Patient on fire - anesthesia emergency in the operating room
Вставка
- Опубліковано 12 чер 2024
- Anesthesiologists receive formal training on how to manage fire in the operating room, including in the patient's mouth! In this video, I highlight how to manage airway fires, and also prevent them in the first place.
0:00 Start
0:37 Introduction
1:53 Immediate first steps
4:25 Prevention
Music:
Subtle Swagger by Ron Gelinas: / atmospheric-music-portal
The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
#Anesthesiology #Residency #MedicalSchool - Наука та технологія
Thank you for the new fear.
If you like to acquire new fears, give the channel Brew a try :)
@@Kitsudote oh you’ve pointed out the gold mine there 😂
Literally 😟
Right....thinking next time I need a surgery, might just die myself instead 😊
Reassuring it's all trained for.
I’d love to hear this explained to the patient…. “Surgery is all done , all went well …except you were briefly on fire”
Worse when the patient responds with "Again?"
@@Puddingskin01 fair point…😂
@@Puddingskin01
That happens a lot, actually...
As a 20+ year firefighter, I’ve extinguished many things I never thought I’d encounter on fire, but if someone told me there was a mouth on fire, I’d anticipate it was an accident involving a flame arts performer, not a surgical case!
Word.
I knew that surgical fires were a thing, didn’t know they happened _inside_ people 😨
That's why people on oxygen aren't allowed to smoke, should look up what happens when those tubes catch fire... Calling it a flamethrower isn't much of an exaggeration and the tubing burns as fast as a fuse, the flame just shoots down it in seconds and suddenly the whole tube is gone. Lotta old people end up burning their house down smoking while they're on oxygen, really huge danger and not only in operating rooms and I'd wager there have been a lot more house fires from covid with the whole oxygen tank shortage and all the sick people requiring tanks at home...
I had heard of patients catching fire because of intestinal gas. Never heard of an airway fire.
@@DrakeOola Any fire in an oxygen-rich environment is TERRIFYING. Our atmosphere is about 21% oxygen, and fires can already be quite violent, só if you increase the amount of oxygen in the air, you can burn stuff really quickly. And if you get something that is more oxidising than oxygen, then you can burn stuff you might expect to not be flammable, like stone.
This is a cool workplace that lets you film in a room with millions of dollars in equipment.
Chocolate flames
justin y 2
I’d move to NY to work with him. I’m sure he covers plenty of neurosurgeries. 😉
Honestly this dude is probably not allowed to be doing this shit
@@23Butanedione I’m sure he probably got permission. I don’t think he would jeopardize his career for a UA-cam video. He not filming patients, so he’s not violating HIPAA.
In 35 years of practice I never experienced an airway or OR fire. However, a surgical group I worked with in Waco, TX, after I moved to another hospital, did have an OR fire. They insisted on prepping the patient with alcohol for their surgeries until they had a fire. Actually, the first episode did not change their behavior and they had another fire three months later. I hear that they finally went back to prepping with water based solutions.
Thanks for this video! It's unlocked a new fear for surgery I had never considered before!
Heh. I was thinking, maybe just ask for a nice bullet to bite.
Wow, thanks for that nightmare! 😅 Seriously though, thanks for all your education and advocacy. I had a really positive GA experience last month because I knew which questions to ask. My anaesthetist and I worked out a plan that avoided previous complications and let me recover much faster. You do such important work.
Thank you,this was very informative. I now plan to quiz every nurse anesthetist when he or she is taking me in to surgery, by saying, "Wait a second, tell me what you do if my airway catches on fire.". If he or she cannot answer to my satisfaction, I'm going to ask for someone else.
I'm currently recovering from lateral epicondylitis surgery. I'm about 15 hours into recovery an doing well. Just wanted to say that in the month leading up to my procedure I watched every video you have posted. Having a very basic understanding of Anastasia really helped with the anxiety yesterday. Thank you!
