“Code Red!” Preventing and Managing Fire and Smoke Hazards in the OR

An approximated 550–650 surgical fires occur in the United States every year. These fires cause devastating trauma to the patient, but also cause significant legal and economic repercussions to the surgical team and the facility involved. The operating room provides all the elements needed to start a fire: an oxidizer, an ignition source, and fuel—also known as the “fire triangle.” Preventing operating room fires includes minimizing the interaction between these three elements in the operating room, effective communication between each operating room (OR) team member, and assessing the “fire risk” prior to each procedure. Once fire risk has been assessed, each team member should be familiar with his or her role in preventing and managing an operating room fire. As these events remain rare, it is difficult to assess how successful the prevention measures are at reducing their occurrence, but efforts should continue to prevent this “never event.”