Question

A fire breaks out during laser vocal cord surgery on the larynx under general anaesthesia. What is NOT to be done in the management of the above situation?

• A. Pouring sterile water into the oral cavity
• B. Removing the endotracheal tube
• C. 100% oxygen after discontinuing anaesthetic gases
• D. Treatment with steroid and antibiotic

Hint:

Fire needs an oxidiser; which step would actually fuel the airway fire?

Answer 1

The Correct Option is C

Step 1: Recognise this as an airway fire emergency. The classic immediate steps are to stop the flow of fresh gases, disconnect the breathing circuit, remove the burning endotracheal tube, and pour saline or water into the airway/oral cavity to extinguish the fire.
Step 2: Option A (pouring sterile water/saline into the oral cavity) is a correct extinguishing manoeuvre, so it IS to be done.
Step 3: Option B (removing the endotracheal tube) is correct, because the tube itself is the fuel and must be taken out, then ventilation re-established with a fresh tube.
Step 4: Option D (steroids and antibiotics for the resulting airway burn/inflammation and to prevent infection) is appropriate later management, so it IS to be done.
Step 5: Option C is the wrong action. Oxygen is an oxidiser that feeds combustion; giving 100% oxygen would intensify the fire. During an airway fire the FiO2 must be reduced, not raised. Hence giving 100% oxygen is exactly what should NOT be done.
Conclusion: The action NOT to be done is administering 100% oxygen (option 3), matching the printed key.