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TECHNOLOGY, COMPUTING, AND SIMULATION

Surgical Field Fire During a Repair of Bronchoesophageal Fistula

Aneesh K. Singla, MD, MPH^*, Jason A. Campagna, MD, PhD^*, Cameron D. Wright, MD, and Warren S. Sandberg, MD, PhD^*

Departments of *Anesthesia and Critical Care, and Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

Address correspondence to Jason A. Campagna, MD, PhD, Department of Anesthesia, University of Pennsylvania, 3620 Hamilton Walk, John Morgan Building 305, Philadelphia, PA 19104. Address e-mail to jcampagna{at}doctorsoffice.org.

Most surgical fires involve the airway but they can also occur in the surgical field. Herein, we report an intraoperative fire in the surgical field during repair of a bronchoesophageal fistula. During the portion of the surgery after the fistula was divided and the bronchus was open to atmosphere, continuos positive airway pressure was applied to the nondependent lung, and in conjunction with the use of electrocautery and dry sponges in the field, resulted in a fire. Anesthesia for thoracic surgery carries unique risks of fire because these patients frequently require large oxygen concentrations, special interventions for improving oxygenation, and have variable degrees of airway disruption. This report highlights unique safety concerns during anesthesia for thoracic surgery, and addresses more general safety issues relating to fire risk in all surgical patients.

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