01 Sep 2011
A fire breaks out in an operating theatre where a spine surgery is underway The surgical team quickly sews the incision on the patient and moves him away from the fire. A nurse rushes out to get a fire extinguisher to put out the fire. A nurse rushes out to trigger the fire alarm while another grabs the nearest fire extinguisher to put out the fire. Another reports the incident to the hospital’s fire safety officer who with the emergency response team heads to the operating theatre within a minute or two to take charge of the situation
The surgical team quickly stitches up sews the incision on the patient and moves him away from the fire. During this time, the anaesthetist takes control of the logistical operations, assessing the patient’s condition to see how best to proceed. The fire isn’t contained and a decision is made to stop the operation surgery, close the incision and after taking care of patient’s airway, CONVERTING TO MANUAL AND T0 ENSURE PATIENT IS BREATHING PROPERLY the Anaesthetist orders to shut down the medical gas supply, which includes Oxygen, by the OT Nurse. This is important to contain the spread of fire. A clear plastic surgical dressing is quickly applied and the patient evacuated to a nearby ward.
Luckily, this didn’t happen but was part of a regular fire exercise that was conducted recently at Singapore General Hospital’s (SGH) 25 Major Operating Theatres (OTs), located on the second level of Block 2 3. According to Ms Goh Meh Meh, Assistant Director of Nursing, Operating Theatres, SGH, a large-scale fire drill involving many departments and staff is organised every two years at the operating theatres, and fire safety-in-service training involving mainly nurses every six months.
“Over time, people tend to may forget or new staff come on board, so we need to remind or train them of the protocol involved. Each person involved in the OT must know what their role is and how to react in the event of a fire in the operating theatre,” said Ms Goh, who was overall in charge of the drill.
The operating theatres are well equipped - fire extinguishers and hoses to put out fires, torches to light the way should the electricity be cut, plunging the rooms into pitch darkness. There are also clear rules governing the use of equipment that can easily start a fire. For instance, when using alcohol-based solutions, doctors must remember to wait for the liquid to dry before using surgical instruments that can create a spark. Gauze, cotton wool, the drape sheet covering the patient – these are materials that are easily combustible, especially in the theatres, an oxygen-rich environment.
So even with all these safeguards in place, said Ms Goh, the reality is that there are “many ways that a fire can start at OTs.”
No fire incident has been reported for the past 13 years when a small fire was quickly put out, but that is no reason to be complacent, said Ms Goh. During the drill, all the operating theatres were simulated to be involved, although not all had a “live patient”, played by a staff member. The operating scenarios included a hysterectomy to remove fibroids, plastic surgery to repair facial fractures, a spine surgery, heart surgery, and transplants.
“We were glad to have the support of surgeons, anaesthetists, perfusionists, radiographer, technicians, our nurses and ancillary staff. With their participations, we were able to put up various scenarios to challenge ourselves, such as transferring a ‘patient’ from the heart-lung machine to a portable device, and evacuating ‘patients’ midway through their procedures from the new complex hybrid theatres,” said Ms Goh.
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