Airway Fires Flashcards
(21 cards)
almost half of fire in OR occur
on head, neck, upper chest
1/5 fires in OR occur
in airway
Most airway fires occur in surgery to
vocal cords
airway fire results in
blow torch effect from lasers
3 elements necessary for fire to start
ignition source/heat
fuel
oxidizer
ignition source
electrosurgical cautery, lasers, tools
fuel
paper/cloth drapes, gauze dressing, ETT, gel mattress, face/body hair, equipment, methane from anaerobes in airway
oxidizers
oxygen, nitrous oxide, air (o2/n20)
Best treatment of airway fires
prevention
Oxidizer prevention
Reduce O2 concentrations in airway
Use air, O2:air, or O2:helium
*N2O IS COMBUSTIBLE
Fuel prevention
exclude flammable materials from airway (ETT, gauze, gloves, pledgets)
Non intubating techniques
Use high-efficiency smoke evacuators
Limit O2 to
21-30%
Avoid ____ which supports combustion
N2O
Use ____techniques
apneic/jet ventilation
Use ____ mixture to reduce risk
O2:Helium
Prelude to fire
ETT cuff rupture
Cuff should be inflated with
saline/methylene blue
What else can be placed to prevent ETT fire?
saline-moistened gauze proximal to tube cuff
FDA approved ETT wrap
Merocel Laser-Guard ET Wrap - Medtronic
*leaving any ETT portion exposed negates use of wrap
If airway fire occurs
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
Laser-resistant ETTs
Airway fire can still occur