Having a basic understanding of the lost Russian princess Anastasia reduced your anxiety? Haha
I'm glad to see spell check doesn't mess up only me.
On a serious note, I hope you have a full & speedy recovery:)
Well that is absolutely terrifying! I have had numerous surgeries, and never once was it brought to my attention that I might go up in flames! Holy Cow!
My cousin is a retired anesthesiologist and would love to regale the wonderful (read with dripping sarcasm) tales he experienced in the OR. He forgot to share this one with us!
Selective memory? 😏
Maybe he never saw one
Once my colleague walks into the resident's room
-Hey, surgeons just set "my patient's name" on fire
-Oh okay... WAIT WHAT?..
Turns out one of them was in such a hurry he began electrocoagulation before op field was dry from antiseptic, promptly setting the patient, his scrubs and op field covers aflame.
Everything was fine in the end, but gave us a whole new meaning to burnout
Wow; I cannot imagine how bad of an injury that would cause! Terrifying stuff! As an industrial worker, I deal with oxygen and flammable materials and other similar hazards. But I really can't fathom how bad it would be to have this happen INSIDE me.
I had my tonsils removed with electrocautery as a middle aged adult. I remember for a few days, I tasted smokey, then like rotting barbecue. I don't imagine an actual fire would be much better.
I know some anesthetic gas are flammable so I’ve been wondering about this for a long time. Thanks for the info!
Some anesthetics used before are actually explosive and flammable, like ethyl ether, or vinyl/divinyl ether (Vinethene), ethylene gas, and cyclopropane. That was the old times.
When in your video you showed the location of a fire extinguisher, the moment I saw it I realized the nossel was damaged probably hit by a patients cart on the way into surgery. That should be replaced as it could throw fire retardant in a direction not intended to go if at all needed.
Really enjoy your videos.
THANK YOU
Rarely talked about but educating everyone is so important. Thank you👍
Wow man! That was really awesome, I learned a lot about airway fires! That was really cool! I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college because of my cerebral palsy, I really wanted to be a anesthesiologist! You rock man
I asked Dr. Kaveh (Harvard trained anesthesiologist out in San Francisco) about this yet didn’t hear back from him yet.
This is great info! Glad its available here. Thanks
Fascinating. Having had both oral (palate & teeth surgery) and a total thyroidectomy in my life, I'm guessing that was a potential I had no idea existed. Amazing to think it could happen.
Thank you so much. Even though all of this were taught by our educators, you covered some major portions. I work as a nurse in a GI department!😊 Would be also nice if you could talk about grounding pad and the fire associated with it!
i have surgery with mount sinai in may and never new about this phenomena, thanks for the video! i'm always trusting of my anesthesiologists, but knowing this is the quality of care sinai offers makes me feel really safe.
What about running a tiny thermometer line somewhere in the tube so you could immediately tell if line gets to the temperature that is present when a fire has begun likely before the tube itself has broken, also a tiny thermal sensor above the mouth to measure if the mouth is getting abnormally hot
In thorax surgery they use lasers sometimes. You have to reduce your FiO2 to 0,4 and then say "you may fire when ready"
This just happened . I shared this video with all my coworkers.
Thanks for this video Dr. Max sir
I’m so glad I didn’t find this (or any of your vides) a week ago when I was having gallbladder surgery. Im pretty sure I would’ve just suffered the pain 😂
Wonderful information. Heck of a topic!!
Excellent video
I ve seen and watched some of your videos from time to time.
My mom was a RN years ago then went back to anesthesia school in Charlotte NC . She finished and started in the OR in our hospital. She worked there 20 + years , loving her job and her co workers before retirement. She passed a few years ago. I cannot remember her mentioning a patient catching fire ( she was very professional and didn't mention too much) I do recognize most of your terms and materials used. Thanks for sharing.
Holy crap. Somethings are better left unknown. Seriously important knowledge for your field. Thank you for sharing knowledge and time and effort with this video.
