Inside ASHE - Fall 2017 - 38

injury if used in extremely close proximity
or in direct contact with skin for an
extended period. A nurse not properly
trained in the use specifically to CO2 could
be infective with extinguishment and risk
patient injury if discharged on or too close
to the patient. Therefore, although a CO2
could be effective in dousing flammable
skin preps and oxygen-driven fires, staff
should be trained on the proper use
and application of a CO2 extinguisher.
Discharging too close to open incisions
could cause thermal damage to tissue,

resulting in much longer healing times. In
addition, consideration should be given
to using only extinguishers that have
been properly cleaned, sterilized, and
filled with non-reclaimed, higher-purity,
lower-moisture CO2. Talk with your fire
extinguisher vendor. A "cleaned" CO2
extinguisher will obviously increase
the cost.
Clean agent extinguishers are rated
for fires in Class A, B, and C. Clean
agents are actually refrigerant-type
liquids that evaporate quickly when

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discharged-these liquids are sometimes
called streaming agents. They extinguish
a fire by providing a break in the
chemical reaction of fuel and oxygen.
They do not extinguish fires by oxygen
displacement, and they have minimal
cooling or wetting effect. They are very
effective at being "clean" since they are
non-conductive, non-corrosive, and
do not leave any residue. The biggest
issue with older first-generation clean
agents (halogenated hydrocarbons
like halon) was that they were cardiac
sensitizers, meaning they could cause
fatal arrhythmias when inhaled in
large concentrations, which could
put a patient at risk. However, the
newer generation HFC (halogenated
hydrofluorocarbon) suppressants like
HFC-236fa are better suited for use as
a fire suppressant in hand-held fire
extinguishers since they have a much
lower toxicity than halon and can be
safely used in small spaces and around
susceptible (high-risk) populations.
Hazards found in the OR are most
frequently Class A, Class B, or Class C
hazards. In the OR, Class A hazards can
involve fuels such as surgical drapes, the
patient's hair, methane gas escaping
from the patient's bowel, and other
combustible materials. Flammable liquids
(e.g., alcohol, flammable prep solutions)
are considered Class B. Class C hazards
are either a Class A or a Class B hazard
combined with an electrical current (e.g.,
laser, electrosurgical unit). If a Class C fire
occurs, unplugging the electrical device
from its power supply or interrupting the
electrical supply by shutting off a circuit
breaker would most likely revert the fire
classification to a Class A or B.
The AORN recommends following the
ECRI recommendation. ECRI recommends
extinguishers in Class A, B, or C. NFPA
recommends extinguishers rated as Class
A, B, C, or AC in the OR. But it also cautions
to check with the authority having
jurisdiction (e.g., local fire marshal).
According to the 2012 edition of
NFPA 99: Health Care Facilities Code
(Section 15.9), Portable fire extinguishers
shall be selected, installed, inspected,
and maintained in accordance with
NFPA 10 - 2010, Standard for Portable
Fire Extinguishers. A.15.9.1 The selection
of portable fire extinguishers for health


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Table of Contents for the Digital Edition of Inside ASHE - Fall 2017

