Document Detail

Laser initiated endotracheal tube explosion.
MedLine Citation:
PMID:  2378234     Owner:  NLM     Status:  MEDLINE    
A 62-year-old male with a diagnosis of subglottic and tracheal stenosis resulting from a prolonged intubation was scheduled for a laser bronchoscopy and placement of a silicon T-shaped tube. His history was significant for two myocardial infarctions, an episode of congestive heart failure and exertional angina. A 6 mm polyvinyl chloride endotracheal tube, wrapped with aluminum tape, was placed in an existing tracheostomy stoma. During the course of the procedure, a sudden bright flash occurred followed by an explosive noise and black smoke rising in the anesthesia circuit and from the patient's mouth. The endotracheal tube was removed and the patient was treated for first and second degree burns in the supraglottic area and base of the tongue. In laser surgery of the airway, special care should be given to reducing the flammability of the inspired gases which can be best accomplished by the mixture of helium with oxygen. Helium acts to retard ignition of polyvinyl chloride tubes in concentrations of 60% or greater. The external surface of the tube can also be protected with the application of a metallic tape affixed in a spiral fashion. Finally, a protocol for the management and treatment of this emergency should be adopted and rehearsed.
G G De Vane
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  AANA journal     Volume:  58     ISSN:  0094-6354     ISO Abbreviation:  AANA J     Publication Date:  1990 Jun 
Date Detail:
Created Date:  1990-09-06     Completed Date:  1990-09-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0431420     Medline TA:  AANA J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  188-92     Citation Subset:  N    
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MeSH Terms
Bronchoscopy / adverse effects
Burns / etiology,  therapy
Intraoperative Complications / etiology*,  therapy
Intubation, Intratracheal / adverse effects*,  instrumentation
Laryngostenosis / complications,  surgery
Laser Therapy / adverse effects*,  instrumentation
Middle Aged
Tracheal Stenosis / complications,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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