Operating room safety is of the utmost importance as it directly impacts the well-being of patients, staff, and the entire healthcare facility. A safe operating room environment is essential for ensuring positive patient outcomes and minimizing the risk of complications. For patients who fully trust surgical teams and hospitals when they are at their most vulnerable state, proactive safety is important. Proper safety protocols also help protect staff from injury and ensure that the facility can remain open and operational. Maintaining a safe operating room can also help prevent costly equipment damage and facility closures. In addition to the physical risks posed to patients, surgical incidents can significantly impact the hospital’s reputation and financial stability. As a result, hospitals are increasingly focused on improving surgical safety and minimizing the risk of accidents or mistakes in the operating room. These initiatives include implementing protocols and procedures to ensure the safety of patients, as well as investing in technology and training to prevent accidents and improve patient outcomes.
Keep reading for an overview of the main safety risks surgical teams face in the operating room, explore the challenges of fire safety and prevention, and uncover solutions to prevent fires in the OR.
What Are the Primary Safety Risks in an Operating Room?
Operating rooms are high-risk environments where patients and staff are subjected to various hazards.
- Biological hazards, such as bacteria and viruses, may be present on surgical instruments or patients. Bloodborne pathogens like hepatitis B and C, HIV, airborne pathogens like tuberculosis and MRSA, and fungal infections are all biological risks that can be present in the OR.
- Chemical hazards, such as anesthesia gasses, cleaning solutions, disinfectants, lubricants and adhesives, contrast, specimen preservatives, and pharmaceuticals, are all common elements in surgical settings.
- Physical hazards, such as radiation from X-ray machines, surgical lasers, ultrasound equipment, noise levels, and thermal hazards from heating and cooling equipment, are all common elements in operating rooms.
- Ergonomic hazards, such as repetitive motions, awkward postures, forceful exertions, and poor lighting and ventilation, can lead to musculoskeletal disorders among operating room staff.
- Psychological hazards, such as stress and burnout due to the high-pressure nature of the work, PTSD and vicarious trauma, teamwork challenges, mentally and emotionally dealing with unforeseen patient harm, and more, can impact safety and care quality.
- Fire hazards, such as alcohol-based sanitizers, cleaners, drapes, fiber optic lighting equipment, power tools, oxygen, nitrous oxide, other gasses, and electrosurgical/laser equipment, all contribute to the risk of staff and patient burns and thermal damage in the operating room. Surgical fires are especially dangerous considering the patient is captive during the procedure.
- Electrical hazards, such as faulty equipment or improper use of electrical devices, unsafe wiring, electrostatic discharge, and overloaded circuits, can cause significant risks of both electrical and fire-related injuries and issues.
- Slips, trips, falls, and bumps due to spillage, cluttered walkways, and uneven surfaces. Clunky or intrusive equipment in the environment can cause injury to patients and staff.
Hospitals need robust safety protocols to minimize these risks and ensure the safety of patients and staff. With a primary focus on surgical fire safety, the Jackson Medical team is committed to developing safe, intuitive, and cost-effective solutions that mitigate the risks of fires in the OR and help ensure patients, surgeons, and staff are protected from any eventuality.
Download Now: Jackson Medical’s new OR Fire Safety Toolkit focuses on surgical fire safety with educational content and visual aids. The tools included are:
- Assessing Fire Risk
- Taking Proper Precautions
- Fire Triangle
- Top Fire Risks in the OR
- Do & Don’ts List
- Time-Out Checklist
How an Operating Room Fire can Start in Seconds
Fires in the operating room can be extremely dangerous and start in seconds due to the combination of common flammable materials such as drapes, gowns, and other medical equipment serving as ignition sources, along with fuels like anesthetic gasses, alcohol-based skin preparations, and oxygen. Ignition sources such as electrosurgical units, lasers, or high-temperature equipment such as fiber optic lighting are usually the origin point for the first spark or ember, while gasses like nitrous oxide and oxygen make for potent fuel sources if they are not properly handled and controlled.
The exact time it takes for a fire to start and spread in an operating room depends on various factors, such as the type of materials involved, the size of the room, and any fire suppression systems. However, cases have been documented where the time from setting a fiber optic light cable down to ignition is less than six seconds. Operating room fires not only start rapidly but also quickly spread if not detected and dealt with promptly. It’s essential to have fire extinguishers, smoke alarms, and fire suppression systems in place and to ensure all staff are trained in fire safety procedures to minimize the risk of fires and respond quickly if one does occur.
But there’s still more that can be done, especially when it comes to fiber optic light cables. As one of the leading causes of OR fires, fiber optic light cables demand proper handling at all times. These fires are often caused by the intense heat of an uncovered cable combined with flammable fabrics, gasses, and chemicals. Sometimes, patients can be burned without notice of fire or smoke until the end of the procedure, when the singing is noticed, and drapes are removed. Fortunately, there’s an elegant and cost-effective solution that provides peace of mind to ensure these types of fires and burns are a thing of the past.
GloShield is an intuitive, reliable, award-winning solution that reduces the risk of fires and burns attributed to fiber-optic light cables. With seamless implementation onto existing cables, GloShield minimizes the chance of a fire occurring and prevents thermal injuries. It works through a combination of three key features.
Silicone construction: GloShield’s silicone construction is strong, durable, and long-lasting to provide shape memory and ensure reliability and insulation during the procedure.
Ceramic heat shield: GloShield’s ceramic heat shield provides primary protective coverage from the 500+°F heat produced at the tip of an unprotected fiber optic light cable.
Light cable compatibility: GloShield is compatible with modern fiber optic light cables used with Xenon and LED light sources in surgical settings, ensuring simple and seamless integration into the management of any operating room.
