VPNG State Conference 2009 Sandra de Rome - Deakin Dave McCurdy - MFB

 You are circulating for a patient undergoing a laparoscopic cholecystectomy  Disposable drapes are in use  The light lead is disconnected from the telescope and accidently placed on the drapes  The intense light ignites the drapes  Smoke begins to quickly fill the room  How will you respond?

 Switch off the electricity at the wall  Extinguish the fire if safe to do so  Press the emergency button  Call the emergency number, state your name, location and code red  Advise the Floor Manager of the situation  Prepare an additional operating room  Transfer the patient on the operating table, while being manually ventilated, to another room to complete surgery  Keep the doors closed as much as possible to contain smoke

 How would you evacuate your Operating Suite?  How can you account for all staff, patients, visitors, students, medical representatives, etc in the Operating Suite?  Which exits would you use?  What is the best process to use when checking all rooms have been evacuated?

 Is the hospital co-located with another hospital?  Ambulances may be required to transport patients to nearby hospitals  Transferring a patient: ◦ With an open surgical wound ◦ An anaesthetised patient  Process for recording where patients are evacuated to & informing concerned relatives

 Who is the ‘Fire Warden’ in your Operating Suite  What is their role?  What is the internal phone number to notify the hospital of an emergency?  In every area of the Operating Suite, how would you evacuate to safety?  Do you know the location of all Emergency Alarms in every operating room and recovery?

 How does a ‘Fire Door’ operate to protect staff / patients  If you rely on ‘swipe cards’ to access the Operating Suite, are these deactivated in a fire situation? Why?  Do you know the location of: ◦ All gas isolation valves – what are these? ◦ All switchboards in the operating suite ◦ All break glass alarms ◦ All Warden Intercom Phones (WIP) ◦ All exits

 What burning substances can you extinguish with a CO2 fire extinguisher?  Can you efficiently use a fire extinguisher?  Operating Suites are usually divided into ‘compartments’ – how are these utilised in a fire emergency?

 Immediate: from an operating room to a corridor  Lateral: from an area of threat to a safe area i.e. behind a smoke door  Partial: from the Operating Suite to another part of the hospital (provided it is not under threat)  Total: controlled evacuation from the Operating Suite to an Evacuation Point outside the hospital

 ACORN Standards for Perioperative Nursing (2008): Australian College of Operating Room Nurses Ltd., Adelaide, South Australia  J. Rothrock, (Ed) (2007), Alexanders Care of the Patient in Surgery, (13 th ed). St Louis, MO: Mosby.  Hogan, C. (2002). Responding to a Fire at a Paediatric Hospital: AORN, Vol. 75(4)