Be ready to defend use of fire blankets in the OR
Fire blanket use in ORs is a topic that crosses my path occasionally. This is yet another one of those instances in which there is just enough information and opinion out there to get you in trouble during surveys if you are using fire blankets in the operating theater.
The ECRI Institute has strongly discouraged the use of fire blankets in the OR. If you check out “A clinician’s guide to surgical fires: how they occur, how to prevent them, how to put them out” at National Guideline Clearinghouse, which cites ECRI in its bibliography, it indicates the following:
Fire blankets — typically wool blankets treated with fire retardants that are placed over a fire to smother it — should never be located in an OR and should never be used for patient fires. Their use will likely cause more severe injuries to the patient. However, they can be placed outside it in case of a fire on a conscious person, such as a surgical team member. In such a fire, the person can actively use the blanket, is likely not O2-enriched, and can tell others where fire is still burning.
I think the prohibition of using fire blankets in the OR revolves around a couple of things:
- The infection control implications of having wool blankets in the OR (wool is not the most desirable fabric from an infection control standpoint)
- In order to effectively put out a fire, you’d need to press the blanket on to the patient in order to remove the source of oxygen, and sharp implements involved in the procedure could be very nasty to deal with
Ultimately, as far as Joint Commission surveys go, the bottom line expectation (and this is true for virtually everything in the EC) is that each organization will manage fire and infection control risks in such a manner as to eliminate the risk or to reduce it to its lowest potential.
About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Briefings on Hospital Safety. Contact Steve at 
Gordon Earhart, PE, RN, CSP, CBO | Mar 26, 2009 | Reply
As a fire protection engineer and former perioperative nurse, I don’t see any use for fire blankets in surgery or anywhere else. They are a relic of the past.
Eric Poach | Mar 26, 2009 | Reply
I don’t believe using the term, “never use wool blankets” applies to OR fires. I believe are contridictions in the guidlines for extinguishing OR fires. Could you please explain how a wool fire retardent blanket stored in a clean commerical container is more of an infection control risk than blowing the contents of a dry powder or CO2 extinguisher into a surgical field. The recommendations of “patting the fire out” only address the fuel source at the fire and in fact could facilitate the introduction of additional O2 sources to the ignition site by “fanning the flames” somewhat. At least a blanket,combined with turning off the O2 or flammable gases denies the fire one side of the fire triangle by reducing exposure to O2 in the room.
Sterile water would be my first choice,however the application of sterile H2O from 500cc bottles amounts to an OR “bucket brigade”. It is clear to me that one single article is not enough to make any clear recommendations from. To further address this problem a more multi disciplined approach is required that includes fire protection and fire suppression professionals in order to formulate a better recommendation to the protection of patients and staff during OR procedures.