Letter from the president
What’s new
Pop quiz
The measurement of a health care facility manager: How do you define success?
Creating a program to identify and monitor pressure dependent spaces
Critical considerations for specifying a building automation system for health care
Bright ideas: LED renovation at Boulder Community Health
Selecting the right fire extinguisher for operating rooms
Still battling reheat energy in hospitals: Short- and long-term ideas for hospitals’ biggest energy use
The financial impact of variable speed ventilation controls in hospital kitchens
Data driven culture fuels University of Florida Health’s success in energy and operational optimization
Energy management in a critical access hospital: How Barnesville Hospital reduced energy consumption by 39 percent
Value analysis: Improving operating margin through cost savings
Member spotlight
Advertisers’ index
Inside ASHE - Fall 2017 - Intro
Inside ASHE - Fall 2017 - bellyband1
Inside ASHE - Fall 2017 - bellyband2
Inside ASHE - Fall 2017 - cover1
Inside ASHE - Fall 2017 - cover2
Inside ASHE - Fall 2017 - 3
Inside ASHE - Fall 2017 - 4
Inside ASHE - Fall 2017 - 5
Inside ASHE - Fall 2017 - 6
Inside ASHE - Fall 2017 - 7
Inside ASHE - Fall 2017 - 8
Inside ASHE - Fall 2017 - Letter from the president
Inside ASHE - Fall 2017 - What’s new
Inside ASHE - Fall 2017 - 11
Inside ASHE - Fall 2017 - Pop quiz
Inside ASHE - Fall 2017 - 13
Inside ASHE - Fall 2017 - 14
Inside ASHE - Fall 2017 - 15
Inside ASHE - Fall 2017 - 16
Inside ASHE - Fall 2017 - 17
Inside ASHE - Fall 2017 - The measurement of a health care facility manager: How do you define success?
Inside ASHE - Fall 2017 - 19
Inside ASHE - Fall 2017 - Creating a program to identify and monitor pressure dependent spaces
Inside ASHE - Fall 2017 - 21
Inside ASHE - Fall 2017 - 22
Inside ASHE - Fall 2017 - 23
Inside ASHE - Fall 2017 - Critical considerations for specifying a building automation system for health care
Inside ASHE - Fall 2017 - 25
Inside ASHE - Fall 2017 - 26
Inside ASHE - Fall 2017 - 27
Inside ASHE - Fall 2017 - Bright ideas: LED renovation at Boulder Community Health
Inside ASHE - Fall 2017 - 29
Inside ASHE - Fall 2017 - 30
Inside ASHE - Fall 2017 - 31
Inside ASHE - Fall 2017 - 32
Inside ASHE - Fall 2017 - 33
Inside ASHE - Fall 2017 - Selecting the right fire extinguisher for operating rooms
Inside ASHE - Fall 2017 - 35
Inside ASHE - Fall 2017 - 36
Inside ASHE - Fall 2017 - 37
Inside ASHE - Fall 2017 - 38
Inside ASHE - Fall 2017 - 39
Inside ASHE - Fall 2017 - 40
Inside ASHE - Fall 2017 - 41
Inside ASHE - Fall 2017 - Still battling reheat energy in hospitals: Short- and long-term ideas for hospitals’ biggest energy use
Inside ASHE - Fall 2017 - 43
Inside ASHE - Fall 2017 - 44
Inside ASHE - Fall 2017 - 45
Inside ASHE - Fall 2017 - The financial impact of variable speed ventilation controls in hospital kitchens
Inside ASHE - Fall 2017 - 47
Inside ASHE - Fall 2017 - 48
Inside ASHE - Fall 2017 - 49
Inside ASHE - Fall 2017 - 50
Inside ASHE - Fall 2017 - 51
Inside ASHE - Fall 2017 - Data driven culture fuels University of Florida Health’s success in energy and operational optimization
Inside ASHE - Fall 2017 - 53
Inside ASHE - Fall 2017 - 54
Inside ASHE - Fall 2017 - 55
Inside ASHE - Fall 2017 - Energy management in a critical access hospital: How Barnesville Hospital reduced energy consumption by 39 percent
Inside ASHE - Fall 2017 - 57
Inside ASHE - Fall 2017 - Value analysis: Improving operating margin through cost savings
Inside ASHE - Fall 2017 - 59
Inside ASHE - Fall 2017 - Member spotlight
Inside ASHE - Fall 2017 - Advertisers’ index
Inside ASHE - Fall 2017 - 62
Inside ASHE - Fall 2017 - cover3
Inside ASHE - Fall 2017 - cover4
Inside ASHE - Fall 2017 - outsert1
Inside ASHE - Fall 2017 - outsert2
Inside ASHE - Fall 2017 - 70
Inside ASHE - Fall 2017 - 71
Inside ASHE - Fall 2017 - 72
Inside ASHE - Fall 2017 - 73
Inside ASHE - Fall 2017 - 74
Inside ASHE - Fall 2017 - 75
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