Spontaneous combustion during surgery.....this is just wonderful!
Reason #9,647 that surgery is terrifying. We didn’t need 9,646 reasons. But now we’re definitely all set. I never knew any of this. I needed to never know this. 😐 THIS is what I’m going to perseverate on if I ever need surgery. 😢
Anaesthesia sounds a lot like being a pilot actually. Hours of tedium with a few minutes of intense focus sprinkled in. And a whooooole lot of practice for rare but extremely time sensitive problems.
thanks, I always wanted a new fear of surgery, I will put it right in between the percentage of things left inside patients and times the wrong surgery was performed
This is one of those things I didn't need to know was a thing as a non medical professional ...
Congratulations on hitting 100k subscribers!
Patient spitting fire!
Wow! I never knew about such surgical risks. Thank you. Dr Feinstein
There are many.
you mean Dr. Frankenstein, right?
Excelente video mi amigo!!!!
Up for surgery in 3 weeks. Ok, I am duly terrified! Thanks doc!
This sounds serious Dr Max! 😮
I thought clickbait but boy was I wrong this can never be undone what I have heard now thank you, you have scared the crap out of me
As rare as this is, it does happen. It even happens with animals. This happened with a cat that a friend of mine has at her animal rescue. She was getting spayed and the oxygen supply caught on fire. Poor baby’s face got burned. Thankfully it wasn’t a horrible burn and she healed fairly quickly. But it’s obviously something to watch for.
Very Good
Very good point on the being how your job is to be ready for emergencies even very rare but extremely dangerous ones. This is a lot of what being a surgeon, airplane pilot, etc is all about. Most of the jobs preformed by these professionals could be done with much less training. Most of these jobs could be performed by someone with a month of 8 hour weekdays of training. However, that would only cover 90% of the work and you wouldn't know which jobs where going to need those extra years of study and training to insure a good outcome much less prevent sever injury and death. It's important for people with these jobs to remember that and to keep their recurrent training up but that most of the actual work will go smoothly. Remember, you're a professional because you're ready for 99.9+% of things that can go wrong not because you can do the job when it goes 99.9% right.
Now, that was funny. I've watched many of your videos with admiration. The blend of humor and science in this one gave me a good laugh, not derisive laugh either. I guess you could say I was laughing with you.
I will never joke about the "Gas Man" ever again after watching your channel.
I came here thinking it was a discussion on inflammation. 😮 I’m glad to know there’s a plan in place in case of a fire during surgery.
Never, ever heard of these things! I was a Nurse for 16 years, but not in hospital environment. New feather in my cap, today!
Oh, CRAP! Horror of horrors. I've been "under" several times but never considered such a thing. My best experience was when I woke up I felt like I had just finished a refreshing nap. I'd prefer that same anesthesiologist if I ever need to go under in the future.
I just hope that you were at least one of the anesthesia providers who has taken care of my nephew during his multiple procedures there. I just wanted to say thanks because we’ll never know because of HIPAA. Thanks! Peace, a concerned uncle and retired healthcare professional.
He was my anesthesia when I got my gallbladder and was like 😯
Hey Max,
Thank you for your videos. Would you speak on potential aftermath of anaesthesia? I had a loss of taste after surgery when I was younger.
In the past few years, I was given Propofol 2 times a week for an ostomy change as my intestines healed. At the time, it was super painful. My memory was fuzzy, and my dreams were very detailed. I would live to know what other side effects people have had. Thank you so much for the way you present your content.
I never thought this was even remotely possible until it was on the news recently in my home city. This happened to a patient during a routine procedure. The patient was later transferred to intensive care.
