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An airway fire is potentially deadly complication that may occur during tracheotomy surgery, during laser surgery and with a number of other procedures. This chapter discusses the prevention and management of airway fires. The anesthesiologist should keep the administered oxygen levels to the minimum needed when a significant potential for an airway fire is present. In general, cases of airway fire call for immediate removal of the endotracheal tube (ETT) and flooding of the field with saline. While this is a reasonable rule of thumb, it should also be noted that there are occasional patients where removal of the ETT would in all likelihood result in irreversible loss of the airway. Some authors have suggested that flooding the surgical site with carbon dioxide will help prevent airway fires during open tracheostomy using cautery.
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