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What maneuvers are instituted to treat an airway fire? Is the risk of fire any less likely with electro-cautery?
The first person to recognize an airway fire will proba-bly be the surgeon. The surgeon must notify the anesthesi-ologists immediately, who should cease ventilation and discontinue oxygen administration to eliminate the source of combustion. In some circumstances, it may be necessary to disconnect the breathing circuit from the anesthesia machine. The flaming material must be removed from the airway and placed in a bucket of water, which should always be available for this purpose. Designated CO2 fire extinguishers are also recommended. Immediately after removal of the tube, ventilate the patient with 100% oxy-gen by face mask and continue the anesthetic. Debris removal and airway examination are performed with a rigid bronchoscope. An airway burn requires reintubation to protect against potential airway obstruction from edema. On occasion, tracheostomy, bronchopulmonary lavage, or fiberoptic tracheobronchoscopy may be indi-cated. If the injury is severe, prolonged intubation and mechanical ventilation may be necessary, along with a course of high-dose steroids and antibiotics when cultures are positive. The long-term sequelae of burns may take weeks to manifest.
Electrocautery fire is no less risky than laser fire.
Electrocautery fire may even be more common.
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