Australian doctors had to extinguish a flash fire that suddenly broke out in the chest cavity of a patient undergoing open heart surgery.
Physicians from the Austin Health hospital in Melbourne recounted how a routine surgery involving an Aussie man became even more life-threatening when surgical instruments triggered a fire in the oxygen-enriched environment of the operating room.
The doctors performing the surgery had to quickly put out the fire to prevent possible injuries to the patient and the operating team.
The unique case, which occurred in the medical facility last year, was presented during the annual meeting of the European Society of Anaesthesiology in Austria this June.
Chest Cavity Fire During Open-Heart Surgery
A 60-year-old man was rushed to Austin Health in August 2018 after suffering an ascending aortic dissection, a condition where the inner wall of a major artery responsible for pumping blood away from the heart ruptures. He was immediately prepared for emergency heart surgery to repair the damage.
However, the operation would not be a simple one since the patient also suffers from lung issues, particularly a chronic obstructive pulmonary disease (COPD). This severely complicated the medical procedure for the doctors.
To reach the patient's heart, the surgeons first had to open his sternum, which is the bone found in the middle of the chest. However, the man's condition has caused his right lung to be stuck to his sternum.
Some of the patient's lung tissues have already developed bullae, which are air-filled blisters commonly found in people suffering from COPD.
The doctors tried to pull off the stuck right lung from the sternum carefully, but they accidentally punctured one of the bullae, causing air to leak from the man's chest. To prevent the patient from going into respiratory distress, the surgery team gave him more anesthesia and changed the flow of air he was receiving to 100 percent oxygen.
As part of the procedure, the surgeons had an electrocautery in the operating theater. The device uses heat to be able to burn away or cut through human tissue. They also had a dry surgical pack placed right next to the patient's chest cavity. This is a bundle used by doctors to carry sterilized surgical instruments during an operation.
Disaster struck right after the doctors changed the patient's air. A spark from the electrocautery landed on the surgical pack, causing the oxygen-rich air around the man's chest cavity to burst into a flash fire.
Fortunately, the surgeons were able to put out the fire immediately before it could cause more injury to the patient or to the medical staff. They were also able to repair the man's damaged artery and wrap up the surgery without any more untoward incidents.
Other Cases Of Chest Cavity Fires During Surgery
Apparently, this was not the only case of a flash fire erupting during surgery.
Physicians also found six other similar incidents, all of which involved patients diagnosed with COPD or other lung disease, electrocautery devices, dry surgical packs, and high concentration of oxygen in the operating theater. No injuries were reported during these events.
The doctors at Austin Health believe theirs was the first case involving the particular kind of surgery that the patient had.
Flash fires during surgery are considered to be a very rare occurrence. However, surgeons hope that more people will become aware of such accidents, given the risk factors commonly found in each of the cases so far.
"This case highlights the continued need for fire training and prevention strategies and quick intervention to prevent injury whenever electrocautery is used in oxygen-enriched environments," said Ruth Shaylor, a doctor at Austin Health and one of the presenters at the Euroanaesthesia Congress.
"In particular, surgeons and anesthetists need to be aware that fires can occur in the chest cavity if a lung is damaged or there is an air leak for any reason, and that patients with COPD are at increased risk."