complication. Qual Saf Health Care. 2004; 12: 467-471.
14. Recommended practices for electrosurgent," in Standards, Recommended Practices, and Guidelines (Denver: AORN, Inc, 2004):245-259.
15. A clinician's guide to surgical fires: Hozo they occur, how to prevent them, how to put them out. Health Devices. 2003; 32: 1-24.
16. Finnegan JM. Staff education can prevent OR fires. Todays OR Nurse. 1994 May-Jun;16(3):24-6.
17. ECRI, Surgical fires, “Operating room risk management” Fire Safety Self Study Guide, November 2004, p.6
18. "Recommended practices for skin preparation of patients,"in Standards, Recommended Practices, and Guidelines (Denver: AORN, Inc, 2004).p. 357- 360.
19. Ball K. Lasers, The perioperative Challenge, Thirth Edition, Mosby Elseiver; 2004.p.50-67.
20. Ball K. Surgical Modalities, Ed. Jane C.Rothrock, Alexander’s Care of the Patient in Surgery, Thirteenth Edition, Mosby Elseiver; 2007. p. 205- 219.
21. Phillips N. Laser Surgery, Berry&Kohn’s Operating Room Technique, Eleventh Edition, Mosby Elseiver; 2007. pp.354-362.
22. IEC, International Electrotechnical Commission, Radiation Safety of Laser Products, Equipment Classification, Requirements and User’s Guide, Publ. 60825-1.1, Geneva, Switzerland,1998.
23. ANSI, Z 136.1, American National Standards Institute (2000), American National Standard for the Safe Use of Lasers,(NY,10036), New York.
24. Sallavanti RA. Protecting your eyes in the lazer operating room. Todays OR Nurse. Jul-Aug 1995;17(4):23-26.
25. Baxter DA. Laser safety in the operating room. Insight Oct-Dec. 2006;31(4):13-14.
26. "Recommended practices for endoscopic minimally invasive surgery," in Standards, Recommended Practices, and Guidelines(Denver: AORN, Inc, 2004).p. 267-271.
27. ECRI, "The patient is on fire! A surgical fire printer,"Medical Device Safety Reports 21 (January 1992).p. 19-34. (Accessed day: 20 May 2012).
28. "Recommended practices for safe care through identificationof potential hazards in the surgical environment "in Standards, Recommended Practices, and Guidelines (Denver: AORN, Inc, 2004).p.301-307.
29. "Recommended practices for product selection in perioperative practice settings," in Standards, Recommended Practices, and Guidelines (Denver: AORN, Inc, 2004).p. 347-350.
30. "Recommended practices for laser safety in practice settings, "in Standards, Recommended Practices, and Guidelines (Denver: AORN Inc, 2004).p. 319-324.
31. "Recommended practices for electrosurgery," in Standards, Recommended Practices, and Guidelines (Denver: AORN, Inc, 2004) .p. 245- 259.
32. "A clinician's guide to surgical fires: How they occur, how to prevent them, how to put them out," .Health Devices. 2003 Jan; 32: 1-24.
33. "Recommended practices for skin preparation of patients," in Standards, Recommended Practices, and Guidelines (Denver: AORN, Inc, 2004).p. 357- 360.
34. Spigelman AD, Swan JR. Skin antiseptics and the risk of operating theatre fires. ANZ J Surg. 2005 Jul;75(7):556-8.
35. Kalkman CJ, Romijn C, van Rheineck Leyssius AT. Fire and explosion hazard during oxygen use in operating rooms. Ned Tijdschr Geneeskd. 2008 Jun 7;152(23):1313-6.
36. Malamed SF. Sedation: A guide to patient management. 4th ed. St. Louis, Missouri, USA: Mosby; 2003.p.107-115.
37. Baygın Ö, Işık B. Çocuk Diş Hekimliğinde Nitröz Oksit/Oksijen Sedasyonu, Hacettepe Diş Hekimliği Fakültesi Dergisi. 2010; 34(1-2): 53-61.
38. M Laster, P Roth, E I Eger. "Fires from the interaction of anesthetics with desiccated absorbent," (Technology, Computing, and Simulation) Anesthesia and Analgesia (September) 2004; 99:769-774.
39. Daane SP, Toth BA. Fire in the operating room: principles and prevention. Plast Reconstr Surg. 2005 Apr 15;115(5):73-75.