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Scalpel. Check. Sponge. Check. Fire extinguisher … check?
When one thinks of the risks of surgery, one does not usually think of "fire". But that 's what happened to a man in Australia who underwent a "flash fire" in his chest cavity during an emergency heart operation, according to a new report from the US Department of Homeland Health. case.
While fires during a surgical procedure are rare – and fires in the thoracic cavity are even more unusual – the case "underscores the continued need for fire training and prevention strategies" at the time of surgery. Surgical intervention, the study's lead author, Dr. Ruth Shaylor, of the Department of Anesthesia and Pain Management at Austin Health in Melbourne, Australia, said in a statement. In particular, physicians should be aware that certain circumstances during surgery, including the presence of high oxygen levels and heat sources, may increase the risk of fire.
In the new case, a 60-year-old man needed surgery to repair a tear in his aortic artery that is life-threatening, the main artery of the chest that carries blood out of the heart . Previously diagnosed in humans was chronic obstructive pulmonary disease (COPD), a chronic lung disease. [27 Oddest Medical Case Reports]
During the operation, the doctors found that the right lung of the man was stuck to the sternum or sternum and that some lung tissue had become too swollen. These areas are called "bubbles" and are often caused by COPD.
The doctors tried to avoid the bubbles by opening the sternum of the man to access his chest. Despite a painstaking effort, the surgeons punctured one of the bubbles, causing air leakage into the lungs of the man.
When this happened, the doctors had to give the man a higher dose of extra oxygen to avoid breathing problems. Later during the operation, the doctors used an electrocautery, which heats the tissue with electricity, to prevent blood vessel bleeding.
Suddenly, sparks from the electrocautery device ignited a fire on the surgical gauze. The fire was quickly extinguished with saline (salt water), without hurting the patient, said Shaylor. Despite the fire, the rest of the surgery went smoothly and the doctors managed to repair the aortic tear.
The case of the man will be presented this week at the Euroanaesthesia congress, the annual meeting of the European Society of Anesthesiology in Vienna, Austria.
Although rare, fires during surgery may occur. In fact, about 600 surgical fires occur each year in the United States, according to the US Food and Drug Administration.
There are three critical "ingredients" for a surgical fire: the first is the presence of an "oxidizer", including additional oxygen; the second is a source of ignition, such as an electrocautery device; and the third is a source of fuel, including surgical gauze, sponges or fields, or even the patient's hair and skin, according to the FDA.
Most surgical fires occur when there are high concentrations of oxygen in an environment – as was the case for this patient. The oxygen itself does not burn, but it decreases the temperature at which a fire can fire. In other words, things that do not usually burn can ignite in the presence of high levels of oxygen, says the FDA.
The authors report that fires in the thoracic cavity appear to be particularly rare, with only seven previous cases reported in the medical literature.
All of these seven cases involved the presence of dry surgical equipment (such as sponges or gauze); electrocautery devices and increased additional oxygen levels; and all patients had COPD or pre-existing lung disease, Shaylor said.
"Surgeons and anesthesiologists need to know that fires can occur in the chest cavity if a lung is damaged or air leaks occur, for whatever reason, and that patients with COPD are at increased risk. "said Shaylor.
Originally published on Science live.
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