Templates
Operating room fire safety checklist template

Operating room fire safety checklist template

Protect patients and staff with this fire safety checklist. It covers critical steps before, during, and after procedures to reduce risks.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF
Operating room fire safety checklist template

Protect patients and staff with this fire safety checklist. It covers critical steps before, during, and after procedures to reduce risks.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

An operating room has many fire risk factors: oxygen-enriched environments, multiple ignition sources, and abundant fuel materials. This customizable fire safety checklist divides prevention measures into logical procedure phases, enabling you to methodically manage these risks at every stage.

The Joint Commission reports that electrosurgical devices account for roughly 70% of surgical fires in the US every year. By implementing this checklist, you create accountability for critical safety measures like ensuring alcohol-based prep solutions are completely dry and maintaining proper ventilation. This practical tool transforms abstract fire safety principles into actionable steps your surgical team can consistently follow.

Related categories

Preview of the template
Page 1
Pre-Procedure Checklist
Fire extinguisher available and easily accessible
Anesthesia gas supply turned off when not in use
All flammable materials removed from surgical field
Alcohol-based skin preparation agents fully dry
Patient's non-flammable safety/monitoring equipment in place
During Procedure Checklist
Ensure ignition sources (e.g. electrosurgical unit, lasers) are not directed at flammable materials
Ensure adequate ventilation to avoid high oxygen concentrations
Monitor patient and surgical field closely for signs of fire
Have a fire response plan and ensure all staff are aware of roles
Post-Procedure Checklist
Ensure all ignition sources are turned off
Confirm flammable materials have been removed from the surgical field
Conduct a final visual inspection of the surgical site
Document any fire-related incidents or near misses

Frequently asked questions

How does this checklist help prevent the most common causes of operating room fires?

This checklist addresses the three elements of the fire triangle—oxygen, fuel, and ignition sources—by prompting specific preventive actions for each. It ensures alcohol-based prep agents are dry before procedures begin, reminds you to keep ignition sources away from flammable materials, and prompts proper ventilation to control oxygen concentration.

When should you complete each section of the operating room fire safety checklist?

Complete the pre-procedure section before the patient enters the room or during surgical prep. The during-procedure section should be reviewed immediately before the first use of any ignition source. The post-procedure section must be completed before the team leaves the operating room after surgery.

What should you do if you identify a “no” response on the checklist?

Immediately address the issue before proceeding with the surgery. For example, if alcohol-based prep solutions haven’t fully dried, wait until they do. If flammable materials can’t be removed from the field, implement additional precautions like lowering oxygen concentration when possible and ensuring extra vigilance around ignition sources.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.