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Radiology Daily
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Patient Education About Flammability of Oxygen Is Critical

March 22, 2008
Written by: , Filed in: Practice Management
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Flash fires that result from a patient lighting a cigarette while receiving
low-level oxygen therapy may be a truly devastating event because, when an
airway is scorched, recovery may or may not be possible.

Patient death or disability associated with a burn incurred from any source
while being cared for in a health care facility is considered an environmental
error and is included on the National Quality Forum’s list of 28 ‘never
events.’ One category of fires in a health care facility involves equipment
that suddenly catches fire. However, in truth, equipment generally does not
‘suddenly’ catch on fire. Instead, it usually smolders for a time,
particularly with beds.

Most beds used in health care facilities have electronic mechanisms somewhere
within them. We place a mattress over these mechanisms, and the equipment will
usually smolder before eventually causing a fire. This is a very rare event.
When investigating these events, we learn that there is often a telltale shock
that hints at the problem in advance of the fire. When these shocks are
reported, the health care team needs to begin looking for the cause.

Perhaps the most devastating fires in health care facilities are those fires
resulting from patients on oxygen therapy who sneak a smoke. We see this
problem with some regularity. A number of patients who need low-level oxygen
also have a significant need for ambulation and independence, so we
accommodate them by giving them long oxygen cords and encouraging them to walk
around their bed.

Those patients who are smokers will sometimes take advantage of the long cord
and walk into the far corner of a room or walk into a bathroom and light up a
cigarette. Because they have oxygen going into their airway, lighting the
cigarette is associated with a tragic flash fire. These patients have horrible
facial and upper airway burns. In many cases, the melted plastic requires
surgical excision.

Usually, patients who experience this do not understand that the oxygen going
in their nose could explode. Health care providers are struggling with how to
help this patient population that needs oxygen and also desires to smoke.
Although the nicotine patch and various other mechanisms for smoking cessation
are available, it is not just the nicotine that these patients crave. They
also crave the routine and the satisfaction they get from the act of smoking.
In conclusion, this type of flash fire may be a truly devastating event
because, when an airway is scorched, recovery may or may not be possible.

Reference:
Kathleen Hale, RN, BSN, MHSA, and Richard P. Kidwell, JD Never Events:
Serious Errors Due to Equipment Fires or Patients Smoking While Receiving
Oxygen Therapy

Flash fires that result from a patient lighting a cigarette while receiving low-level oxygen therapy may be a truly devastating event because, when an airway is scorched, recovery may or may not be possible. Patient death or disability associated with a burn incurred from any source while being cared for in a health care facility is considered an environmental error and is included on the National Quality Forum's list of 28 'never events.' One category of fires in a health care facility involves equipment that suddenly catches fire. However, in truth, equipment generally does not 'suddenly' catch on fire. Instead, it usually smolders for a time, particularly with beds. Most beds used in health care facilities have electronic mechanisms somewhere within them. We place a mattress over these mechanisms, and the equipment will usually smolder before eventually causing a fire. This is a very rare event. When investigating these events, we learn that there is often a telltale shock that hints at the problem in advance of the fire. When these shocks are reported, the health care team needs to begin looking for the cause. Perhaps the most devastating fires in health care facilities are those fires resulting from patients on oxygen therapy who sneak a smoke. We see this problem with some regularity. A number of patients who need low-level oxygen also have a significant need for ambulation and independence, so we accommodate them by giving them long oxygen cords and encouraging them to walk around their bed. Those patients who are smokers will sometimes take advantage of the long cord and walk into the far corner of a room or walk into a bathroom and light up a cigarette. Because they have oxygen going into their airway, lighting the cigarette is associated with a tragic flash fire. These patients have horrible facial and upper airway burns. In many cases, the melted plastic requires surgical excision. Usually, patients who experience this do not understand that the oxygen going in their nose could explode. Health care providers are struggling with how to help this patient population that needs oxygen and also desires to smoke. Although the nicotine patch and various other mechanisms for smoking cessation are available, it is not just the nicotine that these patients crave. They also crave the routine and the satisfaction they get from the act of smoking. In conclusion, this type of flash fire may be a truly devastating event because, when an airway is scorched, recovery may or may not be possible. Reference: Kathleen Hale, RN, BSN, MHSA, and Richard P. Kidwell, JD Never Events: Serious Errors Due to Equipment Fires or Patients Smoking While Receiving Oxygen Therapy [text_ad]
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