Mark Bruley, CCE

Speaker Profile

• Biomedical engineer at the nonprofit ECRI Institute in Plymouth Meeting, Pa.
• Considered the world's leading expert on medical accidents, with a particular expertise in surgical fires.
• Has conducted research into surgical fires for more than 35 years and served as an advisor to the Joint Commission, the FDA and various foreign governments.

It's easy to be complacent about surgical fires. After all, most providers never experience them. But they still happen with alarming regularity — at least 200 times a year, according to some estimates. And when they do, the consequences are often devastating. Mark Bruley, CCE, a biomedical engineer at the nonprofit ECRI Institute in Plymouth Meeting, Pa., is an internationally recognized expert on fire safety. In his presentation, "Only You Can Prevent Surgical Fires," he'll talk about common hazards, new clinical recommendations in fire prevention and the proper way to extinguish flames if they do spark.

• It's not all about dry times. Surgical teams tend to assume alcohol is the most common cause, because everyone knows it's flammable and we frequently hear warnings about adequate drying time. But the reality is that alcohol skin preps that haven't been given adequate time to dry are responsible for only about 5% of surgical fires. Oxygen buildup is a much greater concern.
• The cause of most surgical fires. Oxygen has always been so freely available in the operating room, providers have had a tendency to give patients much more than they actually need, which, interestingly, is something they would never do with any other medication. When oxygen is coming from an open source, like a nasal cannula or disposable mask, it's dangerously easy to have it build up under drapes and in and around the head and neck area. That's how at least 70% of surgical fires happen.

MAGIC TIME An accomplished magician, performing as Magic Marcus, Mark Bruley, CCE, incorporates magic tricks into his talks.

• Limit oxygen delivery. Patients often do just as well with fresh air delivered from an anesthesia machine. But in those unusual cases where patients need supplemental oxygen from an open source, ECRI Institute and the Anesthesia Patient Safety Foundation recommend starting with 30% instead of 40%, 50% or 100%. With pulse oximetry, you can see whether a patient is getting enough oxygen, almost in real time, and at that lower level of administration you eliminate the possibility of a flash oxygen-enriched fire.
• A matter of seconds. Flash fires spread a ripple of flame across skin at a rate of about 10 feet per second. In other words, when fine body hairs or fuzz on towels ignite, they can go from head to toe in less than a second.
• And just like that, the damage is done. Most surgical fires last only about 4 or 5 seconds, but they change lives forever. Not just the lives of patients, who can, of course, suffer severe, life-altering burns, but the lives of providers, too. It can be a devastating emotional experience. I know of one case where an OR team member actually committed suicide after being involved in a fatal operating room fire. In other cases, people say, "I don't understand. I've done this surgery a thousand times and never had a fire. What went wrong?" That's the question we answer.