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      Efficacy of a novel oxygen scavenger mask in reducing local oxygen concentrations below the surgical fire risk threshold: an experimental proof-of-concept study

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          Abstract

          Background

          This study aims to evaluate the efficacy of an oxygen scavenging mask device in reducing local oxygen concentrations from nasal cannula ventilation compared to a standard open facial surgical field.

          Methods

          This is a controlled experiment using a custom-fabricated silicone midfacial oxygen scavenging device, SimMan airway management trainer manikin (Laerdal Medical, Stavanger, Norway), handheld oxygen detector (Forensics Detectors, Los Angeles, United States) and oxygen from a Datex Ohmeda Aisys Carestation anesthesia unit (GE HealthCare, Chicago, United States). Oxygen concentrations were measured at 18 facial landmarks ( Fig. 1) with nasal cannula flow of 2, 4, and 6 L/min of 100% FiO2 in both masked and unmasked conditions ( Fig. 2).

          Results

          The mean oxygen concentration in the facial surgical field was 20.95% with the scavenger mask and 24.8% without ( P < 0.001; two-tailed paired t-test). The unmasked condition was associated with suprathreshold oxygen concentration levels at 13 of 18 facial landmarks ( Table 1). The device significantly reduced local oxygen concentration at 16 of 18 facial landmarks ( Table 1). The device provided safe oxygen concentration levels at all three flow rates, and measured oxygen concentrations directly correlated with oxygen flow rate in the unmasked condition ( Table 2).

          Conclusions

          An oxygen scavenger mask device reduced local oxygen concentrations from nasal cannula ventilation to below the 23% fire threshold in the entire facial surgical field external to the mask in these experiments. The device may reduce intraoperative fire risk in patients that require supplementary oxygen during surgery.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s13037-024-00411-1.

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          Most cited references8

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          • Article: not found

          Reducing the risk of oxygen-related fires and explosions in hospitals treating Covid-19 patients

          On 24 April 2021, a disastrous fire in an Iraqi hospital in April 2021 took the lives of 82 people. Since the outbreak of the pandemic in March 2020, incidents of oxygen-related hospital fires in various countries around the world have caused over 200 deaths, the majority of whom were patients extremely ill with the novel Coronavirus. Fires involving medical oxygen are not a new phenomenon but are more common in the operating theatre where oxygen is routinely administered. In these settings, strict safety protocols are normally enforced and surgical staff are well trained in dealing with oxygen hazards. It appears that some hospitals may not have been fully prepared for the elevated risk of oxygen-related fire in intensive care units due to the high demand for oxygen therapy in severely ill Covid-19 patients. Indeed, gas producers and public health authorities were also slow to recognize and alert hospitals to the potential dangers. Oxygen is essential to life and generally makes up about 21% of the gases in the air we breathe. Pure oxygen reacts with common materials such as oil and grease to cause fires, and even explosions, when released at high pressures. A leaking valve or hose, and openings at interfaces of masks and tubes, when in a confined space or where air circulation is low, can quickly increase the oxygen concentration to a dangerous level. Even a small increase in the oxygen level in the air to 24% can create a fire hazard. In an oxygen-enriched environment, materials become easier to ignite and fires will burn hotter and more fiercely than in normal air. There is also a potentially heightened risk of using ethanol-based and organic solvents as cleaning agents in an oxygen rich atmospheres. This paper will provide an overview of oxygen accident scenarios that may be relevant for hospital intensive care units, with particular reference to recent events and similar accidents that have occurred in the past. The paper will recommend that hospitals recognize their chemical risks as part of their risk governance responsibility and assign chemical risk management a prominent role in their overall management. Investigation of dangerous events to extract causes and lessons learned should be utilized to highlight opportunities for prevention as well as emergency response. The industrial gas industry also needs to actively support hospitals in adoption of more rigorous risk management approaches, building on lessons learned in chemical process safety for managing flammable and explosive atmospheres.
            • Record: found
            • Abstract: found
            • Article: not found

            Operating room fires: a closed claims analysis.

            To assess patterns of injury and liability associated with operating room (OR) fires, closed malpractice claims in the American Society of Anesthesiologists Closed Claims Database since 1985 were reviewed.
              • Record: found
              • Abstract: not found
              • Article: not found

              The Density of Oxygen and Its Compressibility below One Atmosphere: II.

                Author and article information

                Contributors
                yangcd1@hs.uci.edu
                Journal
                Patient Saf Surg
                Patient Saf Surg
                Patient Safety in Surgery
                BioMed Central (London )
                1754-9493
                12 September 2024
                12 September 2024
                2024
                : 18
                : 27
                Affiliations
                [1 ]GRID grid.266093.8, ISNI 0000 0001 0668 7243, Division of Oculofacial and Orbital Surgery, , Gavin Herbert Eye Institute, ; Irvine, CA USA
                [2 ]UC Irvine Health, ( https://ror.org/03fgher32) Irvine, CA USA
                [3 ]University of California Irvine School of Medicine, ( https://ror.org/04gyf1771) Irvine, CA USA
                Article
                411
                10.1186/s13037-024-00411-1
                11391775
                39267129
                3a6f2894-6f6c-4747-b4b9-fa355380a26a
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 24 July 2024
                : 27 August 2024
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2024

                Surgery
                facial surgery,operating room safety,fire risk reduction,operating room fires
                Surgery
                facial surgery, operating room safety, fire risk reduction, operating room fires

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