1. Fiber Optic Light Source Safety

2. Fiber Optic cables Fiber optic cables and light sources are used with many types of rigid endoscopes (e.g., laparoscopes, cystoscopes), fiber optic surgical headlamp systems, and fiber optic retractors, specula, and suction instruments

3. Illumination Many users believe that fiber optic illumination systems supply "cold" light to the visual field. This assumption is false.

4. Fiber Optic Light Sources Fiber optic light sources and cords conduct heat which can start fires.

5. Hazard This hazard exists with most light source and cable combinations when the light source is activated and the output of the disconnected cable is directed at materials that will ignite or support combustion.

6. Prior to the start of the Procedure Always ensure that light sources are not activated until the light cable is connected to the scope or headlight.

7. Check Equipment Check the cable for cracks before and after each use.

8. Complete connections Complete all connections before turning on a light source

9. Activated Light Cables Activated light cables that have become detached from the light source or telescope have been known to ignite surgical drapes and gowns, as well as cause serious tissue burns.

10. End of the Case Place the light source in “standby” mode, or turn the unit off when disconnecting cables Ensure that light sources are deactivated before disconnecting the cord. Disconnect the light cord from the light source. Turn the unit off when disconnecting cables.

11. Never leave a light cord that is still luminating on top of the patient drapes. The heat from the connector at the end of the cable (on either end) is may be extremely hot and may cause a burn on the patient if placed on the patient or the drapes on top of the patient. Although surgical drapes are fire retardant, they are still flammable. Fiber Optic Light Sources

12. Disconnected cables Do not place disconnected cables on the patient, drapes, or on the back table. Have a scrub person hold a disconnected cable when it is necessary to reposition the scope.

13. Retained Heat Additionally, light cable connectors retain heat even after they are no longer illuminated. Thus, they should not be laid on the drapes.

14. Example The fiber optic cable was disconnected from the arthroscope and placed on the surgical drapes with the xenon light source activated. The high-intensity output from the cable ignited the cloth drapes, causing a smoldering fire with considerable smoke. Fortunately, elevated oxygen and nitrous oxide levels were not present (as they might be near the patient's head during anesthesia). The fire was extinguished before the patient was burned. In a second incident, the disconnected fiber optic cable ignited disposable nonwoven surgical paper drapes that had trapped a pocket of oxygen (leaked from a faulty inflation connector of a pneumatic tourniquet). The resulting flash fire severely burned the patient's leg.

15. Recommendations Inform all operating room personnel and endoscopists of the risk of fires from illumination systems used in endoscopy and surgery. Instruct users to make all fiber optic cable connections before activating the light source and to turn off the light source if the endoscope must be disconnected. Instruct users not to turn the light source higher than necessary for adequate viewing. Placard all fiber optic light sources with the following label: Warning: High-intensity fiber optic light sources and cables can ignite drapes and other materials. Complete all fiber optic cable connections before activating the light source.