A doctor has spoken of a rare, yet terrifying incident at a Melboune hospital, warning it’s not the first time it’s happened and it’s something surgeons need to be aware of. Picture: News Corp
A doctor has spoken of a rare, yet terrifying incident at a Melboune hospital, warning it’s not the first time it’s happened and it’s something surgeons need to be aware of. Picture: News Corp

Fire ignites in Aussie man’s chest mid-heart surgery

A Melbourne hospital patient was told after he underwent emergency surgery that a fire ignited inside his chest as he was laying on the operating table.

A doctor who was at the scene revealed the incredibly rare, yet terrifying occurrence happened as the man underwent heart surgery at Austin Health in Victoria.

Dr Ruth Shaylor spoke about the case during the European Society of Anesthesiology conference in Vienna on the weekend with hopes to prevent future incidents.

The anaesthesiologist could not reveal the identity of the patient due to confidentiality, but confirmed the fire flared up inside the 60-year-old man's open chest cavity.

Dr Shaylor said it was triggered by a spark from a piece of medical equipment that ignited oxygen leaking from the man's lungs.

She told News Corp Australia: "I would like to clarify though that the patient was not on fire and there was no tissue damage. it was piece of surgical gauze in the surgical field."

Dr Shaylor, who worked at the Melbourne hospital for a year as an anaesthesia fellow, said the fire was immediately extinguished and the patient was not injured.

HOW IT HAPPENED

The patient required emergency surgery to repair a type A aortic dissection, typically caused by high blood pressure or trauma to the chest.

Before this surgery, the man had undergone recent treatment for chronic obstructive pulmonary disease and coronary artery bypass grafting at a different hospital.

Dr Shaylor said during the man's most recent surgery in August last year, he was placed under anaesthesia but due to his prior lung condition the procedure required extra care as COPD causes bullae (large air filled sacs) to form in the lungs.

 

 

In this case the man had a prior lung condition. Picture: iStock
In this case the man had a prior lung condition. Picture: iStock

 

"One of these had stuck to his sternum (the breast bone doctors needed to crack to access the heart)," Dr Shaylor told science website Inverse.

"Despite being very careful during the operation, these bullae are very fragile, and one of them burst," she said.

This led the medical team to respond swiftly and increase the flow of anaesthetic gas as well as the patient's supplemental oxygen saturation. Unfortunately pure oxygen is able to catch fire easily.

Combined with the doctors' use of dry surgical packs and an electrocautery pen to stop vessels from bleeding, there was enough oxygen, heat and fuel to create a small fire.

Dr Shaylor said the medical team responded quickly to douse the flames with saline solution and inspected the patient for tissue damage.

She confirmed there was no damage and the surgery was completed without further complications and the patient was successfully treated.

 

Dr Ruth Shaylor worked at Austin Health in Melbourne for a year. Picture: Supplied
Dr Ruth Shaylor worked at Austin Health in Melbourne for a year. Picture: Supplied

 

TOO MANY CHEST CAVITY FIRES

Dr Shaylor said she spoke about the incident because she felt there were "very important learning points from this case that would be useful to our colleagues."

"I really do want to emphasise that there was no harm or damage to the patient and we are presenting this in the hope of someone else avoiding a similar situation," she said.

"All anaesthetists are aware of the potential for fire when using laser or performing surgery in the upper airway. Fires in the lower airways are much rarer. We wanted to make our colleagues aware of this risk incase they are ever in a similar situation."

In a case study she presented to the Vienna conference, she noted there had been seven other reported instances of chest cavity fires since 2001.

"As in our case all involved the presence of dry surgical packs, electrocautery increased inspired oxygen concentrations and patients with underlying lung disease. None of the patients involved received any permanent damage," she reported in her case study.

Dr Shaylor stressed it was important for surgeons to be aware of these risks, especially when treating patients with pre-existing lung conditions.

"In future I would use the lowest safest oxygen concentration for the patient rather than premtively increasing the oxygen concentration," she said.

"Care should be taken by the anaesthetic team to use the minimum inspired oxygen concentration possible in these cases. It is the responsibility of the entire surgical team to be aware of this potential risk and ensure surgical packs are damp prior to placing them in the surgical field," she recommended.

News Corp Australia has contacted Austin Health for comment.



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