Special Considerations in the Perioperative Environment for Registered Nurses

Module 3: Emergencies in the OR 

🎯 Module Objectives
  1. Explain the importance of situational awareness in preparing for emergencies.
  2. Describe the three components of the fire triangle and their presence in the OR.
  3. Explain the three key steps in managing a fire in the perioperative environment.
  4. Demonstrate how to support the anesthesia care provider during patient anaphylaxis.
  5. Demonstrate how to support the anesthesia care provider during airway emergency situations.
  6. Respond appropriately to complications and unexpected events by identifying resources needed.
  7. Follow appropriate protocols when an unexpected death in the operating room occurs.
  8. Describe the need for surgical team debriefing after an emergency event in the operating room.
đź“– Required Readings

The ORNAC Standards 2021
4.17 fire/explosion 4.66-4.67
5.7 intraoperative death 5-22 to 5-23

ORNAC Standards 2023
5.4 Death in the OR (5-10)
4.14. Physical Hazards – Fire/Explosion (4-57)

Alexander’s care of the patient in surgery
16th ed. p. 28-30 (start at fires and explosions) ; 124-129 (start at typical sequence of general anesthsia); p. 265-266 (start at respiratory read until obstructive sleep apnea)
17th ed. p. 29 (start at Risk for fires and explosions) ; 121-126 (start at typical sequence of general anesthsia); p. 259-261 (start at respiratory read until obstructive sleep apnea

Articles 
Gillespie, B. M., Gwinner, K., Fairweather, N., & Chaboyer, W. (2013). Building shared situational awareness in surgery through distributed dialog. Journal of Multidisciplinary Healthcare. 6 109–118. DOI https://doi.org/10.2147/JMDH.S40710 

AORN Videos 
Cine Med Video #1968: Perioperative Fire Safety (2014)   

Introduction

As much as surgical procedures are planned and routine, emergencies can occur at any time and perioperative team members must be prepared. While they are on high alert when a trauma or emergency case comes in, it is just as important to be ready and vigilant during routine cases. Perioperative nurses must develop situational awareness to recognize emergency situations when they arise. This module covers operating room fires, airway emergencies and unexpected deaths in the OR. Note that these three events are just some of the emergencies that can occur in the perioperative environment. Developing situational awareness and understanding the need to debrief afterward are key components of this module.

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