PA PSRS Patient Saf Advis 2005 Sep;2(3):20.
Update on Alcohol-Based Surgical Prep Solutions
Dermatology; Nursing; Surgery
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Update on Alcohol-Based Surgical Prep Solutions

This article updates the June 2005 PA-PSRS Patient Safety Advisory article titled “Risk of Fire from Alcohol-Based Solutions,”1 in which we reported on the hazards of fire from mis-use of alcohol-based liquid germicides during surgical procedures and on the controversy over the use of flammable liquid germicides during electrosurgical or electrocautery procedures.

The controversy existed because of interpretations by several government public safety organizations such as the State of Nebraska (state fire marshals, government health and human services departments) and Centers for Medicare and Medicaid Services, of inconsistencies in the 2005 National Fire Protection Association Standards for Health Care Facilities (NFPA 99) between the permitted and restricted use of flammable aerosol and liquid germicides, respectively, in anesthetizing locations during electrosurgical or electrocautery procedures.

Since publication of our June article, the NFPA has issued a Tentative Interim Amendment (TIA 05-2) to NFPA 99 standard section on germicides which became effective August 18, 2005. This amendment now permits the use of flammable liquid germicides in anesthetizing locations during electrosurgical, electrocautery, and laser procedures provided specific fire prevention precautions are followed. The proposed revised language of NFPA section on germicides can be obtained at NFPA’s web site at


  1. Patient Safety Authority (PSA). Patient Safety Advisory. Risk of Fire from Alcohol-Based Solutions [online]. 2005 Jun [cited 2005 Aug 31]. Available from the internet at
  2. National Fire Protection Association (NFPA) Standard for Health Care Facilities. NFPA 99. Quincy, (MA):2005.

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