Burns in the Operating Room
Surgical Fires 1
Setting the patient on fire during surgery: This sounds so bizarre it’s almost funny, but it’s a real-life horror. It happened to Cathy Lake’s mother, and it happens to an estimated four patients every week in American hospitals. These injuries are inexcusable, and patients and families are well justified in pursuing a medical malpractice lawsuit if this happens to you or a loved one.
Fires can occur on – or inside – a patient when an electrocautery device, which is used to seal off cut blood vessels, is deployed improperly. The presence of high concentrations of oxygen, and sometimes flammable alcohol fumes, also can set off a fire when a spark from any electrical device lands in the wrong place.
More on Cathy Lake’s mother’s case:
Her Mom was Catherine Barahona Reuter, a native of El Salvador who came to the United States at age twenty, served as a Catholic nun for twenty-two years, teaching bilingual kindergarten and first grade in the San Francisco area, then left the sisterhood, got married and had two children.
At age sixty-nine, she entered a major Washington, D.C., hospital for heart valve surgery. Cathy Lake remembers the surgeon telling her there had been a fire in the operating room. She assumed it was in some debris in a corner.
No, the fire was on her mother’s skin, and she had inhaled flames into her throat. How did this happen? They used a flammable alcohol-based skin prep to wash the skin and didn’t wait until it evaporated before they started using an electro-cautery device, which ignited the fumes.
Why use a flammable solution instead of old-fashioned, nonflammable Betadine? The alcohol-based solutions are favored in many operating rooms because they dry colorlessly, unlike Betadine, which leaves an orange cast on the skin that has to be scrubbed off.
Oxygen is another thing that can cause fires and explosions in operating rooms. Fires can happen when oxygen is used in too high a concentration near the electro-cautery device, which is used to seal bleeding blood vessels. Or the oxygen, which is an odorless and colorless gas, can leak and accumulate under drapes, ready to be touched off by a drill, a laser or another trigger.
Thanks to Cathy Lake’s drumbeat of publicity and prodding of medical organizations, the Joint Commission, which accredits hospitals, issued a “sentinel alert” about the risks of surgical fires, and the American Society of Anesthesiologists in 2008 issued a “practice advisory” about how to prevent OR fires. You can read more on her Web site: www.surgicalfire.org.
1 This page is adapted from Patrick Malone’s book, The Life You Save: Nine Steps to Finding the Best Medical Care — and Avoiding the Worst. (Da Capo Lifelong 2009).
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