Airway fires are one of the most feared complications of any anesthesiologist. Their management requires rapid action that must be reflexive in order to prevent catastrophic damage to airway structures and lifelong ventilator dependence. The case described in this chapter is that of a 64-year-old male undergoing a left vocal cord ablation with a CO2 laser who is left unable to breathe, eat, or speak on his own after an airway fire ensues. This chapter outlines risk factors for the development of an airway fire as well as ways to prevent it including a summary of two of the most widely used laser-resistant endotracheal tubes available. Finally, this chapter aims to educate the anesthesiologist on the corrective steps to take if in the unfortunate event of an airway fire.
KeywordsBlowtorch fire Ignition source Fuel Oxidizer Examples of components Medtronic Tube Advantages/disadvantages of Medtronic Mallinckrodt tube Advantages/disadvantages of Mallinckrodt Rusch tube Advantages/disadvantages of Rusch Compatible lasers Advantages/disadvantages of small tube Advantages/disadvantages of large tube Depth of tube Volume of indicator Purpose of indicator Saline heat sink Appropriate FiO2 End tidal O2% Nitrous oxide Pledgets Laser energy Assessing damage Fiber optic
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