Call for Safety: Patient Fire During Dental Care
Dr. Robert Bosack, practising oral and maxillofacial surgeon in Chicago and Clinical Assistant Professor at the University of Illinois College of Dentistry, presents an interesting case that was recently published in the Journal of the American Dental Association (October 2016).
Fire risk is present whenever there is a convergence of fuel, oxidizer, and an ignition source, which is called the fire triangle. A heightened awareness of fire risk is necessary whenever a fire triangle is present. The authors provide a sentinel event case report of fire in a dental office.
A 72-year-old woman received second-degree facial burns from a fire that ignited near the nasal hood supplying a nitrous oxide–oxygen mixture. The presumed ignition source was heat generated during the preparation of a titanium post with a high-speed, irrigated carbide bur. The patient was transferred to the local emergency department and subsequently discharged after possible pulmonary complications were ruled out. The patient was then transferred to a regional burn unit and was discharged home with second-degree burns.
When the source of a fuel cannot be removed from the immediate area, soaked with water, or covered with a water-soluble jelly, the dentist should stop the open flow of oxygen or nitrous oxide–oxygen mixtures to the patient for 1 minute before the use of a potential ignition source, and intraoral suction should be used to clear the ambient atmosphere of oxidizer-enriched exhaled gas.