The thrust of such advocacy on the part of practitioners and environmental safety experts is fourfold. The conditions that result in fire must first be vividly identified with appropriate preventative measures then put into place. Ways must be investigated to reduce the damage associated with such fires if they do occur and finally, the elements of an effective fire response must be identified, with an eye on procedures that can be seamlessly integrated into existing operating room practices.

The 40-year old non-profit ECRI Institute, an organization devoted to the use of applied scientific research in the investigation of optimal medical procedures, devices, drugs, and processes, has been keenly engaged with the problem of operating room fires for some time. The organization has published its own guide, "The Patient is on Fire! A Surgical Fires Primer," which cites, in extensive detail, specific features of the operating room environment that represent potential fire hazards, and offers a system for addressing them. Again, the key is standardization, and to that end ECRI has published a printable poster outlining simple prevention procedures to be followed on site. The poster, titled "Only You Can Prevent Surgical Fires" is available for download here: [http://tinyurl.com/pw3x5t ].


Patients call for help!

The other side of the O/R fire equation is the patient, for whom the risks are even higher. The patient is the least empowered presence in the room, and yet statistics show that almost all operating room fires ignite in or on the patient. The layperson is hardly in a position to mediate on behalf of O/R safety, particularly at the very moment that survival and healing are their sole concerns.

A Maryland woman learned this lesson in the most devastating way and today serves as an advocate for O/R fire safety. In late 2002 Cathy Lake's mother, Catherine Reuter, underwent surgery for a non-life threatening condition. Within two years she was dead, having succumbed to ongoing infections, kidney failure, and other complications resulting from the surgical fire that marred an otherwise routine tracheotomy. An electric cauterization device had ignited a topical solution on Ms. Reuter's face, delivering second- and third-degree burns to her face, shoulder, and deep into her respiratory tract. Ms. Lake established a web site, [www.surgicalfire.org] that offers patient advocacy, and at the same time provides an exhaustive set of resource links, articles, advisories and first-hand testimony, all in stark illustration of the axiom that O/R fires are an entirely preventable tragedy. She advocates speaking frankly with physicians before surgical procedures are performed. Offering advice, data and support resources to compensate for the average patient's lack of expertise, Ms. Lake insists that merely inquiring of the physician whether he or she has been trained in surgical fire prevention procedures is both warranted and ethical. "If what happened to my mom can happen and we learn nothing from it," Ms. Lake says, "what a waste of a life."

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