Environment of Care

Get clinical answers to frequently asked questions about the perioperative environment of care.

  • What are the appropriate temperature settings for blanket warming cabinets?

    The temperature range of blanket or linen warming cabinets should set by an interdisciplinary team after conducting a risk assessment based on evidence and the manufacturer’s IFU. Post the temperature parameters on the cabinet for ready reference. The temperature of the warming cabinet should be checked on regular intervals and documented on a log or electronically.

    Resources:

    • Guideline for safe environment of care. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.
    • Hazard report: ECRI Institute revises its recommendation for temperature limits on blanket warmers. Health devices. 2009;38(7):230-231.

    Updated August 1, 2018

  • What is the temperature range for solution warming cabinets?

    The temperature range of solution warming cabinets should be in accordance with the solution manufacturer's specifications. Post the temperature parameters on the cabinet for ready reference. Be consistent within your facility. The temperature of the warming cabinet should be checked on regular intervals and documented on a log or electronically.

    Resources:

    • Guideline for safe environment of care. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.

    Updated August 1, 2018

  • How long can fluids remain in the warmer?

    Refer to the solution manufacturer’s instruction for use and if not present contact the solution manufacturer for maximum temperature and length of time that the fluids may remain in the warming cabinet. The stability of the fluids will vary by the type of solution and the storage container. Post the temperature and length parameters on the cabinet for ready reference. Label and date the fluids with either the date into the warmer or the date the fluids should be removed, according to your facility policy.

    Resources:

    • Guideline for safe environment of care. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.

    Updated August 1, 2018

  • What type of a fire extinguisher should be used in an operating room?

    The health care organization should select fire extinguishers according to standards established by the National Fire Protection Association (NFPA) and the local authority having jurisdiction. The local authority with jurisdiction is frequently the local fire marshal or may be a representative from the state government. Other factors that assist in determining the correct type of fire extinguishers include the:

    • presence of electrical equipment,
    • hazards that are present and may create adverse chemical reactions with the extinguishing agent,
    • maintenance requirements,
    • potential fire size,
    • physical abilities of the potential users,
    • ease of use, and
    • types of fuels that are present.

    According to the NFPA, a water mist or carbon dioxide extinguisher may be used in the OR. This recommendation is based upon the rating of the extinguishers. Water mist extinguishers are rated Class 2A:C and carbon dioxide extinguishers are rated Class B and Class C, but also may be used for Class A fires. The rating is determined by the type of fuel that is being burned. The operating room frequently has Class A fuels which would be drapes, paper, and human tissue. There can also be Class B fuels present such as the flammable skin prep products. Class C fires involve electrical equipment which has electrical current flowing to it. When the equipment is unplugged the electrical current is removed and the fuel is then considered to be either a class A or B. Both of these types of extinguishers maybe used in the OR.

    Resource:

    • Guideline for safe environment of care. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.
    • NFPA 10: Standard for Portable Fire Extinguishers. Quincy, MA: National Fire Protection Association.

    Updated August 1, 2018.

  • Can cell phones be brought into the OR?

    Resources:

    • Guideline for safe environment of care. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.
    • Guideline for surgical attire. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.

    Updated August 1, 2018

  • Can I store formalin in the OR?

    Chemicals such as formalin must be stored according to federal, state, and local regulations; the information on the safety data sheet; the manufacturers' instructions for use; and flammability and combustibility ratings. Based on these criteria, formalin should not be stored in the OR unless the ventilation system is adequate to keep levels below the permissible exposure limits (ie, 8-hour total weighted average of 0.75 ppm; 15-minute, short-term exposure limit of 2.0 ppm).

    Resources:


    Updated August 1, 2018

  • Can we play music in the OR?

    Music can interfere with team communication or be a distraction to patient care, which may lead to an error. If team members consent to music being played in the OR, the volume should be low enough to allow communication among the team.

    Resource:

    • Guideline for safe environment of care. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.

    Updated August 1, 2018