These are examples of fires that have been reported
and published by ECRI, formerly known as the Emergency Care Research
Institute. Many of these fires occurred in the head and neck area,
which is always more at risk because of the greater likelihood
of an oxygen-enriched atmosphere.
The use of a dry sponge in an oxygen-enriched atmosphere
led to a fire in an incision site. A sponge was placed in the incision
site during a lung resection. At the time the fire occurred, an
electrosurgery
pencil was being used to coagulate
a bleeder immediately next to the sponge. The lung lobe had already
been resected, and oxygen was flowing out of the resection area,
enriching the operative site. The oxygen, in turn, enriched the
sponge and allowed it to be easily ignited by the electrosurgery
pencil. Fortunately, because the burning sponge was quickly discarded,
the patient was not injured.
Improper use of electrosurgery can also cause ignition
of methane. In one instance, a methane-producing diet and improper
cleansing of the bowel before surgery led to a bowel explosion.
Without first venting the bowel, the surgeon exposed the colon and
proceeded to enter it using electrosurgery. The hot, active
electrode tip caused the explosive ignition of the bowel gases,
which caused a 10-centimeter tear of the colon. The patient subsequently
recovered.
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