Please report the damage to the cone of that fire extinguisher you show at 3:53 to the team responsible for maintenance of the fire prevention equipment in your hospital. It was probably dented accidently by a patient bed when wheeling a patient into surgery. But it ought to be replaced since the shape of the cone is important to control and direct the flow of gas to effectively extinguish the fire. Having the cone dented like that may make it difficult to effectively aim and deliver the extinguishing agent to the fire in the event of an emergency which is absolutely not when you want to discover this the hard way, so best to report it and get it fixed as soon as possible.
🌬💕I love your channel anything to do with Medical I love. Thank you for sharing your thoughts and journey. Stay STRONG
We are all stronger together
💪🤍💙💪
You know Dr. Feinstein, the terror we pts have to begin with. Your last video was about how to keep a patients stress, panic down. Your killing us here. Pleeassee
Thanks for another educational video. I have been meaning to ask , and the smoke made me think of my question. How much does a tobacco smoker and a cannabis user, affect your decisions on what procedures you would use and/or modify them?
Cannabis, apparently quite a bit, please let anaesthesia know!
Thank god for Florine.
Good thing I didn’t know about this two months ago when I had surgery on my foot
Foot surgery would extremely low risk of this since the surgery is so far away from the face or head
@@Eman1900O I know, but this was the first time I was put under doing a surgery and I have pretty bad anxiety. But yeah I agree with you one hundred percent 😊
Be continuously
Love from india 💜💛💙🧡
This guy is why I’ll choose to go out on my own!
I am more Anxious having to Go Under than Ever after watching your VIDS!! Can't watch anymore!
Seen that happen in a movie. Wasn't sure it was a real thing. Prevention please! This and waking up during surgery are both terrifying thoughts.
Never knew people caught on fire during surgery. That’s wild… and a new fear I have now. I guess I wasn’t afraid of hospitals enough this guy had to up it a notch
I can imagine dousing a patients throat with a fire extinguisher, just a lovely scenario. Do realize I’ll be extremely pissed off if I wake up and find my throat was on fire and I had to deep throat a fire extinguisher to put it out.
New fear unlocked. Move over Chubbyemu 😅
Quite informative.
Hi doctor 🙋 to New York City's Mount Sinai hospital 😊
I was working as a volunteer in Toronto's Mt. Sinai hospital 😊
I know some one that this happened too.. She was young, very popular in her community and greatly missed by everyone. She lived a few hours after the event but passed.. Nancy.
Wow! And I thought I had a bad experience with anesthesia! How do you explain THAT to your patients and family.
That was a smoking good video.😄
Loving ❤️
Thats terrifying! Imagine going in for a simple surgery only to find out you caught on fire 😳💀
Back in the old days the main general anesthetic used was ether and it was extremely flammable and volatile!!
Nice
Oh, joy!
Oh boy - I'm heading to surgery in a couple of weeks under a general. This makes me even more nervous - thanks :(
What surgery are you having?
Wow!
Just a point of clarification. Dropping the concentration prior to removal of the ETT will not reduce FiO2 due to the time constant. Best is to disconnect circuit and pull ETT.
Googled this as my first day volunteering at a hospital there was an alert of a fire in an OR and never thought that could happen until now
That adds a whole new perspective for a patient being “smoking hot.”
That is terrifying
I was reading about robotic abdominal surgery where several different devices, Including cautery but also other instruments are inserted into small incisions in the abdomen. In all sorts of engineered systems there is something called "Ground loop" where parts assumed to be at the same electrical potential actually are not and so current flows between those two points. This can cause internal burning in the patient. What I saw was cautions by the robotic engineers on this and mentioning that novel ways of positioning the instruments need to be thought through for this aspect. Ground loops, could even be a problem elsewhere, with sensors and other electrical connections. Ever encounter this kind of thing?
Well that's a terrifying thought
😱 Was never afraid of surgeries. Now I am.
FYI, The 2018 NFPA 99 (which is only recently being enforced) requires a “clean agent” fire extinguisher in all OR’s. A “clean agent” is either a water type or CO2 type. Most prefer the CO2, like you mentioned. Other chemical extinguishers are not allowed.
