Which of the following is a primary priority during a power outage in a surgical case?

• A. Initiate downtime procedures, preserve the sterile field, switch to backup power, and continue with essential equipment.
• B. Discontinue the case immediately and evacuate.
• C. Ignore the outage and continue as planned.
• D. Replace all lighting immediately and cancel procedures.

Answer: (A)

When a power outage hits the OR, the top priority is patient safety. This means keeping the patient protected, preserving the sterile field, and ensuring essential equipment remains powered so the case can continue without introducing risk. The best approach is to activate downtime procedures, which provide a structured plan to manage the outage, switch to backup power for critical devices, and proceed with only the equipment and steps necessary to safely complete the procedure. This keeps the procedure moving while maintaining sterility and monitoring capabilities, reducing the chance of contamination, hypoxia, or unrecognized equipment failure.

Discontinuing the case and evacuating, ignoring the outage, or replacing lighting and canceling procedures are not the appropriate default actions because they unnecessarily halt patient care or assume all risks are insurmountable when the facility has backup systems and a documented downtime process to manage the situation safely.