ENT Airway: The Shared Field Fire Protocol
Managing lasers, fires, and the 'shared field' with the ENT surgeon.
The Shared Field: War for the Airway
ENT surgery is a unique partnership. You’ve probably felt the "crowded theater" feeling when the surgeon's laser is inches from your ETT. The reality is, OR Fire is one of the most preventable disasters in our field.
The Cliff: The Oxygen Surfeit
The fire triangle needs fuel, heat, and an oxidizer. You provide the oxidizer. "During laser airway surgery, I will maintain the FiO2 at the lowest level necessary to maintain adequate oxygenation, preferably less than 30%, and avoid the use of Nitrous Oxide, which supports combustion."
The Pivot: The Fire Drill
If a fire occurs, you have seconds. "I will immediately: 1. Pull the ETT. 2. Stop the flow of all gases. 3. Pour saline into the airway. 4. Once the fire is extinguished, I will re-establish ventilation via mask and evaluate the airway with a bronchoscope."
Conclusion: Vigilance in the Field
ENT anesthesia is about communication. Practice your fire protocol in the Oral Boards Bot until every step is muscle memory.