All three features enhance surgical patient safety through proactive risk management and integration with fiber optic light cables without disrupting surgical techniques or workflow.
Check It Out: The AORN OR Fire Safety Checklist is another great resource to help hospitals align their operating rooms and surgical departments with AORN’s Environment of Care – Fire Safety guidelines. The tools included are:
- Surgical Fire Hazard Identification
- Fire Prevention & Management Plan
- Safe Use of Equipment
- Preventing Contact – Fire Triangle Components
- Oxidizer Use
The Impact of a Safety Incident on a Hospital
A safety incident in a hospital, such as a fire in an operating room, can significantly impact the facility and the people involved.
- Patient Safety: The first and most obvious impact of a safety incident in a hospital is on the patients. Incidents such as a fire in an operating room can cause serious injuries or even death to patients and lead to complications and adverse outcomes.
- Staff Safety: Staff members, including surgeons, nurses, and other healthcare workers, may also be injured in an incident and can be mentally and emotionally shaken by surgical fires and patient burn experiences.
- Facility Closure: In some cases, a facility may need to be closed temporarily or permanently, disrupting the delivery of healthcare services to the community. In 2010, the Cleveland Clinic reported 6 operating room fires and 3 patient injuries, prompting a brief closure to make safety changes.1 More recently, a CMS inspection of OHSU Hospital in Portland, OR, required immediate corrective action before resuming service.2
- Financial Impact: Safety incidents can also have a significant financial impact on a hospital. The cost of repairing damage to the facility, replacing equipment, and providing compensation for injuries can be substantial. Additionally, a hospital may experience a loss of revenue if forced to close temporarily or if patients choose to seek care elsewhere.
- Legal Liability: Safety incidents can also result in legal liability for a hospital. The hospital may be held responsible for any injuries or deaths resulting from the incident and may need to pay damages to affected parties. On average, patient settlements costs from In addition to the emotional and reputational consequences of these horrific events, surgical fires often result in incredibly expensive malpractice litigation, with up to $30 million in damages being awarded to the victims of surgical fires.3 Another high profile incident from 2013 resulted in damages of $18 million being awarded to a woman from Washington.4 Other settlements as high as $500,000 frequently occur, and the average settlement is over $470,000.5-8
- Reputation: Safety incidents can severely damage any hospital’s reputation, affecting public trust and confidence in the facility, ultimately leading to a loss of patients and revenue. A reputation for safety can be a major contributor to attracting and retaining staff, which is also at the forefront of every hospital’s concerns today.
Overall, safety incidents can majorly impact the hospital, its staff, patients, and the communities it serves. Hospitals need adequate safety protocols to minimize the risk of such incidents and be prepared to respond quickly and effectively in an emergency.
Taking the Next Step in Operating Room Fire Safety & Prevention
Operating room safety is crucial to the success of any surgical procedure. Among the most common safety risks are fires and thermal injuries, which can lead to severe consequences for both patients and healthcare providers. By being proactive and taking measures to mitigate these risks, hospitals can create a safer environment for everyone involved. Proactive strategies include updating your OR protocols and signage and implementing adjunct technologies that add layers of safety for the patient.
Finally, if you want a deeper analysis of the risk of surgical fires, download our free whitepaper: Are Your Operating Rooms at Risk for a Surgical Fire? It provides additional detail into the causes, trends, and impact of fires in the OR and offers insights into safety and risk management.
To learn more about how Jackson Medical and GloShield can help eliminate the risk of fires in the OR for your hospital, request a quote, or order a free sample, contact our team.
- Suchetka, D. (2010, May 1). Cleveland Clinic reports six operating room fires in the past year, three patients injured. Cleveland.com. https://www.cleveland.com/metro/2010/05/clinic_reports_six_operating_r.html
- Carbajal, E. (2023, January 26). OR fire prompted ‘immediate jeopardy’ warning at OHSU. Becker’s Hospital Review. https://www.beckershospitalreview.com/patient-safety-outcomes/or-fire-prompted-immediate-jeopardy-warning-at-ohsu.html
- Abramson, Brown & Dugan Attorneys. (n.d.). Jury Awards $30 Million to Victim of Surgical Fire. https://www.arbd.com/jury-awards-30-million-to-victim-of-surgical-fire/
- Jackson, I. (2013, December 13). Malpractice Lawsuit Over Surgical Fire Results in $18M Damage Award. AboutLawsuits.com. https://www.aboutlawsuits.com/malpractice-lawsuit-surgical-fire-verdict-57263
- Smith, L. P., & Roy, S. (2011). Operating room fires in otolaryngology: Risk factors and prevention. American Journal of Otolaryngology, 32, 109-114. https://doi.org/10.1016/j.amjoto.2009.11.004
- Connor, M. A., Menke, A. M., Vrcek, I., & Shore, J. W. (2018). Operating room fires in periocular surgery. International Ophthalmology, 38, 1085–1093. https://doi.org/10.1007/s10792-017-0564-9
- Aly, A., McIlwain, M., & Duncavage, J. A. (1991). Electrosurgery-induced endotracheal tube ignition during tracheotomy. Annals of Otology, Rhinology & Laryngology, 100(1), 31-33. https://doi.org/10.1177/000348949110000105
- Niskanen, M., Purhonen, S., Koljonen, V., Ronkainen, A., & Hirvonen, E. (2007). Fatal inhalation injury caused by airway fire during tracheostomy. Acta Anaesthesiologica Scandinavica, 51(4), 509-513. https://doi.org/10.1111/j.1399-6576.2007.01280.x