American Society of Anesthesiologists (ASA) operating room fires algorithm

* Ignition sources include but are not limited to electrosurgery or electrocautery units and lasers.
¶ An oxidizer-enriched atmosphere occurs when there is any increase in oxygen concentration above room air level, and/or the presence of any concentration of nitrous oxide.
Δ After minimizing delivered oxygen, wait a period of time (eg, one to three minutes) before using an ignition source. For oxygen-dependent patients, reduce supplemental oxygen delivery to the minimum required to avoid hypoxia. Monitor oxygenation with pulse oximetry, and, if feasible, inspired, inhaled, and/or delivered oxygen concentration.
◊ After stopping the delivery of nitrous oxide, wait a period of time (eg, one to three minutes) before using an ignition source.
§ Unexpected flash, flame, smoke or heat, unusual sounds (eg, a "pop," "snap," or "foomp") or odors, unexpected movement of drapes, discoloration of drapes or breathing circuit, unexpected patient movement or complaint.
¥ In this algorithm, airway fire refers to a fire in the airway or breathing circuit.
‡ A CO₂ fire extinguisher may be used on the patient if necessary.