A Guide to The Joint Commission’s Recommendations for Managing Surgical Ignition Sources

The Joint Commission recently updated its surgical fire prevention guide for the first time in 20 years. For a high level overview of the recommendations, check out our blog. In addition to the actions The Joint Commission requires, they suggest facilities take six additional efforts to prevent surgical fires. In this brief overview, we are going to dive into recommendation #3: carefully manage electrosurgical devices, light sources and cords, surgical draping, and other risks during a procedure.  

Surgical procedures are intricate processes that demand meticulous attention to various details, particularly when it comes to managing potential risks. Patient safety is paramount, and every step taken must prioritize the well-being of both patients and surgical staff. Careful management of electrosurgical devices, light sources, cords, surgical draping, and other potential risks during a procedure is one crucial aspect of the surgical safety protocol.

Electrosurgical Devices:

When utilizing electrosurgical devices, it’s important to exercise caution and adhere to best practices. Avoid using electrosurgical devices in high risk areas like the trachea or bowel. Employ the lowest possible power setting for the device. Active electrosurgical devices or lasers should be kept away from gas sources and flammable materials. When not in use, place the device in the supplied non-conductive safety holster to mitigate the risk further.

Light Sources and Cables:

Proper management of light sources and cables is vital. Label illuminating light sources to warn of burn risks when the cable is not connected to the scope before activating the light source. Keep the light source at the lowest brightness setting necessary. When not in use, put the light source in standby mode and disconnect the light cord or connect protective covers/caps. A burn from a light cord can happen in just a few seconds. Utilizing GloShield is a seamless way to cover the light source and protect patients without interfering with the surgical workflow.

Ensure that illuminated light cords are kept away from drapes, the patient’s skin, personnel’s skin, and any flammable materials. 

Hazard Assessment and Continuous Monitoring:

Throughout the surgical procedure, it is crucial to continuously assess and manage potential hazards. Each team member should be vigilant about hazards under their control and observe the actions of others. Configuring surgical drapes placed near the patient’s head appropriately when using an open oxygen delivery device helps prevent oxygen accumulation. Identifying patients who have used specific bowel preparations is important, as it influences the amount of gas produced during the procedure. For endoscopic procedures, opting for CO2 insufflation instead of air insufflation reduces the risk of bowel fires. Proactively de-risk surgeries with high fire scores to a lower risk level.

Communication and Immediate Reporting:

Encourage open communication within the surgical team, emphasizing the importance of speaking up immediately if any preventable risk or evidence of a potential fire is observed. This collaborative approach ensures that all team members actively contribute to maintaining a safe surgical environment.

Cognitive Aids and Documentation:

Utilize cognitive aids, such as Safety Data Sheets (SDS) for potentially hazardous materials, and keep them accessible in the surgical area and the hospital 24/7. Use one-page handouts or signs as safety reminders before surgery or in case of emergencies.

Attention to detail and adherence to safety protocols are integral to successful surgical outcomes. By carefully managing electrosurgical devices, light sources, cables, and other potential risks, the surgical team can create a secure environment that prioritizes the well-being of both patients and medical professionals. 

To better fireproof your OR, contact GloShield to learn more about reducing the risk of light source fires and burns and get a free sample. 

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