Airway Fires

Question 1

almost half of fire in OR occur

Answer 1

on head, neck, upper chest

Question 2

1/5 fires in OR occur

Answer 2

in airway

Question 3

Most airway fires occur in surgery to

Answer 3

vocal cords

Question 4

airway fire results in

Answer 4

blow torch effect from lasers

Question 5

3 elements necessary for fire to start

Answer 5

ignition source/heat
fuel
oxidizer

Question 6

ignition source

Answer 6

electrosurgical cautery, lasers, tools

Question 7

fuel

Answer 7

paper/cloth drapes, gauze dressing, ETT, gel mattress, face/body hair, equipment, methane from anaerobes in airway

Question 8

oxidizers

Answer 8

oxygen, nitrous oxide, air (o2/n20)

Question 9

Best treatment of airway fires

Answer 9

prevention

Question 10

Oxidizer prevention

Answer 10

Reduce O2 concentrations in airway
Use air, O2:air, or O2:helium
*N2O IS COMBUSTIBLE

Question 11

Fuel prevention

Answer 11

exclude flammable materials from airway (ETT, gauze, gloves, pledgets)
Non intubating techniques
Use high-efficiency smoke evacuators

Question 12

Limit O2 to

Answer 12

21-30%

Question 13

Avoid ____ which supports combustion

Answer 13

N2O

Question 14

Use ____techniques

Answer 14

apneic/jet ventilation

Question 15

Use ____ mixture to reduce risk

Answer 15

O2:Helium

Question 16

Prelude to fire

Answer 16

ETT cuff rupture

Question 17

Cuff should be inflated with

Answer 17

saline/methylene blue

Question 18

What else can be placed to prevent ETT fire?

Answer 18

saline-moistened gauze proximal to tube cuff

Question 19

FDA approved ETT wrap

Answer 19

Merocel Laser-Guard ET Wrap - Medtronic

*leaving any ETT portion exposed negates use of wrap

Question 20

If airway fire occurs

Answer 20

prompt action = imperative
stop gas flow, disconnect ETT 
Extubate/turn off O2
Irrigate site with H20
Reestablish airway - reintubate; trach
perform rigid bronch to assess airway damage
admit to ICU for minimum 24h

Question 21

Laser-resistant ETTs

Answer 21

Airway fire can still occur