I don’t hear it referred to much in the past 20+ yrs, but, we often noted if flammable inhalation anesthesia is used, it would indicate the need for some other codes needing to be considered when constructing patient care/treatment areas. I assume that flammable inhalation anesthesia was not used any longer (thinking “ether”). I’m curious, are any other inhalation anesthetics used currently that are flammable?
You mentioned the number of reported cases, but, it wouldn’t have hurt to include that number, compared to the total number of OR procedures, makes it an extremely rare event (and airway fires, even more rare). Also, thanks for noting that N2O is an oxidizer. I think that is often overlooked when considering the fire triangle.
Thanks always for the video! Great content!
I wonder if Halon 1211 would also be an appropriate extinguishing agent. It also leaves no residue behind, and has better effectiveness and range.
@@Stepclimb Unfortunately, Halon was discontinued and is no longer produced, although it can be sold. The datacenters I've worked in all had the Halon systems removed some years ago.
@@repro7780
I’m not sure that is true.
Halon 1211 is still widely used in the aviation industry currently.
New aircraft are rolling of the assembly line and serviced with Halon 1211 in large quantities in the extinguishing systems for engine fires as well as hand held extinguishers in the cockpit and cabin.
By weight, Halogenated Fluorocarbon extinguishing agents are vastly superior to CO2 for many classes of fires.
Maybe Halon 1211 production is has only been curtailed in the US, but it can still be purchased in the US.
@@Stepclimb As per the EPA: "On January 1, 1994, production and import of virgin halons were phased out in the United States. Since that time, recycled halons are the only supply of halons in the United States for specialty fire suppression applications."...Just like I said.
@@repro7780
Thanks for the link.
It sounds like with regards to aircraft manufacturers in the US, there is still a robust enough supply via domestic and imported “recycled” Halons.
A separate discussion could be had about how the US enforces EPA policy with regards to determining whether an imported Halide extinguishing agent is “virgin” or “recycled”.
The title of this video brought to mind a warning I recall from long ago: In the 1970s TV series Emergency! we saw many times a placard on the wall of the Rampart Hospital treatment room which read 'Flammable Anesthetics Shall Not Be Used In This Room'. I concluded that flash fires in the O.R. have since been eliminated by ending the use of diethyl ether as general anesthesia, but it appears this is not the case.
This is why they made me stop smoking in the OR
LOL
Thanks Doc! Glad I keep putting a 14th surgery off. Think I’ll just die now not on fire instead of going out by fire on the OR table. Wow! 😱
Low risk of fire
200 out of millions
Did you go over 100k while I was binging on your content?! Also. You look like pilot Captain Joe
It never occurred to me the possibility of a fire but it makes sense with all the equipment and flammable objects in an operating room. It is rather a nightmare scenario. How often does a fire require fire department assistance?
And oxygen is there as well.
When should the ET tube be inserted again? A burn will cause inflammation of the airway and spasms.
3:27 I was joking hoping he would say "piss"; but then I noticed he has a golden chain around his neck, there is nothing inherently wrong with such an accessory but just imagine your eye catches _that_ as you are about to black out.
I never even thought about this lol but now I think about it, it's definitely possible. New fear unlocked lol
In over three decades, I never witnessed an airway fire but twice have seen patient abdomens on fire when diathermy ignited pooled alcohol-based surgical preparation spirit on the surgical drapes.
This video just added additional fear for anyone who is scared silly about an upcoming surgery.
What is the positive/negative outcome for endotracheal fires? How many live or die.
Would it be wrong to just disconnect your circuit instead of turning down the O2?
There was an operating room fire in Perth, West Australia very recently. Patient was seriously injured.
A spray bottle like you use for your BBQ filled with sterile water might be handy. I use it when my grill flares up too much, you could use it when your patient flares up..both smell bad if the meat burns..
Holy crap, that's crazy