Präventionsstrategien gegen Brände und thermische Verletzungen im Operationssaal

Zusammenfassung

Hintergrund

Thermische Verletzungen und Brände im Interventionsraum stellen ein erhebliches Risiko für Patienten dar, insbesondere durch den Einsatz energiebasierter Geräte wie monopolare Diathermie. Eine FDA-Studie über einen Zeitraum von 20 Jahren dokumentierte über 3500 Verletzungen und 178 Todesfälle, größtenteils verursacht durch Verbrennungen. Die Hauptursachen für Brände im Interventionsraum lassen sich durch das „Feuerdreieck“ erklären: Entzündungsquellen, Brennstoffe und Oxidationsmittel. Monopolare Diathermie und Laser fungieren als Entzündungsquellen, während alkoholbasierte Desinfektionsmittel Brennstoffe liefern. Sauerstoff und Lachgas erhöhen als Oxidationsmittel das Brandrisiko.

Material und Methode

Diese Übersichtsarbeit basiert auf einer Literaturrecherche und der Analyse von Patientenfällen mit thermischen Verletzungen. Ziel ist es, schwerwiegende Folgen zu verdeutlichen und Präventionsmaßnahmen aufzuzeigen.

Ergebnis

Die Ergebnisse unterstreichen die Notwendigkeit einer multidisziplinären Herangehensweise. Wichtige Strategien sind die Reduktion der Sauerstoffkonzentration und der Einsatz alternativer Desinfektionsmittel. Durch gezielte Schulungen des OP-Teams und die Implementierung von „Fire Risk Assessment Tools“ lässt sich die Patientensicherheit deutlich erhöhen.

Schlussfolgerung

Es zeigt sich, dass ein umfassendes Risikomanagement sowie die Entwicklung spezifischer Protokolle und Schulungen erforderlich sind, um thermische Verletzungen im Interventionsraum zu verhindern und das Risiko für Patienten langfristig zu reduzieren.

Abstract

Background

Thermal injuries and operating room fires pose significant risks to patients, especially when energy-based devices like monopolar diathermy are used. A study conducted by the FDA over 20 years reported over 3,500 injuries and 178 deaths, mostly caused by burns. The main causes of operating room fires can be explained by the "fire triangle": ignition sources, fuels, and oxidizers. Monopolar diathermy and lasers act as ignition sources, while alcohol-based disinfectants provide fuel. As oxidizers, oxygen and nitrous oxide further increase the risk of fire.

Method

This review is based on a literature analysis and case vignettes of patients with thermal injuries. It aims to highlight the severe consequences of such injuries and outline preventive measures.

Results

The findings underscore the need for a multidisciplinary approach. Key strategies include reducing oxygen concentration and using alternative disinfectants. Targeted training for the surgical team, along with the use of “Fire Risk Assessment Tools”, can substantially improve patient safety.

Conclusion

In conclusion, comprehensive risk management, the development of specific protocols, and team training are essential to prevent thermal injuries and sustainably reduce patient risk in the operating room.

Schlüsselwörter

Feuer - Prävention - Patientensicherheit - thermische Verletzungen - Brände im Operationssaal

Keywords

Fire - prevention - patient safety - thermal injuries - operating room fires

Publication History

Received: 21 October 2024

Accepted: 27 December 2024

Article published online:
24 February 2025

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