The Effect of Intraoral Suction on Oxygen-Enriched Surgical Environments: A Mechanism for Reducing the Risk of Surgical Fires

Author:

VanCleave Andrea M.1,Jones James E.2,McGlothlin James D.3,Saxen Mark A.4,Sanders Brian J.5,Vinson LaQuia A.6

Affiliation:

1. Resident in Pediatric Dentistry, James Whitcomb Riley Hospital for Children, Indiana University School of Dentistry

2. Professor and Chair, Department of Pediatric Dentistry, James Whitcomb Riley Hospital for Children, Indiana University School of Dentistry

3. Director, Graduate Occupational and Environmental Health Program, Director, Purdue's Exposure Assessment Research Laboratory (PEARL), Associate Professor of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana

4. Clinical Associate Professor, Department of Oral Medicine, Pathology and Radiology, James Whitcomb Riley Hospital for Children, Indiana University School of Dentistry

5. Professor and Director, Department of Pediatric Dentistry, James Whitcomb Riley Hospital for Children, Indiana University School of Dentistry

6. Clinical Assistant Professor of Pediatric Dentistry, James Whitcomb Riley Hospital for Children, Indiana University School of Dentistry, Indianapolis, Indiana

Abstract

Abstract In this study, a mechanical model was applied in order to replicate potential surgical fire conditions in an oxygen-enriched environment with and without high-volume suction typical for dental surgical applications. During 41 trials, 3 combustion events were measured: an audible pop, a visible flash of light, and full ignition. In at least 11 of 21 trials without suction, all 3 conditions were observed, sometimes with an extent of fire that required early termination of the experimental trial. By contrast, in 18 of 20 with-suction trials, ignition did not occur at all, and in the 2 cases where ignition did occur, the fire was qualitatively a much smaller, candle-like flame. Statistically comparing these 3 combustion events in the no-suction versus with-suction trials, ignition (P = .0005), audible pop (P = .0211), and flash (P = .0092) were all significantly more likely in the no-suction condition. These results suggest a possible significant and new element to be added to existing surgical fire safety protocols toward making surgical fires the “never-events” they should be.

Publisher

American Dental Society of Anesthesiology (ADSA)

Subject

Anesthesiology and Pain Medicine

Reference23 articles.

1. What does it take to start an oropharyngeal fire? Oxygen requirements to start fires in the operating room;Roy;Int J Pediatr Otorhinolaryngol,2011

2. Surgical fire injuries continue to occur: prevention may require more cautious use of oxygen;Stoelting;APSF Newsletter,2012

3. Cautery fires in the operating room;Menta;American Society of Anesthesiologists Newsletter,2012

4. Surgical fires: perioperative communication is essential to prevent this rare but devastating complication;Bruley;Qual Saf Health Care,2004

5. Prevention and Management of Operating Room Fires;Anesthesia Patient Safety Foundation

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