I have a question about evacuation of patients

Scrubby · Nov 10, 2007

I don't know if this is helpful but at my HCF we do have a documented plan. Will try to get hold of for you in possible. if there is a fire and the patient is on table and intubated the general plan is this:

The nurses, surgeons etc pretty much get out of there. The anaesthetist stays with the patient. In case of a fire you have to line the trolleys from the door to the table, so the fire services can find their way to the patient in case of smoke.

danporcun · Nov 10, 2007

Thanks a lot appreciate if you could get me the document so that could start working a plan for my hospital. Don´t think the anaesthetist are going to like the ideia but somebody has to stay .

Waiting for more news

shodobe · Nov 11, 2007

So, scrubby, you pretty much abandon the anesthesiologist and the patient? The OP should do a search on the net and look for ECRI or one of the companies that deal with surgical fires like Valleylab or Megadyne. We have a policy in place that has tasks for everyone in the OR room when evacuating a patient during a disaster or fire. I do the inservices for our department along with L&D and have a alot of info on this subject so if needed just PM me and I will get the websites to you.

ewattsjt · Nov 11, 2007

this may not help because it specifically deals with fire ( you need to be an aorn member to download the resourse kit) http://www.aorn.org/practiceresources/toolkits/firesafetytoolkit/fireevacuationplanningsoftware/

like shodobe, our facility policy views it as patient abandonment, the entire team stays with the patient until successfully extubated and transported to safety.

i hope it helped!

maeyken · Nov 11, 2007

Just curious as to why the patient is extubated before moving them? Couldn't they just grab an ambu bag to transport them?

I do not know whether we have a policy in place for such a situation. I know our policies are all being reviewed and rewritten currently. Perhaps we will get a policy. :)

shodobe · Nov 11, 2007

I think that being able to extubated your patient is preferred but in certain situations you just can't do it. That is why all rooms have ambu bags in them and O2 tanks available. Now, with that said if a fire was close in proximity an O2 tank wouldn't be the brightest thing to get. Unfortuanetly anesthesia would have to bag on room air. There arre several web sites that give you certain scenarios and what to do.

mcmike55 · Nov 12, 2007

I'm currently in the process of giving talks to our staff about surgical fires. In fact we are going to cover evacuations tomorrow morning!

Our policy, and based on most research I've done, if you can't get a fire under control in 60 seconds...GET OUT!!

I've not read anything that talks about abandoning the anes. doc and pt.

Anyway, we have Ambu bags in all rooms, and O2 bottles right outside each room, and 5 lb CO2 extinguishers inside each OR.

The way I get it is, pull flaming drapes to the floor, shoot with CO2, disconnect pt, go to Ambu/bottle, pull up stakes and move the pt out of the room on the OR table!

It's separating the fire triangle. Remove the heat (bovie), remove the fuel (drapes to the floor) remove the air (in this case eliminate extra O2 sources, ie the anes. machine.

As far as other disasters go, I suspect evacuation depends on the type, location, severity of the incident. You don't want to move out of the OR into a worse situation!

Mike

shodobe · Nov 14, 2007

The biggest item that you will find on most web sites regarding fires in the OR is water on the back table at the beginning of the case. This not just for wetting laps or wiping the gloves off. It is very important to have some liquid close to the surgical site so if a fire does occur, the scrub can simply throw some water on it. Some ORs have fire extinquishers close but not close enough. Just this simple item can keep a small fire from becoming a disaster.