Airway Fire

This is an anaesthetic crisis
Priority is to: * Extinguish fire * Remove oxygen source

#####Emergency Management

Immediately:

• Call for help
• Remove ETT
• Stop oxygen flow
• Irrigate airway
  Saline or water.
• Remove any foreign body
  • ETT fragments
  • Gauze/sponges

Once fire extinguished:

• Reintubate
  Swelling will begin to occlude airway.
• Bronchoscopy
  • Remove debris
  • Assess extent of injury

Management

Prevention is key

For high risk procedures:

• Discuss prevention and management plan
  Advised by local policy.
• Avoid:
  • Oxidisers:
    • Keep FiO₂ < 0.3
    • Avoid N₂O
  • Alcohol based antisetpics
  • Diathermy
    Bipolar preferable to unipolar.

For laser surgery in airway:

• Use laser-resistant ETT
• Fill proximal cuff with methylene blue
  Will provide early warning in case of cuff damage.
• Place wet gauze around ETT cuff
• Avoid oxidisers:
  • Keep FiO₂ AND FeO₂ < 0.3
  • Avoid N₂O

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References