Fire safety in the surgical suite requires frequent review and assessment. Hospitals are paying more attention to the issue, improving policies and procedures.

  • More hospitals are conducting OR fire drills.
  • Hospitals also are including OR fire safety in surgical timeouts.
  • Alcohol-based prep solutions have been eliminated in some facilities.

Hospitals are taking fire safety in the OR seriously but still must conduct frequent reviews and update policies as necessary, says Solveig Dittmann, RN, BA, BSN, CPHRM, senior risk specialist with Coverys, a medical professional liability insurer in Boston.

Dittmann frequently visits hospitals to assess risk management issues such as OR fire safety and sees more hospitals conducting OR fire drills on a regular basis, at least annually and some even quarterly. That is an improvement over recent years, she says.

“Not everyone is doing the drills or even the surgical fire safety education, but the numbers are increasing dramatically,” Dittmann says. “There have been incidents in the news that got attention, including one in which a premature baby was having surgery and there was a fire that ended up injuring her quite severely. There was also a 30-year Chicago firefighter who had never been burned on duty, but suffered severe facial burns during a stent placement.”

At a recent hospital perioperative assessment, Dittmann learned there had been no perioperative fire incident for about 30 years, and only a month before her visit had begun conducting OR fire drills with all staff. A week after everyone had been trained, the first OR fire occurred.

“They told me almost tearfully that had they not had that drill, they hated to think what would have happened to the patient,” she says. “But because they had the drills, they managed to control the fire so quickly that the patient wasn’t harmed at all. It really speaks to the importance of the drills.”

She also notices that more perioperative teams are including a fire risk assessment as part of their timeout protocol. That was not the case even a few years ago, she says.

“They’re asking questions like whether they really need to use 100% oxygen if they’re using cautery or laser around the face, neck, or upper torso. That’s the biggest risk for an airway fire,” she says. “More teams are consistently doing that, and that’s a very good change.”

More hospitals also are eliminating alcohol-based prep solutions, she says, favoring less flammable options like Betadine. Those sticking with alcohol-based preps take extra precautions, such as making sure the alcohol dries thoroughly before applying drapes, so the drapes don’t become saturated and more flammable.

Another development involves notification technology for OR fires, says Thomas Connell, senior product manager for Johnson Controls in Westminster, MA. Previous fire alarm technology was broad and signaled a general fire alarm in a part of the hospital or a particular department, but newer technology allows for directed alarms and limited evacuations, he says.

“This can be important in a healthcare setting where you don’t want to interrupt procedures going on in the entire surgery center or department, in cases where it is not necessary to evacuate the entire facility,” Connell explains. “You can send directed alarms and notifications to only certain areas or certain individuals telling them what the situation is and what to do, rather than sounding a general alarm and leaving it up to individuals to decide based on surroundings and visual clues what they should do.”


  • Solveig Dittmann, RN, BA, BSN, CPHRM, Senior Risk Specialist, Coverys, Boston. Phone: (517) 866-7999. Email: sdittmann@coverys.com.
  • Thomas Connell, Senior Product Manager, Johnson Controls, Westminster, MA. Phone: (888) 746-7539.